Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application and Statement - SSA-3192 Modified 290 145 0 Form and Instruction SSA-3192
Physician's Report - SSA-3193 Modified 580 870 0 Form and Instruction SSA-3193
Renewal Certification - SSA-3194 Modified 93 8 0 Form and Instruction SSA-3194
Total burden requested under this ICR: 963 1023 0  
To view an IC, click on IC Title