Request for Accommodation in Communication Method - SSA-9000 & iAccommodate

Request for Accommodation in Communication Method

OMB: 0960-0777

IC ID: 192018

Documents and Forms
Document Name
Document Type
Form
Other-Intranet Screens
Other-Intranet Screens
Other-Revised PRA Statement
Other-Revised PRA Statement
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Request for Accommodation in Communication Method - SSA-9000 & iAccommodate
 
No Modified
 
Voluntary
 
45 CFR 85.51

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-9000-F6 Request for Accommodation SSA-9000 F-6 - Revised Version.pdf No   Paper Only
Other-Intranet Screens iAccommodate Intranet Screenshots.pdf Yes Yes Fillable Fileable Signable
Other-Revised PRA Statement SSA-9000 F-6 - Revised PRA Statement.pdf Yes Yes Printable Only

Income Security General Retirement and Disability

 

5,000 0
   
Individuals or Households
 
   100 %

  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 5,000 0 0 0 0 5,000
Annual IC Time Burden (Hours) 3,250 0 0 1,583 0 1,667
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-9000-F6 SSA-9000 F-6 - Current Version.pdf 11/04/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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