View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0247	ICR Reference No: 198509-0960-009
Status: Historical Active	Previous ICR Reference No: 198412-0960-007
Agency/Subagency: SSA	Agency Tracking No:
Title: WORKERS' COMPENSATION/PUBLIC DISABILITY BENEFIT QUESTIONNAIRE
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 09/20/1985
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/20/1985
	Date Received in OIRA: 09/20/1985
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1987	09/30/1987	09/30/1985
Responses	100,000	0	100,000
Time Burden (Hours)	25,000	0	25,000
Cost Burden (Dollars)	0	0	0

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