Information Collection

Statement for Determining Continuing Eligibility, Supplemental Security Income Payment--BK

IC 45419 under ICR 201807-0960-013 · OMB 0960-0145.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0145 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-8202 Statement for Determining Continuing Eligibility, Supplemental Security Income Payment--BK Form
SSA-8202 Statement for Determining Continuing Eligibility Supplem SSA-8202-BK - Revised.pdf Form
SSA-8203 (current).pdf SSA-8202 (current version) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement for Determining Continuing Eligibility, Supplemental Security Income Payment--BK	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 416.204

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-8202	Statement for Determining Continuing Eligibility Supplemental Security Income Payment	SSA-8202-BK - Revised.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,307	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	10,307	10,307
Annual IC Time Burden (Hours)	3,607	3,607
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-8202 (current version)	SSA-8203 (current).pdf	07/24/2018

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