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: 0960-0734	ICR Reference No: 201503-0960-003
Status: Historical Active	Previous ICR Reference No: 201204-0960-014
Agency/Subagency: SSA	Agency Tracking No:
Title: Statement of Reclamation Action
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: 08/24/2015
	Date Received in OIRA: 05/28/2015
Terms of Clearance: This collection is approved based on the additional materials provided by the Agency.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2018	36 Months From Approved	09/30/2015
Responses	15	0	15
Time Burden (Hours)	1	0	1
Cost Burden (Dollars)	0	0	0

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
SSA-1713/Not-For-Profit	SSA-1712-CN, SSA-1712, SSA-1713	, ,
SSA-1713/businesses	SSA-1713, SSA-1712, SSA-1712 CN	, ,

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