Disability Hearing Officer's Report of Disability Hearing

ICR 200108-0960-007

OMB: 0960-0440

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
0960-0440 200108-0960-007
Historical Active 199806-0960-014
SSA
Disability Hearing Officer's Report of Disability Hearing
Extension without change of a currently approved collection   No
Regular
Approved without change 10/09/2001
Retrieve Notice of Action (NOA) 08/14/2001
  Inventory as of this Action Requested Previously Approved
10/31/2004 10/31/2004 10/31/2001
100,000 0 100,000
100,000 0 100,000
0 0 0

The information on Form SSA-1205-BK is used by the Disability Hearing Officers (DHOs) at the Social Security Administration (SSA) as a guide to conducting and recording disability hearings. It ensures that all of the pertinent issues are considered. The respondents are DHOs in the State Disability Determination Services and Federal DHOs.

None
None


No

1
IC Title Form No. Form Name
Disability Hearing Officer's Report of Disability Hearing SSA-1205-BK

  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) 100,000 100,000 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.
08/14/2001


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