Information Collection

Listing of Impairments

IC 9674 under ICR 200708-0960-013 · OMB 0960-0642.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Medical Listings 404-ap10.pdf www.socialsecurity.gov/OP_Home/cfr20/404/404-ap10.htm	Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.1512-404.1515 20 CFR 416.912-416.915

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Medical Listings 404-ap10.pdf	http://www.socialsecurity.gov/OP_Home/cfr20/404/404-ap10.htm	Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

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	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.