Application for Disability Insurance Benefits - 20 CFR, Subpart P, 404.1501-.1512 and Subpart D, 404.315-.322

ICR 200211-0960-001

OMB: 0960-0060

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0960-0060 200211-0960-001
Historical Active 200005-0960-006
SSA
Application for Disability Insurance Benefits - 20 CFR, Subpart P, 404.1501-.1512 and Subpart D, 404.315-.322
Revision of a currently approved collection   No
Regular
Approved without change 01/08/2003
Retrieve Notice of Action (NOA) 11/13/2002
  Inventory as of this Action Requested Previously Approved
01/31/2006 01/31/2006 06/30/2003
1,513,677 0 1,185,942
504,559 0 395,314
0 0 0

The information collected on Form SSA-16 helps to determine eligibility for social security disability benefits. The respondents are applicants for Social Security disability benefits.

None
None


No

1
IC Title Form No. Form Name
Application for Disability Insurance Benefits - 20 CFR, Subpart P, 404.1501-.1512 and Subpart D, 404.315-.322 SSA-16-F6

  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 1,513,677 1,185,942 0 0 327,735 0
Annual Time Burden (Hours) 504,559 395,314 0 0 109,245 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.
11/13/2002


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