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Federal forms, ICRs, and supporting documents

Information Collection

Statement of Living Arrangements, In-Kind Support and Maintenance

IC 9146 under ICR 202103-0960-003 · OMB 0960-0174.

Documents and Forms
Document Name
Document Type
Form
Form
Other-Paperwork Reduction Act Revise
Other-Paperwork Reduction Act Revise
Other-Privacy Act Statement revised
Other-Privacy Act Statement revised
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Statement of Living Arrangements, In-Kind Support and Maintenance
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1130-416.1148

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-8006-F4 Statement of Living Arrangements, In-Kind Support and Maintenance SSA-8006-F4 (revised).pdf No   Paper Only
Other-Paperwork Reduction Act Revised 0174 PRA.doc No   Paper Only
Other-Privacy Act Statement revised 0174 Privacy Act Statement (revised).docx No   Paper Only

Income Security General Retirement and Disability

 

12,160 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 12,160 0 0 -161,220 0 173,380
Annual IC Time Burden (Hours) 7,499 0 0 -12,729 0 20,228
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-8006-F4 (current) SSA-8006-F4 (current).pdf 03/12/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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