Information Collection

Request for Reconsideration--Internet version (i561)

IC 180746 under ICR 201907-0960-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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
iAppeals TOS and Submit Tab - Revised Screens.pdf www.ssa.gov/benefits/disability/appeal.html	Other-Revised iAppeals Terms of Serv
iAppeals TOS and Submit Screen - Currently Approved version.pdf Current iAppeals Terms of Service and Submit Screens	IC Document

IC Title:

Request for Reconsideration--Internet version (i561)

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 418.1009 20 CFR 418.1325 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
Other-Revised iAppeals Terms of Service and Submit Tab			iAppeals TOS and Submit Tab - Revised Screens.pdf	https://www.ssa.gov/benefits/disability/appeal.html	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: 1,161,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,161,300	1,161,300
Annual IC Time Burden (Hours)	96,775	96,775
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current iAppeals Terms of Service and Submit Screens	iAppeals TOS and Submit Screen - Currently Approved version.pdf	07/30/2019

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