Authorization to Disclose Information to the Social Security Administration

ICR 200806-0960-010

OMB: 0960-0623

Federal Form Document

ICR Details
0960-0623 200806-0960-010
Historical Active 200712-0960-006
SSA
Authorization to Disclose Information to the Social Security Administration
Revision of a currently approved collection   No
Regular
Approved without change 11/26/2008
Retrieve Notice of Action (NOA) 10/10/2008
  Inventory as of this Action Requested Previously Approved
11/30/2011 36 Months From Approved 04/30/2011
16,001,944 0 16,001,944
864,329 0 864,329
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

  73 FR 40005 07/11/2008
73 FR 53919 09/17/2008
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 16,001,944 0 0 0 0
Annual Time Burden (Hours) 864,329 864,329 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$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.
10/10/2008


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