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OMB Control No: 0960-0624	ICR Reference No: 202606-0960-011
Status: Received in OIRA	Previous ICR Reference No: 202007-0960-006
Agency/Subagency: SSA	Agency Tracking No:
Title: Medical Permit Parking Application
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 07/31/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2026
Responses	623	937
Time Burden (Hours)	497	900
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	623	937	302	-616
Annual Time Burden (Hours)	497	900	686	-1,089
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: When we cleared this ICR in 2023, the burden was 900 hours. However, we are currently reporting a burden of 497 hours. The decrease in burden is due to the decrease in responses from 937 to 623. The significant reason for the decrease in responses is the elimination of Form SSA-3194 from the Information Collection. We removed Form SSA-3194 from our information collection because it is no longer needed; fewer than 10 respondents per year fail to recover within the expected duration provided by the physician, eliminating the need for renewal. This change has significantly reduced completion time and the resulting burden. These figures reflect current Management Information data.

Annual Cost to Federal Government: $23,610

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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