Application of Circuit Court Law

ICR 200010-0960-002

OMB: 0960-0581

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
9551 Migrated
ICR Details
0960-0581 200010-0960-002
Historical Active 199709-0960-005
SSA
Application of Circuit Court Law
Extension without change of a currently approved collection   No
Regular
Approved without change 12/06/2000
Retrieve Notice of Action (NOA) 10/23/2000
  Inventory as of this Action Requested Previously Approved
01/31/2004 01/31/2004 12/31/2000
100,000 0 100,000
28,333 0 28,333
0 0 0

SSA will use the information provided in the statement to readjudicate the claim, if the claimant demonstrates the Ruling could change the prior determination. Claimants may use Form SSA-795, Statement of Claimant or Other Person (OMB No. 0960- 0045), to request and support application of a published Acquiescence Ruling (AR) to the prior determination or decision. The respondents are claimants whose determinations or decisions on their claims may be affected by an AR.

None
None


No

1
IC Title Form No. Form Name
Application of Circuit Court Law 20CFR404.985(B), 20CFR416.1485B

  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 100,000 100,000 0 0 0 0
Annual Time Burden (Hours) 28,333 28,333 0 0 0 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.
10/23/2000


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