SSA-827 - Electronic Versions (EDCS and eAuthorization)

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⚠️ Notice: This information collection may be referencing outdated material.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
Medical Release Form 827 EDCS Screens - eAuthorization.pdf Other-Internal Screens
827 eAuthorization screen shots.pdf www.socialsecurity.com Other-Internet Screens
827 iAppeal screen shots.pdf www.socialsecurity.com Other-Internet Screens
827 iClaim screen shots.pdf www.socialsecurity.com Other-Internet Screens

Information Collection (IC) Details

IC Title:	SSA-827 - Electronic Versions (EDCS and eAuthorization)	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 416.912 45 CFR 160 & 164 20 CFR 404.1512

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Screens	Medical Release Form 827 EDCS Screens - eAuthorization.pdf		Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	827 eAuthorization screen shots.pdf	www.socialsecurity.com	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	827 iAppeal screen shots.pdf	www.socialsecurity.com	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	827 iClaim screen shots.pdf	www.socialsecurity.com	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: 4,189,270	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,189,270	2,266,332	1,922,938
Annual IC Time Burden (Hours)	628,391	339,950	288,441
Annual IC Cost Burden (Dollars)	0	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.