Report on Individual with Mental Impairment - 20 CFR, Subparts O & I

ICR 200210-0960-005

OMB: 0960-0058

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
0960-0058 200210-0960-005
Historical Active 199908-0960-006
SSA
Report on Individual with Mental Impairment - 20 CFR, Subparts O & I
Extension without change of a currently approved collection   No
Regular
Approved with change 12/20/2002
Retrieve Notice of Action (NOA) 10/21/2002
Approved for use through 12/2005 under the condition that SSA amends the PRA disclosure statement to include a solicitation for public comment.
  Inventory as of this Action Requested Previously Approved
01/31/2006 01/31/2006 12/31/2002
50,000 0 50,000
30,000 0 30,000
0 0 0

Form SSA-824 is usedx by the Social Security Administraion to determine the claimant's medical status prior to making a disability determination. The respondents are physicians, medical directors, medical records librarians and other health professionals.

None
None


No

1
IC Title Form No. Form Name
Report on Individual with Mental Impairment - 20 CFR, Subparts O & I SSA-824

  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 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 30,000 30,000 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.
10/21/2002


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