Information Collection

Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof Disability Cessation

IC 9238 under ICR 201811-0960-003 · OMB 0960-0351.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0351 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-770-U4 Notice Regarding Substitution of Party Upon Death of Claimant--Reconsideration of Disability Cessation Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof Disability Cessation	Form
Revised PA & PRA Statements.pdf	Other-Revised PA and PRA Statements
SSA-770-U4 Notice Regarding Substitution of Party Upon Death of Cla SSA-770-U4 - Revised.pdf	Form
SSA-770-U4 - Current.pdf SSA-770-U4 - Current	IC Document

IC Title:

Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof 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 404.907-404.921 20 CFR 416.1407-416.1421

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
Form	SSA-770-U4				No		Fillable Printable
Other-Revised PA and PRA Statements					No		Fillable Printable

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

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	1,200	1,200
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-770-U4 - Current		12/19/2018

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].