Information Collection

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

IC 43709 under ICR 202412-0960-001 · OMB 0960-0622.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-561-U2 Request for Reconsideration--Paper and MCS/SSI Claims System	Form and Instruction
Form SSA-561-U2 Request for Reconsideration Request for Reconsideration--Paper and MCS/SSI Claims System	Form and Instruction
SSI Claims System Appeals Screens in Path Order.pdf	Other-Internal SSI Claims System Scr
SSI Claims System Appeals Screens in Path Order.pdf	Other-Internal SSI Claims System Scr
SSA-561 - Current MCS Screens.pdf	Other-Internal MCS Screens
SSA-561 - Current MCS Screens.pdf	Other-Internal MCS Screens
SSA-561-U2 Request for Reconsideration SSA-561 (revised).pdf	Form and Instruction
SSA-561-U2 Request for Reconsideration SSA-561 (revised).pdf	Form and Instruction
SSA-561-U2 (current).pdf Current SSA-561	IC Document
SSA-561-U2 (current).pdf Current SSA-561	IC Document

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 404.907-404.921 20 CFR 418.1325

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-561-U2	No		Fillable Printable
Other-Internal SSI Claims System Screens		Yes	Yes	Fillable Fileable Signable
Other-Internal MCS Screens		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 339,217

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	339,217	38,847	300,370
Annual IC Time Burden (Hours)	429,675	389,626	40,049
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-561		03/14/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].