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View ICR - OIRA Conclusion

OMB Control No: 0960-0662	ICR Reference No: 200210-0960-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Medical Source Statement of Ability To Do Work-Related Activities (Physical & Mental)
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/24/2002
	Date Received in OIRA: 10/21/2002
Terms of Clearance: Approved for use through 12/2005 under the condition that SSA amends the PRA disclosure statement to include a solicitation for public comment.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2005	12/31/2005
Responses	20	0	0
Time Burden (Hours)	50,000	0	0
Cost Burden (Dollars)	0	0	0

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