Disability Hearing Officer's Decision

ICR 200105-0960-011

OMB: 0960-0441

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
9305 Migrated
ICR Details
0960-0441 200105-0960-011
Historical Active 199806-0960-006
SSA
Disability Hearing Officer's Decision
Extension without change of a currently approved collection   No
Regular
Approved without change 08/03/2001
Retrieve Notice of Action (NOA) 05/29/2001
  Inventory as of this Action Requested Previously Approved
08/31/2004 08/31/2004 08/31/2001
100,000 0 100,000
75,000 0 75,000
0 0 0

The information collected on form SSA-1207 is used by State Disability Hearing Officers (DHO) to formalize disability decisions. The form will aid the DHO in addressing the crucial elements of the case in a sequential and logical fashion. The form is used as the official determination of the DHO's decision and the personalized portion of the notice to the claimant. The respondents are State DHOs.

None
None


No

1
IC Title Form No. Form Name
Disability Hearing Officer's Decision SSA-1207, SSA-1207-SUP1, SUP3, SUP4, SUP5

  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) 75,000 75,000 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.
05/29/2001


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