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Federal forms, ICRs, and supporting documents

Information Collection

Waiver of Right to Appear--Disability Hearing (telephone and field office interview)

IC 9446 under ICR 202412-0960-008 · OMB 0960-0534.

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Waiver of Right to Appear--Disability Hearing (telephone and field office interview)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.913-404.914 20 CFR 416.1416(b)(5) 20 CFR 416.1413-416.1414 20 CFR 404.916(b)(5)

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

Income Security General Retirement and Disability

 

1,306 0
   
Individuals or Households
 
   0 %

  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 1,306 0 0 1,106 0 200
Annual IC Time Burden (Hours) 1,175 0 0 1,065 0 110
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-773-U4 - 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.