View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0960-0579	ICR Reference No: 200210-0960-008
Status: Historical Active	Previous ICR Reference No: 200106-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Disability Report, Adult - 20 CFR 404.1512, Subpart O and 416.912, Subpart I
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/23/2002
	Date Received in OIRA: 10/21/2002
Terms of Clearance: Approved for use through 12/2003 under the conditions that SSA: 1) combines this approval package with the internet version of the forms, currently cleared as a pilot under OMB #0960-0650, expiration date of 4/2003; and 2) amends the PRA disclosure statement to include a solicitation for public comment.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2003	12/31/2003	07/31/2004
Responses	2,050,667	0	2,116,667
Time Burden (Hours)	2,050,667	0	2,116,667
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,050,667	2,116,667	-66,000
Annual Time Burden (Hours)	2,050,667	2,116,667	-66,000
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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