OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Work Activity Report (Self-Employed Person)

IC 9580 under ICR 201904-0960-002 · OMB 0960-0598.

Documents and Forms
Document Name
Document Type
Form
Other-Sample Due Process Notice
Form
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Work Activity Report (Self-Employed Person)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1584-.1593 20 CFR 404.1571-1576 20 CFR 416.971-.976 20 CFR 404.1520(b)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-820-BK Work Activity Report (Self-Employment) SSA-820-BK - Revised Version.pdf www.socialsecurity.gov Yes No Fillable Printable
Other-Sample Due Process Notice Work CDR Sample Notice.pdf No   Paper Only

Income Security General Retirement and Disability

 

100,000 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 100,000 0 0 0 0 100,000
Annual IC Time Burden (Hours) 50,000 0 0 0 0 50,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-820-BK SSA-820-BK - Current Version.pdf 04/05/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.