BLACK LUNG STUDENT'S STATEMENT REGARDING RESUMPTION OF SCHOOL ATTENDANCE, SSA-2602, REPORT OF BLACK LUNG STUDENT BENEFICIARY AT END OF SCHOOL YEAR, SSA-2613

ICR 199309-0960-001

OMB: 0960-0314

Federal Form Document

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Document
Name
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ICR Details
0960-0314 199309-0960-001
Historical Active 199007-0960-001
SSA
BLACK LUNG STUDENT'S STATEMENT REGARDING RESUMPTION OF SCHOOL ATTENDANCE, SSA-2602, REPORT OF BLACK LUNG STUDENT BENEFICIARY AT END OF SCHOOL YEAR, SSA-2613
Revision of a currently approved collection   No
Regular
Approved without change 11/26/1993
Retrieve Notice of Action (NOA) 09/08/1993
  Inventory as of this Action Requested Previously Approved
12/31/1996 12/31/1996 09/30/1993
8,000 0 8,000
1,667 0 666
0 0 0

THE INFORMATION COLLECTED BY FORMS SSA-2602 AND 2613 IS NEEDED TO DETERMINE WHETHER OR NOT A STUDENT BENEFICIARY WILL RESUME FULL-TIME SCHOOL ATTENDANCE AFTER THE END OF THE REGULAR SCHOOL YEAR AND BE ENTITLED TO ADDITIONAL BENEFITS. THE AFFECTED PUBLIC IS COMPRISED OF STUDENTS WHO ARE CHILDREN OF DECEASED OR DISABLED COAL MINERS AND OFFICIALS OF THE SCHOOLS THEY ATTEND.

None
None


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 8,000 8,000 0 0 0 0
Annual Time Burden (Hours) 1,667 666 0 0 1,001 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
09/08/1993


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