Survey 1 (non-respondents)

SSA Work Disability Functional Assessment Battery (WD-FAB) Data Collection

Documents and Forms

Document Name Document Type
Attachment B1. Survey 1 Web Nonresponders Follow-up Script.pdf Other-Follow-up Script
Attachment B2. Survey 2 Web Nonresponders Follow-Up Script.pdf Other-Follow-up Script

Information Collection (IC) Details

IC Title:	Survey 1 (non-respondents)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Follow-up Script			Attachment B1. Survey 1 Web Nonresponders Follow-up Script.pdf		No		Paper Only
Other-Follow-up Script			Attachment B2. Survey 2 Web Nonresponders Follow-Up Script.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	53	53
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.