Statement of Living Arrangements, In-Kind Support and Maintenance

Statement of Living Arrangements, In-Kind Support and Maintenance

OMB: 0960-0174

IC ID: 9146

Information Collection (IC) Details

View Information Collection (IC)

Statement of Living Arrangements, In-Kind Support and Maintenance
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1130-416.1148

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-8006-F4 Statement of Living Arrangements, In-Kind Support and Maintenance SSA-8006-F4 (revised).pdf No   Paper Only
Other-null SSI claim system pages.pdf Yes Yes Fillable Printable
Other-Paperwork Reduction Act Revised 0174 PRA.doc No   Paper Only
Other-Privacy Act Statement revised Privacy Act Statement 0174 revised.doc No   Paper Only

Income Security General Retirement and Disability

 

173,380 0
   
Individuals or Households
 
   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 173,380 0 0 0 0 173,380
Annual IC Time Burden (Hours) 20,228 0 0 0 0 20,228
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-8006-F4 (current) SSA-8006-F4 (current).pdf 11/28/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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