Information Collection

Request for Accommodation in Communication Method

IC 192018 under ICR 202001-0960-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
SSA-9000 - iSNO Screen Shots.pdf	Other-Intranet (internal SSA) screen
iAccomodate screens.pdf	Other-Intranet Screens
mySSA mySNO Screens.pdf	Other-Intranet Screens
SSA-9000-F6 Request for Accommodation SSA-9000-F6.pdf	Form

IC Title:

Request for Accommodation in Communication Method

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Intranet (internal SSA) screens			SSA-9000 - iSNO Screen Shots.pdf	Yes	Yes	Fillable Fileable Signable
Form	SSA-9000-F6	Request for Accommodation	SSA-9000-F6.pdf	No		Paper Only
Other-Intranet Screens			iAccomodate screens.pdf	Yes	Yes	Fillable Fileable Signable
Other-Intranet Screens			mySSA mySNO Screens.pdf	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: 5,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	1,667	1,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.