Authorization to Disclose Information to the Social Security Administration

ICR 200712-0960-006

OMB: 0960-0623

Federal Form Document

ICR Details
0960-0623 200712-0960-006
Historical Active 200704-0960-007
SSA
Authorization to Disclose Information to the Social Security Administration
Revision of a currently approved collection   No
Regular
Approved without change 04/15/2008
Retrieve Notice of Action (NOA) 03/12/2008
  Inventory as of this Action Requested Previously Approved
04/30/2011 36 Months From Approved 06/30/2010
16,001,944 0 15,415,712
864,329 0 835,017
0 0 0

SSA must obtain sufficient medical evidence to make eligibility determinations for title II and title XVI payments. Therefore, the applicant must authorize their medical source(s) to release the information to SSA. The applicant may use form SSA-827 to provide consent for the release of information. Generally, the State DDS completes the form(s) based on information provided by the applicant, and sends the form(s) to the designated medical source(s).

US Code: 42 USC 405 Name of Law: null
   US Code: 42 USC 1383 Name of Law: null
   US Code: 42 USC 423 Name of Law: null
   US Code: 42 USC 1382c Name of Law: null
  
None

Not associated with rulemaking

  72 FR 62510 11/05/2007
73 FR 7782 02/11/2008
No

  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 16,001,944 15,415,712 0 0 586,232 0
Annual Time Burden (Hours) 864,329 835,017 0 0 29,312 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The public reporting burden has been increased by 29,312 hours to account for the time it takes Internet users to read the form explanation screens.

$23,740,196
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 liz.davidson@ssa.gov

  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.
03/12/2008


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