Information Collection

Waiver of Right to Appear--Disability Hearing (Upload Documents Portal Version)

IC 273307 under ICR 202412-0960-008 · OMB 0960-0534.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-773 Waiver of Right to Appear--Disability Hearing (Upload Documents Portal Version)	Form
Form SSA-773 Waiver of Right to Appear - Disability Hearing Waiver of Right to Appear--Disability Hearing (Upload Documents Portal Version)	Form
SSA-773 Waiver of Right to Appear - Disability Hearing SSA-773 (revised).pdf	Form
SSA-773 Waiver of Right to Appear - Disability Hearing SSA-773 (revised).pdf	Form
SSA-773 (current).pdf Waiver of Right to Appear - Disability Hearing SSA-773 (current)	IC Document
SSA-773 (current).pdf Waiver of Right to Appear - Disability Hearing SSA-773 (current)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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-773				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: 3,050

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 30 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	3,050	3,050
Annual IC Time Burden (Hours)	153	153
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Waiver of Right to Appear - Disability Hearing SSA-773 (current)		12/20/2024

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

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