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Waiver of Right to Appear--Disability Hearing (Upload Documents Portal Version)
Waiver of Right to Appear--Disability Hearing
OMB: 0960-0534
IC ID: 273307
OMB.report
SSA
OMB 0960-0534
ICR 202412-0960-008
IC 273307
( )
Documents and Forms
Document Name
Document Type
Form SSA-773
Waiver of Right to Appear--Disability Hearing (Upload Documents Portal Version)
Form
SSA-773 Waiver of Right to Appear - Disability Hearing
SSA-773 (revised).pdf
Form
SSA-773 (current).pdf
Waiver of Right to Appear - Disability Hearing SSA-773 (current)
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Waiver of Right to Appear--Disability Hearing (Upload Documents Portal Version)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-773
Waiver of Right to Appear - Disability Hearing
SSA-773 (revised).pdf
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:
3,050
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
30 %
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
3,050
0
0
3,050
0
0
Annual IC Time Burden (Hours)
153
0
0
153
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Waiver of Right to Appear - Disability Hearing SSA-773 (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.