Information Collection

Request for Reconsideration--Internet version (i561)

IC 180746 under ICR 201910-0960-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Disability Screens - i561.pdf www.ssa.gov/benefits/disability/appeal.html	Other-Current iAppeals Screens

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-Current iAppeals Screens			iAppeals Disability Screens - i561.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
	Requested	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
No associated records found

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