Response to Notice of Revised Determination

Response to Notice of Revised Determination

OMB: 0960-0347

IC ID: 9225

Documents and Forms

Document Name Document Type
Form SSA-765 Response to Notice of Revised Determination Form
SSA-765 Response to Notice of Revised Determination SSA-765 (revised).pdf Form
SSA-765 - Updated PA Statement.pdf Other-Revised Privacy Act Statement
0347 PRA (revised).docx Other-Paperwork Reduction Act (revised)
SSA-765 (current).pdf Current SSA-765 IC Document