Request for Accommodation in Communication Method

Request for Accommodation in Communication Method

OMB: 0960-0777

IC ID: 192018

Information Collection (IC) Details

View Information Collection (IC)

Request for Accommodation in Communication Method
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 85.51

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Intranet (internal SSA) screens SSA-9000 - Screen Shots - Revised Version.pdf Yes Yes Fillable Fileable Signable
Form SSA-9000-F6 Request for Accommodation SSA-9000-F6 - Revised Version.pdf No   Paper Only
Other-Intranet Screens iAccommodate Intranet Screens - Revised Version.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

5,000 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 5,000 0 3,583 0 0 1,417
Annual IC Time Burden (Hours) 1,667 0 1,195 0 0 472
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-9000 Intranet Screen Shots SSA-9000 - Screen Shots - Current Version.pdf 10/31/2016
Current Paper SSA-9000-F6 SSA-9000-F6 - Current Version.pdf 10/31/2016
Current iAccommodate Screens iAccommodate Intranet Screens - Current Version.pdf 10/31/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy