Application for Supplemental Security Income--Paper Version

Application for Supplemental Security Income (SSI)

OMB: 0960-0229

IC ID: 44924

Information Collection (IC) Details

View Information Collection (IC)

Application for Supplemental Security Income--Paper Version
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.207 20 CFR 416.305-.335

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-8000-BK Application for Supplemental Security Income (Revised) SSA-8000-BK (revised).pdf No   Paper Only

Income Security General Retirement and Disability

 

17,541 0
   
Individuals or Households
 
   0 %

  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 17,541 0 0 -21,754 0 39,295
Annual IC Time Burden (Hours) 11,986 0 0 -14,866 0 26,852
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-8000-BK SSA-8000-BK current.pdf 05/25/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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