SSA-632 - Request for Waiver of Overpayment Recovery

Request for Waiver of Overpayment Recovery or Change in Repayment Rate

OMB: 0960-0037

IC ID: 8941

Documents and Forms
Document Name
Document Type
Form
Other-Revised PA and PRA Statements
Other-Electronic Waiver Application
Other-SSA Internet Instructions for
Form
IC Document
Information Collection (IC) Details

View Information Collection (IC)

SSA-632 - Request for Waiver of Overpayment Recovery
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.572 20 CFR 404.502-404.513 20 CFR 404.515 20 CFR 416.550-416.570 20 CFR 416.581 20 CFR 422.310 20 CFR 404.520-404.521

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-632-BK Request to Waiver of Overpayment Recovery SSA-632-BK - Revised.pdf Yes No Fillable Printable
Other-Revised PA and PRA Statements SSA-632-BK - Revised PA & PRA Statements.pdf Yes No Fillable Printable
Other-Electronic Waiver Application Screens Waivers Screen Package.pdf Yes Yes Fillable Fileable Signable
Other-SSA Internet Instructions for the SSA-632-BK & SSA-634 SSA Internet Instructions for the SSA-632-BK & SSA-634.docx Yes No Fillable Printable

Income Security General Retirement and Disability

 

400,000 0
   
Individuals or Households
 
   0 %

  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 400,000 0 0 0 0 400,000
Annual IC Time Burden (Hours) 800,000 0 0 0 0 800,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-632-BK - Current SSA-632-BK - Current.pdf 10/20/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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