Information Collection

Disability Hearing Officer's Report of Disability Hearing (DC)

IC 9409 under ICR 200712-0960-005 · OMB 0960-0507.

Documents and Forms

Document Name Document Type
Form SSA-1204-BK Disability Hearing Officer's Report of Disability Hearing (DC) Form and Instruction
SSA-1204-BK Disability Hearing Officer's Report of Disability Hearin 0960-0507 (SSA-1204).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disability Hearing Officer's Report of Disability Hearing (DC)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 416.1407

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-1204-BK	Disability Hearing Officer's Report of Disability Hearing	0960-0507 (SSA-1204).pdf		No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,000	-33,000	35,000
Annual IC Time Burden (Hours)	2,000	-33,000	35,000
Annual IC Cost Burden (Dollars)	0	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.