Disability Report - Adult, 20 CFR 404.1512 and 416.912

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0579 can be found here:

Documents and Forms

Document Name Document Type
i3368 Proposed Review & Send 08-21-06.doc s044a90.ssa.gov/apps6z/i3369/ee001-fe.jsp Other-Internet Collection Screen
i3368 current Review & Send Screen.doc s044a90.ssa.gov/apps6z/i3369/ee001-fe.jsp Other-Internat Collection Screen

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disability Report - Adult, 20 CFR 404.1512 and 416.912	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Collection Screen			i3368 Proposed Review & Send 08-21-06.doc	https://s044a90.ssa.gov/apps6z/i3369/ee001-fe.jsp	Yes	Yes	Fillable Fileable
Other-Internat Collection Screen			i3368 current Review & Send Screen.doc	https://s044a90.ssa.gov/apps6z/i3369/ee001-fe.jsp	Yes	Yes	Fillable Fileable

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,116,667	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 7 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,116,667	2,116,667
Annual IC Time Burden (Hours)	2,257,667	2,257,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.