Information Collection

iClaim Applicant After 3rd Party Completion

IC 184984 under ICR 202101-0960-004 · OMB 0960-0618.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0618 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
New Notices to Beneficiaries for 3rd-party iClaim Completion.doc	Other-Notices to Beneficiaries with
New Notices to Beneficiaries for 3rd-party iClaim Completion.doc	Other-Notices to Beneficiaries with
iClaim-Authentication Screens - Revised Screens (Only).pdf www.ssa.gov	Other-Revised iClaim Screens - TOS
iClaim-Authentication Screens - Revised Screens (Only).pdf www.ssa.gov	Other-Revised iClaim Screens - TOS
iClaim iSSI Screen Package for Revising the SSI Protective Filing Language.pdf www.ssa.gov	Other-Revised "Additional Informatio
iClaim iSSI Screen Package for Revising the SSI Protective Filing Language.pdf www.ssa.gov	Other-Revised "Additional Informatio

IC Title:

iClaim Applicant After 3rd Party Completion

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 404.601-.603 20 CFR 404.1501-.1512 20 CFR 404.310-.311 20 CFR 404.315-.322 20 CFR 404.330-.333

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Revised "Additional Information" iClaim Screen			iClaim iSSI Screen Package for Revising the SSI Protective Filing Language.pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350,519

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	350,519	350,519
Annual IC Time Burden (Hours)	29,210	29,210
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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