OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

ELIGIBILITY FOR SSA DISABILITY BENEFITS, SSA BENEFITS DENIED

ICR 199404-3206-001 · OMB 3206-0217 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
157126 ELIGIBILITY FOR SSA DISABILITY BENEFITS, SSA BENEFITS DENIED Form Migrated
ICR Details
3206-0217 199404-3206-001
Historical Active
OPM
ELIGIBILITY FOR SSA DISABILITY BENEFITS, SSA BENEFITS DENIED
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/01/1994
Retrieve Notice of Action (NOA) 04/04/1994
  Inventory as of this Action Requested Previously Approved
07/31/1997 07/31/1997
750 0 0
63 0 0
0 0 0
THE INFORMATION PROVIDED BY THE ANNUITANT IS USED BY OPM TO VERIFY RECEIPT OF SSA DISABILITY BENEFITS, MAKE NECESSARY ADJUSTMENTS TO THE FERS DISABILITY BENEFIT, AND NOTIFY THE ANNUITANT OF ANY OVERPAYMENT AMOUNT PAYABLE TO OPM. IT ALSO SPECIFICALLY NOTIFIED THE ANNUITANT OF THEIR RESPONSIBILITY TO NOTIFY OPM OF HIS OR HER SOCIAL SECURITY
None
None
No
1
IC Title Form No. Form Name
ELIGIBILITY FOR SSA DISABILITY BENEFITS, SSA BENEFITS DENIED RI 98-6
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 750 0 0 750 0 0
Annual Time Burden (Hours) 63 0 0 63 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/04/1994