Information Collection

Adult Disability Survey

IC 259923 under ICR 202111-0960-011 · OMB 0960-0526.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0526 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Adult Disability Survey.docx	Other-Adult Disability Survey
Description of Adult Disability Survey - 0526.docx Description of Adult Disability Survey	IC Document

IC Title:

Adult Disability Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Other-Adult Disability Survey					Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,452

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,452	6,452
Annual IC Time Burden (Hours)	1,613	1,613
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Description of Adult Disability Survey		05/09/2023

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].