Information Collection Request

Request for Waiver of Overpayment Recovery or Change in Repayment Rate

ICR 202106-0960-008 · OMB 0960-0037 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-632-BK Request to Waiver of Overpayment Recovery Form Modified Repair queued
Form SSA-632-BK SSA-632 - Request for Waiver of Overpayment Recovery Form Modified Available
Form SSA-634 Request for Change in Repayment Notice Form Removed Repair queued
Form SSA-632-BK Request For Waiver Of Overpayment Recovery Form Removed Repair queued
Form SSA-634 Request for Change in Repayment Notice Form Modified Repair queued
Form SSA-634 SSA-634 - Request for Change in Repayment Notice Form Modified Repair queued
Addendum - 0037 (Final).docx Supplementary Document Uploaded 2021-10-27 Repair queued
Supporting Statement - 0037 (Final).docx Supporting Statement A Uploaded 2021-10-29 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8941 SSA-632 - Request for Waiver of Overpayment Recovery Form ModifiedRequest to Waiver of Overpayment Recovery
8941 SSA-632 - Request for Waiver of Overpayment Recovery Form Modified
8941 SSA-632 - Request for Waiver of Overpayment Recovery Other-Revised PA and PRA Statements Modified
232349 Internet Instructions - SSA-634 Instruction Removed
195878 Internet Instructions - SSA-632 Instruction Removed
195877 Regional Application (NY Debt Management-NYDM) Form RemovedRequest for Change in Repayment Notice
195877 Regional Application (NY Debt Management-NYDM) Form RemovedRequest For Waiver Of Overpayment Recovery
195877 Regional Application (NY Debt Management-NYDM) Other-DMS Screens Removed
180027 SSA-634 - Request for Change in Repayment Notice Form ModifiedRequest for Change in Repayment Notice
180027 SSA-634 - Request for Change in Repayment Notice Form Modified
180027 SSA-634 - Request for Change in Repayment Notice Other-Revised PA and PRA Statements Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2024 36 Months From Approved 09/30/2023
500,000 0 1,060,000
475,000 0 979,166
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Internet Instructions - SSA-632
Internet Instructions - SSA-634
Regional Application (NY Debt Management-NYDM) SSA-632-BK, SSA-634 ,  
SSA-632 - Request for Waiver of Overpayment Recovery SSA-632-BK
SSA-634 - Request for Change in Repayment Notice SSA-634

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 500,000 1,060,000 0 -560,000 0 0
Annual Time Burden (Hours) 475,000 979,166 0 -104,166 -400,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No