Information Collection

SSA-454-BK, Continuing Disability Review Report - Full Paper Version

IC 9017 under ICR 201911-0960-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form SSA-454-BK SSA-454-BK, Continuing Disability Review Report - Full Paper Version Form
SSA-454-BK Continuing Disability Review Report SSA-454.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SSA-454-BK, Continuing Disability Review Report - Full Paper Version	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.989 20 CFR 404.1589

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-454-BK	Continuing Disability Review Report	SSA-454.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: 406,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	406,500	136,000	270,500
Annual IC Time Burden (Hours)	406,500	136,000	270,500
Annual IC Cost Burden (Dollars)	0	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.