SSA-827 (with electronic signature(adult first person only)

Authorization to Disclose Information to the Social Security Administration

OMB: 0960-0623

IC ID: 197969

Information Collection (IC) Details

View Information Collection (IC)

SSA-827 (with electronic signature(adult first person only)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1512 20 CFR 416.912 45 CFR 160 & 164

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internal Screens eAuthorization final EDCS screenshots for OMB).pdf Yes Yes Fillable Fileable Signable
Other-Internet Screens eauthorization Final i3368 screens 022012 Finals.pdf www.socialsecurity.com Yes Yes Fillable Fileable Signable
Other-Internet Screens eAuthorization final i3341 screens 022012 Finals.pdf www.socialsecurity.com Yes Yes Fillable Fileable Signable
Other-Internal Screens PA Statement for SSA-827.pdf Yes Yes Fillable Fileable Signable
Other-Internal Screens eAuthorization final eView screenshots.pdf Yes Yes Fillable Fileable Signable
Other-Internal Screens eAuthorization Screens for July 2013 release - childhood claims.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

2,710,115 0
   
Individuals or Households
 
   100 %

  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 2,710,115 0 0 0 0 2,710,115
Annual IC Time Burden (Hours) 406,517 0 0 0 0 406,517
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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