Development of Participation in a Vocational Rehabilitation or Similar Program (telephone)

Development of Participation in a Vocational Rehabilitation or Similar Program

Documents and Forms

Document Name Document Type
Form SSA-4920-F5 Development of Participation in a Vocational Rehabilitation or Similar Program (telephone) Form
0960-0282 Privacy Act Statement (revised).docx Other-Privacy Act Statement (revised
SSA-4920-F5 Development of Participation in a Vocational Rehabilitat SSA-4290-F5 (revised).pdf Form

Information Collection (IC) Details

IC Title:	Development of Participation in a Vocational Rehabilitation or Similar Program (telephone)	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
Form	SSA-4920-F5	Development of Participation in a Vocational Rehabilitation or Similar Program	SSA-4290-F5 (revised).pdf		No		Paper Only
Other-Privacy Act Statement (revised)			0960-0282 Privacy Act Statement (revised).docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	790	790
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.