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Black Lung Student's Statement Regarding Resumption of School Attendance; Report of Black Lung Student Beneficiary at End of School Year
Black Lung Student's Statement Regarding Resumption of School Attendance; Report of Black Lung Student Beneficiary at End of School Year
OMB: 0960-0314
IC ID: 9210
OMB.report
SSA
OMB 0960-0314
ICR 199910-0960-006
IC 9210
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Black Lung Student's Statement Regarding Resumption of School Attendance; Report of Black Lung Student Beneficiary at End of School Year
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-2613
No
No
Form
SSA-2602
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
150
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
150
0
-15,850
0
0
16,000
Annual IC Time Burden (Hours)
16
0
-1,651
0
0
1,667
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.