Information Collection

Request for Reconsideration--Disability Cessation

IC 9232 under ICR 201801-0960-005 · OMB 0960-0349.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0349 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSA-789 - Revised PA Statement.pdf	Other-Revised Privacy Act Statement
SSA-789 Request for Reconsideration--Disability Cessation SSA-789 - Revised Version.pdf	Form
SSA-789 - Current Version.pdf Current SSA-789	IC Document

IC Title:

Request for Reconsideration--Disability Cessation

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 416.1409 20 CFR 404.909

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Revised Privacy Act Statement			SSA-789 - Revised PA Statement.pdf	www.ssa.gov	Yes	No	Printable Only
Form	SSA-789	Request for Reconsideration--Disability Cessation	SSA-789 - Revised Version.pdf	www.ssa.gov	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	30,000	30,000
Annual IC Time Burden (Hours)	6,500	6,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-789	SSA-789 - Current Version.pdf	05/09/2018

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