Information Collection

Reporting Events - SSI

IC 9105 under ICR 201311-0960-007 · OMB 0960-0128.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-8150 Reporting Events - SSI	Form and Instruction
SSA-8150-MSSICS Screens.pdf	Other-Internal Screens
SSA-8150 Reporting Events - SSI SSA-8150 - Revised Version.pdf	Form and Instruction
SSA-8150 - Current Version.pdf Current SSA-8150	IC Document

IC Title:

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 416.701-.732

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
Form and Instruction	SSA-8150	Reporting Events - SSI	SSA-8150 - Revised Version.pdf		No		Paper Only
Other-Internal Screens			SSA-8150-MSSICS Screens.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 36,767

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	36,767	9,447	27,320
Annual IC Time Burden (Hours)	3,064	787	2,277
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-8150	SSA-8150 - Current Version.pdf	02/10/2014

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