Request for Reconsideration--Paper and MCS/MSSICS

Request for Reconsideration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0622 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-561-U2 Request for Reconsideration--Paper and MCS/MSSICS Form
SSA-561-U2 Request for Reconsideration SSA-561 (Revised Version).pdf Form
SSA-561-U2 (MSSICS Request for Reconsideration MSSICS Screens - SSA-561.pdf Form
SSA-561-U2 (MCS Sc Request for Reconsideration MCS Screens - SSA-561.pdf Form
SSA-561 (Current Version).pdf Current SSA-561 IC Document

Information Collection (IC) Details

IC Title:	Request for Reconsideration--Paper and MCS/MSSICS	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 418.1325 20 CFR 416.1407-416.1421 20 CFR 418.1009 20 CFR 404.907-404.921

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-561-U2	Request for Reconsideration	SSA-561 (Revised Version).pdf	No		Paper Only
Form	SSA-561-U2 (MCS Screens)	Request for Reconsideration	MCS Screens - SSA-561.pdf	Yes	Yes	Fillable Fileable Signable
Form	SSA-561-U2 (MSSICS Screens)	Request for Reconsideration	MSSICS Screens - SSA-561.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 550,370	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	550,370	-180,480	730,850
Annual IC Time Burden (Hours)	73,383	-24,064	97,447
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-561	SSA-561 (Current Version).pdf	12/06/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.