Information Collection

Application for Widow(er)'s Benefits, 20 CFR 404.335 - 404.338, 404.603

IC 8870 under ICR 200212-0960-011 · OMB 0960-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0004 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Application for Widow(er)'s Benefits, 20 CFR 404.335 - 404.338, 404.603	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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-10-BK				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 288,580	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Previously Approved
Annual Number of Responses for this IC	288,580	288,580
Annual IC Time Burden (Hours)	72,145	72,145
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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