Work Activity Report, Employee

ICR 199709-0960-006

OMB: 0960-0059

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
8977 Migrated
ICR Details
0960-0059 199709-0960-006
Historical Active 199402-0960-003
SSA
Work Activity Report, Employee
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 11/04/1997
Retrieve Notice of Action (NOA) 09/17/1997
  Inventory as of this Action Requested Previously Approved
11/30/2000 11/30/2000
300,000 0 0
225,000 0 0
0 0 0

The form SSA-821-BK is used by the Social Security Administration to obtain information on work activity. The information is needed to determine if disabled individuals are performing substantial gainful activity and, if so, whether they continue to meet the disability criteria of the law. The respondents are social security and SSI disability applicants and recipients.

None
None


No

1
IC Title Form No. Form Name
Work Activity Report, Employee SSA-821-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 300,000 0 0 300,000 0 0
Annual Time Burden (Hours) 225,000 0 0 225,000 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.
09/17/1997


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