MEDICAL REPORT (INDIVIDUAL WITH CHILDHOOD IMPAIRMENT)

ICR 198808-0960-002

OMB: 0960-0102

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
114668 Migrated
ICR Details
0960-0102 198808-0960-002
Historical Active 198509-0960-001
SSA
MEDICAL REPORT (INDIVIDUAL WITH CHILDHOOD IMPAIRMENT)
Revision of a currently approved collection   No
Regular
Approved without change 10/07/1988
Retrieve Notice of Action (NOA) 08/10/1988
  Inventory as of this Action Requested Previously Approved
10/31/1991 10/31/1991 10/31/1988
75,000 0 75,000
37,500 0 37,500
0 0 0

THE INFORMATION COLLECTED BY USE OF FORM SSA-3827 IS USED TO DETERMINE IF AN INDIVIDUAL WITH A CHILDHOOD IMPAIRMENT IS ENTITLED TO DISABILITY BENEFITS. THE AFFECTED PUBLIC IS COMPRISED OF ATTENDING PHYSICIANS.

None
None


No

1
IC Title Form No. Form Name
MEDICAL REPORT (INDIVIDUAL WITH CHILDHOOD IMPAIRMENT) SSA-3827

  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 75,000 75,000 0 0 0 0
Annual Time Burden (Hours) 37,500 37,500 0 0 0 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.
08/10/1988


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