Authorization To Disclose Information To The Social Security Administration / SSA-827 (sign and date only)

Authorization to Disclose Information to the Social Security Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0623 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-827 Authorization To Disclose Information To The Social Security Administration / SSA-827 (sign and date only) Form
SSA-827 Authorization to Disclose Information to the Social Secu SSA-827.pdf Form

Information Collection (IC) Details

IC Title:	Authorization To Disclose Information To The Social Security Administration / SSA-827 (sign and date only)	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 404.1512 20 CFR 416.912

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-827	Authorization to Disclose Information to the Social Security Administration	SSA-827.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,853,928	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	11,561,784	11,561,784
Annual IC Time Burden (Hours)	192,696	192,696
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.