WAIVER OF RIGHT TO APPEAR - DISABILITY HEARING

ICR 198606-0960-006

OMB: 0960-0352

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
115384 Migrated
ICR Details
0960-0352 198606-0960-006
Historical Active 198508-0960-044
SSA
WAIVER OF RIGHT TO APPEAR - DISABILITY HEARING
Revision of a currently approved collection   No
Regular
Approved without change 08/21/1986
Retrieve Notice of Action (NOA) 06/12/1986
  Inventory as of this Action Requested Previously Approved
08/31/1989 08/31/1989 07/31/1986
22,200 0 2,220
2,220 0 555
0 0 0

THE INFORMATION COLLECTED BY USE OF THE FORM SSA-773 IS NEEDED TO PROVIDE CLAIMANTS AN EFFECTIVE MEANS FOR WAIVING THEIR RIGHT TO A HEARING. THE INFORMATION COLLECTED WILL BE USED AS DOCUMENTATION THAT CLAIMANTS UNDERSTOOD THEIR RIGHT TO APPEAR AND THE EFFECTS OF THE DECISION TO WAIVE THIS RIGHT. THE AFFECTED PUBLIC IS COMPRISED OF CLAIMANTS WHO WISH TO WAIVE THEIR RIGHT TO APPEAR AT A DISABILITY HEARING.

None
None


No

1
IC Title Form No. Form Name
WAIVER OF RIGHT TO APPEAR - DISABILITY HEARING SSA-773

  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 22,200 2,220 0 19,980 0 0
Annual Time Burden (Hours) 2,220 555 0 1,665 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
06/12/1986


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