Forms Catalog Document - SSA765 :-: SSA :-: Response to Notice of Revised Determination

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Response to Notice of Revised Determination

Response to Notice of Revised Determination - Form-765 is used by claimants or their representative to request a disability hearing and/or to submit additional information before a revised reconsideration determination is issued. When a disability hearing is requested, the Disability Hearing Units will use this form to schedule the hearing, to ensure that an interpreter is present when needed and to ensure that notices regarding the time and place of the hearing are sent to the claimant/representative.

Form #: SSA 765
Agency: Social Security Administration

	TYPE	PAGES	SIZE (KB)	CAPABILITY	WHAT'S NEEDED
	Form Only	2		[1] Paper Only	Other Client Software

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