PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
0960-0300 HA-4633 (ERE) 410.1560; 404.1565; 416.960; 416.965
New
157700
52567
0
Other-Internet Screens
0960-0300 HA-4633 (Paper Form) 410.1560; 404.1565; 416.960; 416.965
New
32300
10767
0
Form and Instruction
HA-4633
Claimant's Work Background
0960-0578 SSA-3369 (EDCS Screens) 410.1560 416.960
New
38049
38683
0
Other-Intranet Screens
0960-0578 SSA-3369 (Paper Form) 410.1560; 404.1565; 416.960; 416.965
New
1553900
1035933
0
Form and Instruction
SSA-3369
Work History Report
0960-0579 SSA-3368 (EDCS Screens) 410.1560 416.960
New
1263104
2126225
0
Other-Intranet Screens
0960-0579 SSA-3368 (Paper Form) 410.1560 416.960
New
6045
10176
0
Form and Instruction
SSA-3368
Disability Report - Adult
0960-0579 i3368 (Internet Screens), 401.1560, 404.1565, 416.960, and 416.965
New
989361
1319148
0
Other-Internet Screens
Other-Internet Screens
Total burden requested under this ICR:
4040459
4593499
0
To view an IC, click on IC Title
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