View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0247	ICR Reference No: 201603-0960-015
Status: Historical Active	Previous ICR Reference No: 201407-0960-014
Agency/Subagency: SSA	Agency Tracking No:
Title: Workers' Compensation/Public Disability Benefit Questionnaire
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/25/2016
	Date Received in OIRA: 03/18/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	12/31/2017	12/31/2017
Responses	248,000	0	248,000
Time Burden (Hours)	62,000	0	62,000
Cost Burden (Dollars)	0	0	0

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