Information Collection Request

Social Security Benefits Application

ICR 200805-0960-018 · OMB 0960-0618 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-16 Paper Form SSA-16 (Application for Disability Insurance Benefits ) Form and Instruction Modified Repair queued
Form SSA-2 Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits) Form and Instruction Modified Available
Form SSA-1 Paper Form SSA-1 (Application for Retirement Insurance Benefits) Form Modified Available
0960-0618 addendum.doc Supplementary Document Uploaded 2008-05-23 Available
0960-0618 supporting statement.doc Supporting Statement A Uploaded 2008-05-23 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
9628 1st Party Internet Social Security Benefits Application (ISBA) Other-ISBA Screens - 1st party respondents Modified
184984 Notices to Beneficiaries who Have Third Parties Applying for them Via ISBA Other-Notices to Beneficiaries with 3rd-party IBSA completion New
184982 3rd Party Internet Social Security Benefits Application (ISBA) Other-ISBA screens -- for 3rd parties New
179349 Paper Form SSA-16 (Application for Disability Insurance Benefits ) Form and Instruction Modified
179348 SSA-16 MCS Signature Proxy Other-MCS/Signature Proxy Modified
179347 SSA-16 MCS Screens Other-MCS Screens Modified
179344 Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits) Form and Instruction Modified
179343 SSA-2 MCS Signature Proxy Other-MCS Signature Proxy Screens Modified
179341 SSA-2 MCS Screens Other-MCS Screens Modified
179340 Paper Form SSA-1 (Application for Retirement Insurance Benefits) Form Modified
179338 SSA-1 MCS Signature Proxy Other-MCS/Signature Proxy Modified
179334 SSA-1 MCS Screens Other-MCS Screens Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2011 36 Months From Approved 08/31/2010
4,924,218 0 3,843,369
1,230,239 0 963,056
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,924,218 3,843,369 0 429,087 651,762 0
Annual Time Burden (Hours) 1,230,239 963,056 0 -5,837 273,020 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No