OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Travel Expense Reimbursement

OMB 0960-0434 ยท SSA.

OMB 0960-0434

The Social Security Act establishes travel expense reimbursement by Federal and state agencies for claimants travel incidental to medical examinations and to parties, their representatives, and all reasonably necessary witnesses for travel exceeding 75 miles to attend medical examinations, reconsideration interviews and proceedings before an administrative law judge. Reimbursement procedures require the claimant to provide 1) a list of expenses incurred, and 2) receipts of such expense. State and Federal personnel review the listings and receipts to verify the amount to be reimbursed to the claimant. The respondents are claimants for Title II benefits and Title XVI payments, their representatives and witnesses.

The latest form for Travel Expense Reimbursement expires 2028-08-31 and is listed under ICR 202502-0960-010.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Addendum to Supporting Statement 0960-0434.docx (document unavailable)Supplementary Document
Supporting Statement - 0960-0434.docxSupporting Statement A
Travel Expense Reimbursement Information collection

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202502-0960-010 Extension without change of a currently approved collection 2025-04-17
202112-0960-001 Revision of a currently approved collection 2022-02-25 Approved without change
201906-0960-005 Revision of a currently approved collection 2019-10-07 Approved with change
201607-0960-007 Extension without change of a currently approved collection 2016-10-28 Approved without change
201305-0960-010 Extension without change of a currently approved collection 2013-09-11 Approved without change
201006-0960-002 Extension without change of a currently approved collection 2010-08-31 Approved without change
200709-0960-012 Extension without change of a currently approved collection 2007-11-19 Approved without change
200410-0960-002 Extension without change of a currently approved collection 2004-10-08 Approved without change
200109-0960-002 Extension without change of a currently approved collection 2001-09-14 Approved without change
199809-0960-003 Extension without change of a currently approved collection 1998-09-02 Approved without change
199506-0960-022 Reinstatement without change of a previously approved collection 1995-06-30 Approved without change
199204-0960-006 Extension without change of a currently approved collection 1992-04-29 Approved without change
198903-0960-003 Extension without change of a currently approved collection 1989-03-13 Approved without change
198603-0960-008 New collection (Request for a new OMB Control Number) 1986-03-11 Approved without change