Information Collection Request
Statement From Excluded Medical Sources of Evidence
ICR 202301-0960-002 · OMB 0960-0803 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0960-0803 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Supporting Statement - 0803 (Final).docx |
Supporting Statement A | Uploaded 2023-06-06 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 222015 |  20 CFR 404.1503b(c) & 416.903b(c) |
Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | SSA |
| OMB Control No | 0960-0803 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 201904-0960-013 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |