DISABILITY REPORT

ICR 199110-0960-003

OMB: 0960-0141

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
114864 Migrated
ICR Details
0960-0141 199110-0960-003
Historical Active 199106-0960-004
SSA
DISABILITY REPORT
Revision of a currently approved collection   No
Regular
Approved without change 12/03/1991
Retrieve Notice of Action (NOA) 10/22/1991
This information collection is approved through 12-92 under the following condition: SSA will reevaluate the burden estimate. OMB has received a number of complaints that the SSA estimate of 30 minutes dramatically underestimates the time it takes applicants to complete the form. In addition, OMB notes that SSA's did not adequately describe changes in the burden under item 14 of the "Justification". Future submissions must thoroughly describe changes in burden due to form changes, and may not be included in an addendum. Any future packages that fail to substantiate burden changes in the overall submission will be returned.
  Inventory as of this Action Requested Previously Approved
12/31/1992 12/31/1992 11/30/1993
2,200,000 0 2,200,000
1,055,000 0 1,100,000
0 0 0

THE INFORMATION COLLECTED BY THE USE OF FORM SSA-3368 IS NEEDED TO MAKE A DETEMINATION FOR A DISABILITY CLAIM. FORM SSA-3369 SUPPLEMENTS THE SSA-3368 REGARDING ADDITIONAL INFORMATION ABOUT PAST WORK EXPERIENCE. WITHOUT THIS INFORMATION COLLECTION THE SOCIAL SECURITY ADMINISTRATION WOULD BE UNABLE TO AWARD DISABILITY BENEFITS TO CERTAIN

None
None


No

1
IC Title Form No. Form Name
DISABILITY REPORT SSA-3368-F6

  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 2,200,000 2,200,000 0 0 0 0
Annual Time Burden (Hours) 1,055,000 1,100,000 0 -45,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
10/22/1991


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