Statutory Benefit Continuation Election Statement- Hearing Appeal Level: Form

Statutory Benefit Continuation Election Statement

OMB:

IC ID: 271879

Information Collection (IC) Details

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Statutory Benefit Continuation Election Statement- Hearing Appeal Level: Form
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-792 Statutory Benefit Continuation Election Statement SSA-792.pdf No   Paper Only

Income Security General Retirement and Disability

 

17,107 0
   
Individuals or Households
 
   0 %

  Requested 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 17,107 0 17,107 0 0 0
Annual IC Time Burden (Hours) 26,801 0 26,801 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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