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Request for Reconsideration--Internet version (i561)
Request for Reconsideration
OMB: 0960-0622
IC ID: 180746
OMB.report
SSA
OMB 0960-0622
ICR 201910-0960-003
IC 180746
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0622 can be found here:
2024-11-06 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
iAppeals Disability Screens - i561.pdf
www.ssa.gov/benefits/disability/appeal.html
Other-Current iAppeals Screens
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request for Reconsideration--Internet version (i561)
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 418.1009
20 CFR 418.1325
20 CFR 404.907-404.921
20 CFR 416.1407-416.1421
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Current iAppeals Screens
iAppeals Disability Screens - i561.pdf
https://www.ssa.gov/benefits/disability/appeal.html
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,161,300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
1,161,300
0
0
0
0
1,161,300
Annual IC Time Burden (Hours)
96,775
0
0
0
0
96,775
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.