State Agency Schedule for Equipment Purchases for SSA Disability Programs

ICR 200003-0960-002

OMB: 0960-0406

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
0960-0406 200003-0960-002
Historical Active 199702-0960-005
SSA
State Agency Schedule for Equipment Purchases for SSA Disability Programs
Extension without change of a currently approved collection   No
Regular
Approved without change 04/12/2000
Retrieve Notice of Action (NOA) 03/08/2000
  Inventory as of this Action Requested Previously Approved
04/30/2003 04/30/2003 04/30/2000
216 0 54
216 0 54
0 0 0

SSA uses the information collected on Form SSA-871 to budget and account for expenditures of funds for equipment purchases by the State Disability Determination Services (DDS) that administer the disability determination program. The respondents are State governments that make disability determinations.

None
None


No

1
IC Title Form No. Form Name
State Agency Schedule for Equipment Purchases for SSA Disability Programs SSA-871

  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 216 54 0 0 162 0
Annual Time Burden (Hours) 216 54 0 0 162 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.
03/08/2000


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