Information Collection Request

Medical Certification for Disability Exceptions

ICR 201208-1615-001 · OMB 1615-0060 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form N-648 Medical Certification for Disability Exceptions Form Modified Available
N-648 Supp Statement 8-8-12.doc Supporting Statement A Uploaded 2012-09-26 Available
Reference citation 8-8-12.doc Supplementary Document Uploaded 2012-08-08 Available
SORN.htm Supplementary Document Uploaded 2012-08-08 Repair queued
PIA.pdf Supplementary Document Uploaded 2012-08-08 Available
N-648 published 30-day notice 8-8-12.pdf Supplementary Document Uploaded 2012-08-08 Repair queued
N-648 published 60-day notice 5-10-12.pdf Supplementary Document Uploaded 2012-08-08 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
20362 Medical Certification for Disability Exceptions Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2014 36 Months From Approved 12/31/2012
13,801 0 20,000
27,602 0 40,000
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Medical Certification for Disability Exceptions N-648 Medical Certification for Disability Exceptions

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 13,801 20,000 0 0 -6,199 0
Annual Time Burden (Hours) 27,602 40,000 0 0 -12,398 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No