Disability Hearing Officer's Decision - Title XVI Disabled Child Continuing Disability Review

ICR 200208-0960-006

OMB: 0960-0657

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0960-0657 200208-0960-006
Historical Active
SSA
Disability Hearing Officer's Decision - Title XVI Disabled Child Continuing Disability Review
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/29/2002
Retrieve Notice of Action (NOA) 08/30/2002
Approved for use through 10/2003 under the conditions that SSA: 1) immediately incorporates the solicitation for public comment in its disclosure statement as mandated by the PRA; and 2) no later than 11/2002 submits to OMB any necessary correction worksheets to adjust burdens for the SSA-1207.
  Inventory as of this Action Requested Previously Approved
10/31/2003 10/31/2003
35,000 0 0
43,750 0 0
0 0 0

The information collected on form SSA-1209 will be 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.

None
None


No

1
IC Title Form No. Form Name
Disability Hearing Officer's Decision - Title XVI Disabled Child Continuing Disability Review SSA-1209

  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 35,000 0 0 35,000 0 0
Annual Time Burden (Hours) 43,750 0 0 43,750 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
08/30/2002


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