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Customer Experience Survey for Feedback on Claimants Who have Refiled Claims since Updated Application Forms

IC 267722 under ICR 202503-1225-001 · OMB 1225-0093.

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Instruction
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Customer Experience Survey for Feedback on Claimants Who have Refiled Claims since Updated Application Forms
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form N/A CX Survey - Claimants Refiled After Form Updates CX Survey-Claimants Refiled After Form Updates 5-16-2024.docx No   Paper Only
Instruction Black Lung Survey- Pending Claim - Instructions Final.docx No   Paper Only

Income Security General Retirement and Disability

 

500 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 500 0 0 0 0 500
Annual IC Time Burden (Hours) 42 0 0 0 0 42
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement DCMWC - ICR _A11 Section 280 Clearance -Survey to refiled Claimants since form updates_MN clean.docx 05/16/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.