QUESTIONNAIRE TO DETERMINE THE STATUS OF AUTOMATION IN THE STATE DDSS

ICR 199303-0960-001

OMB: 0960-0514

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0514 199303-0960-001
Historical Active
SSA
QUESTIONNAIRE TO DETERMINE THE STATUS OF AUTOMATION IN THE STATE DDSS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 04/05/1993
Retrieve Notice of Action (NOA) 03/17/1993
This information collection is approved through 3-94 under the following condition: As agreed to by the Agency, this will be a one-time only survey.
  Inventory as of this Action Requested Previously Approved
03/31/1994 03/31/1994
54 0 0
270 0 0
0 0 0

THE INFORMATION OBTAINED BY THIS QUESTIONNAIRE WILL BE USED TO DETERMI THE STATUS OF AUTOMATION IN THE 54 STATE AGENCIES WHICH MAKE DISABILIT DETERMINATIONS FOR THE SOCIAL SECURITY ADMINISTRATION. THE RESPONDENT WILL BE THESE AGENCIES.

None
None


No

1
IC Title Form No. Form Name
QUESTIONNAIRE TO DETERMINE THE STATUS OF AUTOMATION IN THE STATE DDSS SSA-54-BK

  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 54 0 0 54 0 0
Annual Time Burden (Hours) 270 0 0 270 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
03/17/1993


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