View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0689	ICR Reference No: 200405-0960-017
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Certification of Contents of Document(s) or Record(s)
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: 07/21/2004
	Date Received in OIRA: 05/27/2004
Terms of Clearance: SSA is required to display the burden hour estimate per form on form itself._OMB notes SSA previously used this form in violation of the PRA.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2007	07/31/2007
Responses	4,800	0	0
Time Burden (Hours)	800	0	0
Cost Burden (Dollars)	0	0	0

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