Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Interviews to Collect Customer Feedback Regarding SSA's Earnings Submission Process. Unchanged 50 50 0 Other-Survey Documentation
Chicago Model FO Employee Feedback Survey and Visitor Feedback Survey Unchanged 10040 837 0 Other-Survey Documentation
Consultative Examination Satisfaction Survey Unchanged 1444404 361101 0 Other-Consultative Examination Satisfaction Survey
FY 19 Caller Surveys Unchanged 12000 3000 0 Other-FY19 800# Caller Survey
Other-FY19 FO Caller Survey
Fast Healthcare Interoperability Resources (FHIR) and Consumer Directed Exchange Feasiblility Study Questinnaire Unchanged 61 25 0 Other-FHIR Reasiblility Study Questionnaire
Other-FHIR Survey Participation Tracker
Other- Consumer Directed Exchange Feasibility Study Questionnaire
Other- Consumer Directed Exchange Feasibility Study Questionnaire Participant List
Fast Track Template Blank Unchanged 68549 12853 0 Other-Generic Clearance Blank Template
IdeaScale Forum for Advance Designation of Representative Payees Unchanged 300 25 0 Other-IdeaScale Forum Questions
Other-IdeaScale Forum Sample Screen
Interviews to Collect Customer Feedback Regarding SSA's Earnings Submission Process. Unchanged 10 520 0 Other-Interviews to Collect Customer Feedback Regarding SSA’s Earnings Submission Process.
National Disability Forum (NDF) Unchanged 1200 3000 0 Other-Disability Forum Evaluation Form FY 19
Other-Evaluation Template- NDF-Live Stream or In Person
Other-Registration Template- NDF 19
Other-Sample Engage SSA for NDF FY 19
National Disability Forum FY 2019 New 900 2700 0 Other-NDF Registration Template FY 20
Other-NDF Facilitator and Panelist FY 20
Other-Disability Forum Evaluation Form FY 20
Other-Sample Engage SSA for NDF FY 20
Retirement Research Consortium (RRC) and Disability Research Consortium (DRC) Unchanged 700 117 0 Other-Survey
Other-Survey
Social Security Statement Focus Groups New 32 48 0 Other-Focus Group Discussion Guide
Other-Focus Group Screener
Usability Testing of SSA Electronic Projects Unchanged 1800 3600 0 Other-Usability Testing of SSA Electronic Projects FY18 Product List
Other-PostTest Survey
Usability Testing of SSA Electronic Projects Unchanged 1800 3600 0 Other-Usability Testing of SSA Electronic Projects FY19 Product List
Other-Post Test Survey
Other-Consent (recording)
Other-Consent (non-recording)
User Research & Usability Testing of SSA Electronic Projects New 1800 3600 0 Other-Content Form (Recording)
Other-Consent (Non-Recording)
Other-Usability Testing of SSA Electronic Projects 2020 Product List
Other-Usability Testing of SSA Electronic Projects 2020 Post Test Survey
User Research for SSA Projects - Usability Testing Unchanged 1800 3600 0 Other-Sample Questionnaire
Other-Sample Interview Questions
Work Incentive Planning and Assistance (WIPA) Customer Comment Instrument Unchanged 20400 2380 0 Other-WIPA Sample
eCBSV Outreach Survey under the Economic Growth, Regulatory Relief, and Consumer Protection Act Unchanged 7500 1875 0 Other-2018 SSA Initiative Needs Assessment Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 1573346 402931 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title