Information Collection

Medical Certification for Disability Exceptions

IC 12151 under ICR 199901-1115-002 · OMB 1115-0205.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Medical Certification for Disability Exceptions	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	N-648				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,000	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	20,000	-280,000	300,000
Annual IC Time Burden (Hours)	40,000	-860,000	900,000
Annual IC Cost Burden (Dollars)	1,600,000	-31,400,000	33,000,000

Documents for IC

Title	Document	Date Uploaded

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