Approved on the
condition that prior to the next clearance request for this form,
SSA consider whether to combine it with the largely identical Title
XVI form (0960-0443). The next request for clearance will present
either a combined form or an explanation for why the two should
remain separate.
Inventory as of this Action
Requested
Previously Approved
11/30/2001
11/30/2001
12/31/1998
627,973
0
268,700
313,987
0
134,350
0
0
0
The information collected on form
SSA-833 is used by the SDDS to prepare for SSA determinations of
whether individuals receiving title II disability or blindness
benefits continue to be unable to engage in substantial gainful
work due to their impairments and are still eligible for benefit
payments. The respondents are SDDS employees.
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.