Statement for Determining Continuing Eligibility, Supplemental Security Income Payment--BK & MSSICS Screens

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments, 20 CFR 416.204

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0145 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-8202-BK Statement for Determining Continuing Eligibility, Supplemental Security Income Payment--BK & MSSICS Screens Form
SSA-8202-BK FS Instructions 09-27-06.pdf Instruction
Fact Sheet - English -- FS 8202 BK 01-16-07 FINAL.doc Other-Fact Sheet Food Stamps
Fact Sheet - English -- NFS 8202 BK 01-29-07 FINAL.doc Other-Fact Sheet Non-Food Stamps
8202-BK INST-NFS 02-06-07.pdf Instruction
MISSICS Screens 8202 08-06.pdf Other-MISSIC Collection Screens
SSA-8202-BK Statement for Determining Continuing Eligibility Supplem SSA-8202-BK 01-16-07 FINAL.pdf Form

Information Collection (IC) Details

IC Title:	Statement for Determining Continuing Eligibility, Supplemental Security Income Payment--BK & MSSICS Screens	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.204

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-8202-BK	Statement for Determining Continuing Eligibility Supplemental Security Income Payment	SSA-8202-BK 01-16-07 FINAL.pdf	No		Paper Only
Other-Fact Sheet Food Stamps			Fact Sheet - English -- FS 8202 BK 01-16-07 FINAL.doc	No		Paper Only
Other-Fact Sheet Non-Food Stamps			Fact Sheet - English -- NFS 8202 BK 01-29-07 FINAL.doc	No		Paper Only
Instruction			8202-BK INST-NFS 02-06-07.pdf	No		Paper Only
Other-MISSIC Collection Screens			MISSICS Screens 8202 08-06.pdf	Yes	Yes	Fillable Fileable
Instruction			SSA-8202-BK FS Instructions 09-27-06.pdf	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	300,000	300,000
Annual IC Time Burden (Hours)	105,000	105,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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