Information Collection

SSA-634 - Request for Change in Repayment Notice

IC 180027 under ICR 202404-0960-011 · OMB 0960-0037.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-634 SSA-634 - Request for Change in Repayment Notice	Form
Form SSA-634 Request for Change in Repayment Notice SSA-634 - Request for Change in Repayment Notice	Form
SSA Internet Instructions for the SSA-632-BK & SSA-634.docx	Other-SSA Internet Instructions for
SSA-634 Request for Change in Repayment Notice SSA-634.pdf	Form

IC Title:

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 416.550-416.570 20 CFR 416.572 20 CFR 404.515 20 CFR 404.502-404.513

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-634	Request for Change in Repayment Notice	SSA-634.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

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	100,000	0	100,000
Annual IC Time Burden (Hours)	160,000	85,000	75,000
Annual IC Cost Burden (Dollars)	0	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.