Information Collection

SSA-454-ICR - Paper Short Version with follow up EDCS Interview

IC 189922 under ICR 201308-0960-008 · OMB 0960-0072.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0072 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-454-ICR SSA-454-ICR - Paper Short Version with follow up EDCS Interview	Form
SSA-454-ICR Cover Letter (Mock Up).pdf	Instruction
SSA-454-ICR Continuing Disability Review Report SSA-454-ICR - Revised Version.pdf	Form
SSA-454-ICR - Current Version.pdf Current Pilot Version of the SSA-454-ICR	IC Document

IC Title:

SSA-454-ICR - Paper Short Version with follow up EDCS Interview

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.1589 20 CFR 416.989

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
Form	SSA-454-ICR	Continuing Disability Review Report	SSA-454-ICR - Revised Version.pdf		No		Paper Only
Instruction			SSA-454-ICR Cover Letter (Mock Up).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 541,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-541,000	541,000
Annual IC Time Burden (Hours)	-495,917	495,917
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current Pilot Version of the SSA-454-ICR	SSA-454-ICR - Current Version.pdf	01/05/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.