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1st Party Internet Social Security Benefits Application (iClaim) - Domestic Applicants
Social Security Benefits Application
OMB: 0960-0618
IC ID: 9628
OMB.report
SSA
OMB 0960-0618
ICR 201603-0960-006
IC 9628
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0618 can be found here:
2022-08-25 - No material or nonsubstantive change to a currently approved collection
2021-03-24 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
iClaim - Revised Screens.pdf
secure.ssa.gov/iCLM/rib
Other-Internet Screens
Revised iClaim PA Statments Screen.pdf
www.socialsecurity.gov
Other-Internet Screen
iClaim - Current Screens.pdf
Current iClaim Screens
IC Document
Current iClaim PA Statments Screen.pdf
Current iClaim Privacy Act Statements
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
1st Party Internet Social Security Benefits Application (iClaim) - Domestic Applicants
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 404.310-.311
20 CFR 404.330-.333
20 CFR 404.1501-.1512
20 CFR 404.315-.322
20 CFR 404.601-.603
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Internet Screens
iClaim - Revised Screens.pdf
https://secure.ssa.gov/iCLM/rib
Yes
Yes
Fillable Fileable Signable
Other-Internet Screen
Revised iClaim PA Statments Screen.pdf
http://www.socialsecurity.gov
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,838,943
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,838,943
0
0
0
0
1,838,943
Annual IC Time Burden (Hours)
459,736
0
0
0
0
459,736
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Current iClaim Screens
iClaim - Current Screens.pdf
08/06/2013
Current iClaim Privacy Act Statements
Current iClaim PA Statments Screen.pdf
08/06/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.