Form SSA-3033 is used to determine if
the claimant meets the disability requirements of the law, when the
claimant returns to work after the alleged or established onset
date of disability. When a possible unsuccessful work attempt or
nonspecific subsidy is involved, Form SSA-3033 will be used to
request a description of the employee's work effort. The
respondents are employers of Old-Age and Survivors Disability
Insurance (OASDI) and SSI disability applicants and
beneficiaries.
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.