Disability Hearing Officer's Report on Disability Hearing

ICR 199806-0960-014

OMB: 0960-0440

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0440 199806-0960-014
Historical Active 199505-0960-002
SSA
Disability Hearing Officer's Report on Disability Hearing
Extension without change of a currently approved collection   No
Regular
Approved without change 08/12/1998
Retrieve Notice of Action (NOA) 06/22/1998
  Inventory as of this Action Requested Previously Approved
10/31/2001 10/31/2001 08/31/1998
100,000 0 10,860
100,000 0 10,860
0 0 0

The information on form SSA-1205-BK is used by Disability Hearing Officers (DHO) to conduct and record disability hearings. The form serves as a guide in conducting the hearings and ensures that all pertinent issues are considered. The respondents are DHOs in the State Disability Determination Services.

None
None


No

1
IC Title Form No. Form Name
Disability Hearing Officer's Report on Disability Hearing SSA-1205-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 100,000 10,860 0 89,140 0 0
Annual Time Burden (Hours) 100,000 10,860 0 89,140 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.
06/22/1998


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