Subpoena-Disability Hearing

ICR 200405-0960-009

OMB: 0960-0428

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
9280 Migrated
ICR Details
0960-0428 200405-0960-009
Historical Active 200105-0960-013
SSA
Subpoena-Disability Hearing
Extension without change of a currently approved collection   No
Regular
Approved without change 06/30/2004
Retrieve Notice of Action (NOA) 05/21/2004
  Inventory as of this Action Requested Previously Approved
06/30/2007 06/30/2007 07/31/2004
36 0 36
18 0 18
0 0 0

The information on form SSA-1272-U4 is used by the Social Security Administration to subpoena evidence or testimony needed at disability hearings. The respondents are comprised of officers from Federal and State Disability Determination Services.

None
None


No

1
IC Title Form No. Form Name
Subpoena-Disability Hearing SSA-1272-U4

  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 36 36 0 0 0 0
Annual Time Burden (Hours) 18 18 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.
05/21/2004


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