Report of New Information in Disability Cases, 20 CFR 404.460, 404.468, 404.408, and 404.1588

ICR 200601-0960-002

OMB: 0960-0071

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0960-0071 200601-0960-002
Historical Active 200303-0960-004
SSA
Report of New Information in Disability Cases, 20 CFR 404.460, 404.468, 404.408, and 404.1588
Extension without change of a currently approved collection   No
Regular
Approved without change 03/13/2006
Retrieve Notice of Action (NOA) 01/17/2006
  Inventory as of this Action Requested Previously Approved
03/31/2009 03/31/2009 04/30/2006
27,000 0 27,000
2,250 0 2,250
0 0 0

The information collected on the form SSA-612 is used to update the disability records of a respondent based on reported changes contained in the form. These changes may affect the respondent's Title II disability benefits. The respondents are applicants for Title II disability benefits.

None
None


No

1
IC Title Form No. Form Name
Report of New Information in Disability Cases, 20 CFR 404.460, 404.468, 404.408, and 404.1588 SSA-612

  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 27,000 27,000 0 0 0 0
Annual Time Burden (Hours) 2,250 2,250 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.
01/17/2006


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