Information Collection

Request for Accommodation in Communication Method - SSA-9000 & iAccommodate Intranet Screens (Telephone Interview)

IC 192018 under ICR 202603-0960-011 · OMB 0960-0777.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-9000-F6 Request for Accommodation in Communication Method Request for Accommodation in Communication Method - SSA-9000 & iAccommodate Intranet Screens (Telephone Interview)	Form and Instruction
iAccommodate - Intranet Screenshots.pdf	Other-Intranet Screens
SSA-9000-F6 Request for Accommodation in Communication Method SSA-9000-F6.pdf www.ssa.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 45 CFR 85.51

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-Intranet Screens					Yes	Yes	Fillable Fileable Signable
Form and Instruction	SSA-9000-F6			www.ssa.gov	No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 128

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	128	-4,872	5,000
Annual IC Time Burden (Hours)	96	-3,154	3,250
Annual IC Cost Burden (Dollars)	0	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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