Report on Individual with Childhood Impairment

ICR 199606-0960-008

OMB: 0960-0084

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
9026 Migrated
ICR Details
0960-0084 199606-0960-008
Historical Active 199306-0960-001
SSA
Report on Individual with Childhood Impairment
Extension without change of a currently approved collection   No
Regular
Approved without change 08/08/1996
Retrieve Notice of Action (NOA) 06/17/1996
  Inventory as of this Action Requested Previously Approved
09/30/1999 09/30/1999 08/31/1996
7,000 0 7,000
2,333 0 2,333
0 0 0

The information collected by SSA is used to determine the dates and results of psychometric testing and how the impairment affects the individual's progress in school. The respondents are public and private school officials and agencies which provide medical treatment to the applicant or claimant for benefits.

None
None


No

1
IC Title Form No. Form Name
Report on Individual with Childhood Impairment SSA-1323

  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 7,000 7,000 0 0 0 0
Annual Time Burden (Hours) 2,333 2,333 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.
06/17/1996


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