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Information Collection

Quality Review Questionnaire--disability Quality Review Questionnaire--insured Individual

IC 115105 under ICR 198106-0960-001 · OMB 0960-0244.

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Information Collection (IC) Details

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QUALITY REVIEW QUESTIONNAIRE--DISABILITY QUALITY REVIEW QUESTIONNAIRE--INSURED INDIVIDUAL
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-4678 No No
Form SSA-2930 No No


    

6,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,000 0 6,000 0 0 0
Annual IC Time Burden (Hours) 2,000 0 2,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.