OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Category I, CE a) Medical Evidence from CE Providers (Electronic Transmission through ERE; subset of "CE Forms Samples" category)

IC 179017 under ICR 202604-0960-004 · OMB 0960-0555.

Documents and Forms
Document Name
Document Type
Other-Sample of types of information
Information Collection (IC) Details

View Information Collection (IC)

Category I, CE a) Medical Evidence from CE Providers (Electronic Transmission through ERE; subset of "CE Forms Samples" category)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1519 20 CFR 404.1624 20 CFR 416.914 20 CFR 416.917 20 CFR 404.1518(c) 20 CFR 416.918(c) 20 CFR 404.1512 20 CFR 416.1513 20 CFR 416.919 20 CFR 416.1503a 20 CFR 416.903a 20 CFR 416.912 20 CFR 416.913 20 CFR 416.1514 20 CFR 416.1013 20 CFR 416.1024 20 CFR 404.1613 20 CFR 404.1614 20 CFR 416.1014 20 CFR 404.1517

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Sample of types of information sent through ERE; electronic version of CE paper Category I - CE a) Electronic Submissions Samples - Revised.pdf http://www.ssa.gov/ere/ Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

2,327,217 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 2,327,217 0 0 2,031,217 0 296,000
Annual IC Time Burden (Hours) 581,804 0 0 532,471 0 49,333
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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