OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Disability Report--Appeal (Internet Version)

IC 180152 under ICR 200803-0960-003 · OMB 0960-0144.

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Disability Report--Appeal (Internet Version)
 
No Unchanged
 
Voluntary
 
20 CFR 422.140 20 CFR 416.912 20 CFR 416.1416(c) 20 CFR 405 20 CFR 404.1512 20 CFR 404.916(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction i3441 Disability Report--Appeal i3441.pdf Yes Yes Fillable Fileable Signable
Form and Instruction i3441 (iAppeals) Disability Report--Appeal (i3441--Revisions to the Screening Questions for Use with the New iAppeals Program) i3441 (iAppeals Revisions).pdf Yes Yes Fillable Fileable Signable
Instruction New Welcome Screens for iAppeals (About Your Appeal).pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

158,607 0
   
Individuals or Households
 
   100 %

  Approved 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 158,607 0 0 0 0 158,607
Annual IC Time Burden (Hours) 79,304 0 0 0 0 79,304
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
New First Paragraph of Welcome Screen iAppeals proposed language for first paragraph - final 10-26[2].doc 10/26/2007
iAppeals Welcome page first paragraph - 11-9-2007 iAppeals Welcome page first paragraph - 11-9-2007 (3).doc 12/04/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.