Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application and Statement Modified 75 38 0 Form and Instruction SSA-3192
Physician's Report Modified 400 600 0 Form and Instruction SSA-3193
Renewal Certification Modified 500 42 0 Form and Instruction SSA-3194
Total burden requested under this ICR: 975 680 0  
To view an IC, click on IC Title