Information Collection

Disability Determination Ready Claim (DDRC) Certification Statement (for DDRC Pilot)

IC 272179 under ICR 202502-0960-015 · OMB 0960-0618.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Mock-Up Certification Statement Form - FINAL.pdf www.ssa.gov	Other-Certification Statement
Mock-Up Certification Statement Form - FINAL.pdf www.ssa.gov	Other-Certification Statement

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.310-404.311 20 CFR 404.315-404.322 20 CFR 404.330-404.333 20 CFR 404.601-404.603 20 CFR 404.1501-404.1512

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-Certification Statement				www.ssa.gov	No		Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,008,976

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	Previously Approved
Annual Number of Responses for this IC	2,008,976	2,008,976
Annual IC Time Burden (Hours)	33,483	33,483
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.

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