View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

HA-4633 - Electronic Records Express Submissions
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1520(a)(4) 20 CFR 404.1512(a) 20 CFR 416.965(b) 20 CFR 404.1565(b) 20 CFR 416.912(a) 20 CFR 416.920(a)(4)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction HA-4633 www.ssa.gov (mySocial Security Account - Representative Payees) Yes Yes Fillable Fileable Signable
Other-Internet Screens www.ssa.gov (ERE) Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

236,550 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 236,550 0 0 78,850 0 157,700
Annual IC Time Burden (Hours) 78,850 0 0 0 0 78,850
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current HA-4633 03/11/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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