View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0247	ICR Reference No: 201111-0960-001
Status: Historical Active	Previous ICR Reference No: 200902-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Workers' Compensation/Public Disability Benefit Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/26/2012
	Date Received in OIRA: 02/22/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2015	36 Months From Approved	05/31/2012
Responses	250,000	0	250,000
Time Burden (Hours)	62,500	0	62,500
Cost Burden (Dollars)	0	0	0

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