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Disability Update Report (Telephone Interview Process)
Disability Update Report
OMB: 0960-0511
IC ID: 243650
OMB.report
SSA
OMB 0960-0511
ICR 202303-0960-005
IC 243650
( )
Documents and Forms
Document Name
Document Type
Form SSA-455
Disability Update Report (Telephone Interview Process)
Form and Instruction
Form SSA-455
Disability Update Report (Telephone Interview Process)
Form and Instruction
SSA-455 Disability Update Report
SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf
Form and Instruction
SSA-455 Disability Update Report
SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf
Form and Instruction
SSA-455-OCR-SM Disability Update Report (scannable version)
SSA-455-OCR-SM (Revised Version).pdf
Form and Instruction
SSA-455-OCR-SM Disability Update Report (scannable version)
SSA-455-OCR-SM (Revised Version).pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Disability Update Report (Telephone Interview Process)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 416.988-.996
20 CFR 404.1589-1595
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
SSA-455
Disability Update Report
SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf
Yes
Yes
Fillable Fileable Signable
Form and Instruction
SSA-455-OCR-SM
Disability Update Report (scannable version)
SSA-455-OCR-SM (Revised Version).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:
100
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
100
0
0
0
0
100
Annual IC Time Burden (Hours)
65
0
0
0
0
65
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.