Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof Disability Cessation

Notice Regarding Substitution of Party Upon Death of Claimant Reconsideration of Disability Cessation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0351 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-770-U4 Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof Disability Cessation Form
Revised PA & PRA Statements.pdf Other-Revised PA and PRA Statements
SSA-770-U4 Notice Regarding Substitution of Party Upon Death of Cla SSA-770-U4 - Revised.pdf Form
SSA-770-U4 - Current.pdf SSA-770-U4 - Current IC Document

Information Collection (IC) Details

IC Title:	Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof Disability Cessation	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 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
Form	SSA-770-U4	Notice Regarding Substitution of Party Upon Death of Claimant--Reconsideration of Disability Cessation	SSA-770-U4 - Revised.pdf		No		Fillable Printable
Other-Revised PA and PRA Statements			Revised PA & PRA Statements.pdf		No		Fillable Printable

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-770-U4 - Current	SSA-770-U4 - Current.pdf	12/19/2018

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