Request for Reconsideration--Paper and MCS/SSI Claims System

Request for Reconsideration

OMB: 0960-0622

IC ID: 43709

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Internal SSI Claims System Scr
Other-Internal SSI Claims System Scr
Other-Internal MCS Screens
Other-Internal MCS Screens
Other-Revised PA and PRA Statements
Other-Revised PA and PRA Statements
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Request for Reconsideration--Paper and MCS/SSI Claims System
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1407-416.1421 20 CFR 418.1009 20 CFR 404.907-404.921 20 CFR 418.1325

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-561-U2 Request for Reconsideration SSA-561 - Revised Version.pdf No   Fillable Printable
Other-Internal SSI Claims System Screens SSI Claims System Appeals Screens in Path Order.pdf Yes Yes Fillable Fileable Signable
Other-Internal MCS Screens SSA-561 - Current MCS Screens.pdf Yes Yes Fillable Fileable Signable
Other-Revised PA and PRA Statements SSA-561 - Revised PA and PRA Statements.pdf Yes No Printable Only

Income Security General Retirement and Disability

 

300,370 0
   
Individuals or Households
 
   95 %

  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 300,370 0 0 0 0 300,370
Annual IC Time Burden (Hours) 40,049 0 0 0 0 40,049
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-561 SSA-561 - Current Version.pdf 10/11/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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