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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.


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0960-0247 199309-0960-003
Historical Active 199008-0960-007
SSA
WORKERS' COMPENSATION/PUBLIC DISABILITY BENEFIT QUESTIONNAIRE
Revision of a currently approved collection   No
Regular
Approved without change 11/26/1993
09/10/1993
  Inventory as of this Action Requested Previously Approved
12/31/1996 12/31/1996 10/31/1993
100,000 0 100,000
25,000 0 25,000
0 0 0