View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Category I, CE a) Medical Evidence from CE Providers (Electronic Transmission through ERE; subset of "CE Forms Samples" category)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1517 20 CFR 416.1514 20 CFR 416.919 20 CFR 416.1013 20 CFR 416.1024 20 CFR 404.1613 20 CFR 404.1614 20 CFR 416.1014 20 CFR 404.1519 20 CFR 404.1624 20 CFR 416.903a 20 CFR 416.912 20 CFR 416.913 20 CFR 416.914 20 CFR 416.917 20 CFR 416.1503a 20 CFR 416.1513 20 CFR 404.1512

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Sample of types of information sent through ERE; electronic version of CE paper CE Samples Revised.pdf http://www.ssa.gov/ere/ Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

3,500,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,500,000 0 0 3,215,000 0 285,000
Annual IC Time Burden (Hours) 583,333 0 -291,667 803,750 0 71,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CE Electronic Medical Evidence from Providers 0960-0555 sample CE forms[2].pdf 05/19/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.