Application for Lump-Sum Death Payment - Paper

Application for Lump-Sum Death Payment

OMB: 0960-0013

IC ID: 8890

Information Collection (IC) Details

View Information Collection (IC)

Application for Lump-Sum Death Payment - Paper
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 404.390-404.392

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-8-F4 Application For Lump-Sum Death Payment SSA-8-F4 - Revised (Fillable).pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

8,164 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 8,164 0 0 0 0 8,164
Annual IC Time Burden (Hours) 1,361 0 0 0 0 1,361
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-8-F4 SSA-8-F4 - Current.pdf 06/20/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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