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Person-Centered Interview
Supported Employment Demonstration (SED) Project
OMB: 0960-0806
IC ID: 226133
OMB.report
SSA
OMB 0960-0806
ICR 202002-0960-002
IC 226133
( )
Documents and Forms
Document Name
Document Type
SED Attachments L-S (05-03-2017).pdf
Other-Person Centered Interview
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Person-Centered Interview
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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-Person Centered Interview
SED Attachments L-S (05-03-2017).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:
180
Number of Respondents for Small Entity:
0
Affected Public:
Federal Government
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
720
0
0
0
0
720
Annual IC Time Burden (Hours)
720
0
0
0
0
720
Annual IC Cost Burden (Dollars)
0
0
0
0
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.