OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Waiver of Supplemental Security Income Payment Continuation

IC 191692 under ICR 201904-0960-005 · OMB 0960-0783.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Revised Privacy Act Statement
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Waiver of Supplemental Security Income Payment Continuation
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1400 - 416.1422

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-263 Waiver of Supplemental Security Income Payment Continuation SSA-263 - Revised Version.pdf Yes No Fillable Printable
Other-Revised Privacy Act Statement SSA-263 - Revised PA Statement.pdf Yes No Printable Only

Income Security General Retirement and Disability

 

3,000 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 3,000 0 0 0 0 3,000
Annual IC Time Burden (Hours) 250 0 0 0 0 250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-263 SSA-263 - Current Version.pdf 08/07/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.