SSA CONTRACTOR REPORT FORMS

ICR 198503-0960-003

OMB: 0960-0393

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
115446 Migrated
ICR Details
0960-0393 198503-0960-003
Historical Active
SSA
SSA CONTRACTOR REPORT FORMS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 04/05/1985
Retrieve Notice of Action (NOA) 03/07/1985
  Inventory as of this Action Requested Previously Approved
12/31/1985 12/31/1985
648 0 0
504 0 0
0 0 0

THE INFORMATION COLLECTED BY USE OF THE FORMS SSA-870, SSA-871, SSA-4513, SSA-4514, SSA-4515 AND SSA-4516 IS NEEDED AND USED TO MAKE BUDGETARY DECISIONS ON FEDERAL REIMBURSEMENT OF STATE DISABILITY DETERMINATION STAFFS (DDS) FOR EQUIPMENT, EXPENDITURES AND PERSONNEL COSTS. THE AFFECTED PUBLIC IS COMPRISED OF STATE DDS'.

None
None


No

1
IC Title Form No. Form Name
SSA CONTRACTOR REPORT FORMS SSA-870, 871, 4513, 4514, 4515 & 4516

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 648 0 0 0 648 0
Annual Time Burden (Hours) 504 0 0 0 504 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/07/1985


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