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Category I, CE b) Claimant/Appointment Letter Information (subset of "CE Forms Samples" category)
Disability Case Development Information Collections
OMB: 0960-0555
IC ID: 179018
OMB.report
SSA
OMB 0960-0555
ICR 202008-0960-015
IC 179018
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0555 can be found here:
2024-02-14 - No material or nonsubstantive change to a currently approved collection
2020-12-09 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
CE b) Appointment Ltr - Revised.pdf
Other-Sample of Appointment Letter I
CE b) Appointment Ltr - Current.pdf
CE b) Appointment Ltr - Current
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Category I, CE b) Claimant/Appointment Letter Information (subset of "CE Forms Samples" category)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 416.1013
20 CFR 416.1024
20 CFR 416.917
20 CFR 416.919
20 CFR 404.1614
20 CFR 404.1514
20 CFR 404.1512
20 CFR 404.1517
20 CFR 416.912
20 CFR 404.1513
20 CFR 416.1014
20 CFR 404.1519
20 CFR 404.1613
20 CFR 404.1503a
20 CFR 404.1624
20 CFR 416.903a
20 CFR 416.913
20 CFR 416.914
20 CFR 404.1518(c)
20 CFR 416.918(c)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Sample of Appointment Letter Included
CE b) Appointment Ltr - Revised.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
880,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
880,000
0
0
0
0
880,000
Annual IC Time Burden (Hours)
73,333
0
0
0
0
73,333
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CE b) Appointment Ltr - Current
CE b) Appointment Ltr - Current.pdf
06/13/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.