Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
SSA-5665-BK (electronic) Modified 368098 245399 0 Form and Instruction SSA-5665-BK (Electronic)
Other-Cover Letter
SSA-5665-BK (paper) Modified 2562 1708 0 Form and Instruction SSA-5665-BK
Other-ODAR Cover Letter
SSA-5666 Modified 1843 922 0 Form and Instruction SSA-5666
Other-ODAR Cover Letter
SSA-5666 (Electronic) New 137590 68795 0 Form and Instruction SSA-5666
Total burden requested under this ICR: 510093 316824 0  
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