SSA-634 - Request for Change in Repayment Notice

Request for Waiver of Overpayment Recovery or Change in Repayment Rate

OMB: 0960-0037

IC ID: 180027

Documents and Forms
Document Name
Document Type
Form
Form
Other-SSA Internet Instructions for
Other-SSA Internet Instructions for
Form
Form
IC Document
IC Document
IC Document
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Information Collection (IC) Details

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SSA-634 - Request for Change in Repayment Notice
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.550-416.570 20 CFR 416.572 20 CFR 404.515 20 CFR 404.502-404.513

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-634 Request for Change in Repayment Notice SSA-634 (Revised).pdf www.ssa.gov Yes No Fillable Printable
Other-SSA Internet Instructions for the SSA-632-BK & SSA-634 SSA Internet Instructions for the SSA-632-BK & SSA-634.docx Yes No Fillable Printable

Income Security General Retirement and Disability

 

100,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 100,000 0 0 0 0 100,000
Annual IC Time Burden (Hours) 75,000 0 0 0 0 75,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-634 Current SSA-634 (Current).pdf 11/22/2023
SSA-634 PA and PRA Statements SSA-634 PA & PRA Statements (Current).pdf 11/22/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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