Information Collection

Request for Reconsideration--Internet version (i561)

IC 180746 under ICR 202412-0960-001 · OMB 0960-0622.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
iAppeals Disability Screens - i561.pdf www.ssa.gov/benefits/disability/appeal.html	Other-Current iAppeals Screens
iAppeals Disability Screens - i561.pdf www.ssa.gov/benefits/disability/appeal.html	Other-Current iAppeals Screens
iAppeals Revised Terms of Service - Clean Copy.docx	Other-Revised Terms of Service Scree
iAppeals Revised Terms of Service - Clean Copy.docx	Other-Revised Terms of Service Scree

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 416.1407-416.1421 20 CFR 418.1009 20 CFR 418.1325 20 CFR 404.907-404.921

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
Other-Current iAppeals Screens				https://www.ssa.gov/benefits/disability/appeal.html	Yes	Yes	Fillable Fileable Signable
Other-Revised Terms of Service Screen					Yes	Yes	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 447,139

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	447,139	-714,161	1,161,300
Annual IC Time Burden (Hours)	223,570	126,795	96,775
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.

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