Confirmation of Request for Reasonable Accommodation

OMB 0704-0498

The information collection requirement is necessary to obtain and record requests for reasonable accommodation, with the intent to measure and ensure Agency compliance with 29 U.S.C. § 791, Employment of Individuals with Disabilities; E.O. 13164, Requiring Federal Agencies to Establish Procedures to Facilitate the Provision of Reasonable Accommodation; EEO MD-715, EEO Reporting Requirements for Federal Agencies.

The latest form for Confirmation of Request for Reasonable Accommodation expires 2022-09-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form SD Form 827 Confirmation of Request for Reasonable Accommodation Form and Instruction
PIA-1.pdf Supplementary Document
0704-0498_SSA_10.25.22.docx Supporting Statement A
Confirmation of Request for Reasonable Accommodation Form and Instruction

All Historical Document Collections

202210-0704-002 Approved without change	Extension without change of a currently approved collection	2022-10-27
201907-0704-002 Approved without change	Extension without change of a currently approved collection	2019-08-02
201607-0704-004 Approved without change	Extension without change of a currently approved collection	2016-07-28
201305-0704-003 Approved with change	New collection (Request for a new OMB Control Number)	2013-05-02