Information Collection

Black Lung Student's Statement Regarding Resumption Of School Attendance, Ssa-2602, Report Of Black Lung Student Beneficiary At End Of School Year, Ssa-2613

IC 115288 under ICR 199309-0960-001 · OMB 0960-0314.

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Information Collection (IC) Details

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IC Title:	BLACK LUNG STUDENT'S STATEMENT REGARDING RESUMPTION OF SCHOOL ATTENDANCE, SSA-2602, REPORT OF BLACK LUNG STUDENT BENEFICIARY AT END OF SCHOOL YEAR, SSA-2613	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-2602				No	No
Form	SSA-2613				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	8,000	0	8,000
Annual IC Time Burden (Hours)	1,667	1,001	666
Annual IC Cost Burden (Dollars)	0	0	0

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