Approved for use
through 1/2006 under the condition that SSA incorporates a public
solicitation into its disclosure statement mandated by the
PRA.
Inventory as of this Action
Requested
Previously Approved
02/28/2006
02/28/2006
01/31/2003
59,100
0
59,100
9,850
0
9,850
0
0
0
The information collected on these
forms assist field offices/disability determination services to
make findings of presumptive disabiity that confirm the claimants'
disease manifestations meet the severity of listing-level criteria
for HIV infection. The respondents are medical sources of claimants
for title XVI disability payments based on HIV infection.
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.