20 CFR Parts 404 Subpart P & 416 Subpart 1 404.1512, 404.1545, 404.1560, 416.912, 416.945 & 416.960

ICR 200309-0960-005

OMB: 0960-0654

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0960-0654 200309-0960-005
Historical Active 200207-0960-001
SSA
20 CFR Parts 404 Subpart P & 416 Subpart 1 404.1512, 404.1545, 404.1560, 416.912, 416.945 & 416.960
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/09/2003
Retrieve Notice of Action (NOA) 09/08/2003
  Inventory as of this Action Requested Previously Approved
10/31/2006 10/31/2006
1 0 0
1 0 0
0 0 0

The medical and vocational evidence described in these sections is used by State Disability Determination Services to assess the alleged disability using the sequential evaluation process. The information, together with other evidence, is used to determine if an individual has an impairment-related limitation(s) or restriction(s) that is severe, meets or equals a listed impairment, prevents past relevant work, or prevents other work. The respondents are applicants for Title-II and Title-XVI Disability Benefits and Medical Providers.

None
None


No

1
IC Title Form No. Form Name
20 CFR Parts 404 Subpart P & 416 Subpart 1 404.1512, 404.1545, 404.1560, 416.912, 416.945 & 416.960

  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 0 0 1 0 0
Annual Time Burden (Hours) 1 0 0 1 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.
09/08/2003


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