Information Collection

Request for Reconsideration--Paper and MCS/MSSICS

IC 43709 under ICR 201712-0960-008 · OMB 0960-0622.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-561-U2 Request for Reconsideration--Paper and MCS/MSSICS	Form and Instruction
MSSICS Appeals Screens in Path Order.docx	Other-Internal MSSICS Screens
MCS Appeals screens RCN1 RCN2 HNG1 HNG2.doc	Other-Internal MCS Screens
Privacy Act and PRA.pdf	Other-Revised Privacy Act and Paperw
SSA-561-U2 Request for Reconsideration SSA-561 (revised).pdf	Form and Instruction
Request for Reconsideration - SSA-561.pdf Current SSA-561	IC Document
SSA-561 - Current MSSICS Screens.pdf Current SSA-561 MSSICS Screens	IC Document
SSA-561 - Current MCS Screens.pdf Current HA-561 MCS Screens	IC Document

IC Title:

Request for Reconsideration--Paper and MCS/MSSICS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.907-404.921 20 CFR 418.1325 20 CFR 416.1407-416.1421 20 CFR 418.1009

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-561-U2	Request for Reconsideration	SSA-561 (revised).pdf	No		Paper Only
Other-Internal MSSICS Screens			MSSICS Appeals Screens in Path Order.docx	Yes	Yes	Fillable Fileable Signable
Other-Internal MCS Screens			MCS Appeals screens RCN1 RCN2 HNG1 HNG2.doc	Yes	Yes	Fillable Fileable Signable
Other-Revised Privacy Act and Paperwork Reduction Act			Privacy Act and PRA.pdf	No		Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300,370

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	300,370	300,370
Annual IC Time Burden (Hours)	40,049	40,049
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-561	Request for Reconsideration - SSA-561.pdf	08/10/2016
Current SSA-561 MSSICS Screens	SSA-561 - Current MSSICS Screens.pdf	08/10/2016
Current HA-561 MCS Screens	SSA-561 - Current MCS Screens.pdf	08/10/2016

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