Information Collection

1st Party Internet Social Security Benefits Application (iClaim)

IC 9628 under ICR 201105-0960-009 · OMB 0960-0618.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0618 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Basic29_Screen Package English iClaim Updated 05202011.docx htttp://www.socialsecurity.gov	Other-Revised iClaim screens
Screen Package English iClaim AllElse 05202011.docx	Other-revised screens
FY 2010 OMB-Approved iClaim Screen Package.pdf Currently Approved iClaim Screens	IC Document

IC Title:

1st Party Internet Social Security Benefits Application (iClaim)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.330-.333 20 CFR 404.1501-.1512 20 CFR 404.601-.603 20 CFR 404.310-.311 20 CFR 404.315-.322

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Revised iClaim screens			Basic29_Screen Package English iClaim Updated 05202011.docx	htttp://www.socialsecurity.gov	Yes	Yes	Fillable Fileable Signable
Other-revised screens			Screen Package English iClaim AllElse 05202011.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 541,851

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	541,851	541,851
Annual IC Time Burden (Hours)	135,463	135,463
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Currently Approved iClaim Screens	FY 2010 OMB-Approved iClaim Screen Package.pdf	08/12/2010

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