SSA-827 with wet signature(paper version) or EDCS Screens with verbal attestation (Intranet version)

Authorization to Disclose Information to the Social Security Administration

OMB: 0960-0623

IC ID: 9639

Documents and Forms
Document Name
Document Type
Other-Revised PA & PRA Statements
Other-EDCS Screens
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

SSA-827 with wet signature(paper version) or EDCS Screens with verbal attestation (Intranet version)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.912 20 CFR 404.1512 45 CFR 160 & 164

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-827 Authorization To Disclose Information To The Social Security Administration SSA-827 - Revised.pdf http://www.ssa.gov/online/ssa-827.pdf Yes No Fillable Printable
Other-Revised PA & PRA Statements Revised PA & PRA Statements - Paper.pdf Yes No Fillable Printable
Other-EDCS Screens 827 EDCS Screens.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

1,055,807 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 1,055,807 0 0 0 0 1,055,807
Annual IC Time Burden (Hours) 175,968 0 0 0 0 175,968
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-827 - Current SSA-827 - Current.pdf 02/18/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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