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

Document Name Document Type
Form SSA-773 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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Waiver of Right to Appear--Disability Hearing (Upload Documents Portal Version)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-773	Waiver of Right to Appear - Disability Hearing	SSA-773 (revised).pdf		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 %

	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

Title	Document	Date Uploaded
Waiver of Right to Appear - Disability Hearing SSA-773 (current)	SSA-773 (current).pdf	12/20/2024

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