Information Collection

Disability Hearing Officer's Decision 20 CFR Sections 404.917 and 416.1417

IC 9307 under ICR 200612-0960-013 · OMB 0960-0441.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1207 Disability Hearing Officer's Decision Disability Hearing Officer's Decision 20 CFR Sections 404.917 and 416.1417	Form
Form SSA-1207-SUP1 Disability Hearing Officer's Decision (Supplement 1) Disability Hearing Officer's Decision 20 CFR Sections 404.917 and 416.1417	Form
Form SSA-1207-SUP3 Disability Hearing Officer's Decision (Supplement 3) Disability Hearing Officer's Decision 20 CFR Sections 404.917 and 416.1417	Form
SSA-1207 Disability Hearing Officer's Decision ssa1207.pdf	Form
SSA-1207-SUP1 Disability Hearing Officer's Decision (Supplement 1) ssa1207s.pdf	Form
SSA-1207-SUP3 Disability Hearing Officer's Decision (Supplement 3) ssa1207s sup 3.pdf	Form
PRA statement OHA Forms.doc PRA Statements	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 416.1417 20 CFR 404.917

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Electronic Capability
Form	SSA-1207	No	Paper Only
Form	SSA-1207-SUP1	No	Paper Only
Form	SSA-1207-SUP3	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 65,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	65,000	65,000
Annual IC Time Burden (Hours)	48,750	48,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PRA Statements		03/01/2007

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

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