SSA-827 with wet signature

Authorization to Disclose Information to the Social Security Administration

OMB: 0960-0623

IC ID: 9639

Information Collection (IC) Details

View Information Collection (IC)

SSA-827 with wet signature
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1512 20 CFR 416.912

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-827 Authorization To Disclose Information To The Social Security Administration SSA-827--marked revisions.pdf http://www.ssa.gov/online/ssa-827.pdf Yes No Paper Only
Form and Instruction SSA-827 Fillable PDF Version ssa-827.pdf No   Fillable Printable

Income Security General Retirement and Disability

 

1,411,436 0
   
Individuals or Households
 
   0 %

  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 1,411,436 0 0 0 0 1,411,436
Annual IC Time Burden (Hours) 235,239 0 0 0 0 235,239
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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