Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Beneficiaries

Protection and Advocacy for Beneficiaries of Social Security (PABSS)

Documents and Forms

Document Name Document Type
Form SSA-4570 Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Beneficiaries Form
SSA-4570 Protection and Advocacy for Beneficiaries of Social Secu SSA-4570 -Revised Version.pdf Form
SSA-4570 -Current Version.pdf Current SSA-4570 IC Document

Information Collection (IC) Details

IC Title:	Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Beneficiaries	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 435.51-435.52

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-4570	Protection and Advocacy for Beneficiaries of Social Security (PABSS) Annual Performance Report	SSA-4570 -Revised Version.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,284	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	8,284	8,284
Annual IC Time Burden (Hours)	4,142	4,142
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-4570	SSA-4570 -Current Version.pdf	03/18/2025

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