Information Collection

Request for Accommodation in Communication Method (Intranet screens/field office interview)

IC 192018 under ICR 201012-0960-003 · OMB 0960-0777.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0777 can be found here:

Documents and Forms

Document Name Document Type
iSNO_Screens.doc Other-Intranet (internal SSA) screen

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Accommodation in Communication Method (Intranet screens/field office interview)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 85.51

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Intranet (internal SSA) screens			iSNO_Screens.doc		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,250	2,250
Annual IC Time Burden (Hours)	375	375
Annual IC Cost Burden (Dollars)	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.