Information Collection

Disability Service Improvement (DSI) Report Card

IC 45265 under ICR 200609-0960-019 · OMB 0960-0526.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0526 can be found here:

Documents and Forms

Document Name Document Type
DSI Report Card Survey Cover Letter.doc Other-DSI Cover Letter to Accompany
DSI Report Card Survey Questionnaires.doc has not yet been created Other-DSI Surveys
DSI Report Card Survey Followup letter.doc Other-DSI Follow-Up Letter
DSI Report Card Survey Description.doc DSI Report Card Survey Description IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disability Service Improvement (DSI) Report Card	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-DSI Cover Letter to Accompany	DSI Report Card Survey Cover Letter.doc		No		Paper Only
Other-DSI Surveys	DSI Report Card Survey Questionnaires.doc	has not yet been created	Yes	Yes	Fillable Fileable Signable
Other-DSI Follow-Up Letter	DSI Report Card Survey Followup letter.doc		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 78,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	78,000	0	0	0	0	0
Annual IC Time Burden (Hours)	6,500	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
DSI Report Card Survey Description	DSI Report Card Survey Description.doc	09/18/2006

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