OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Work Activity Report (Self-Employed Person)

IC 9580 under ICR 202108-0960-004 · OMB 0960-0598.

Documents and Forms
Document Name
Document Type
Form
Other-Work CDR Sample Notice
Other-Work CDR Sample Notice
Form
Form
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
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 416.971-.976 20 CFR 404.1584-.1593 20 CFR 404.1520(b) 20 CFR 404.1571-1576

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.pdf www.socialsecurity.gov Yes No Fillable Printable
Other-Work CDR Sample Notice Work CDR Sample Notice.pdf No   Paper Only
Form and Instruction SSA-820-APP (submittable PDF) Work Activity Report (Self-Employment) SSA-820-APP Screen Package - Revised Version.pdf Yes Yes Fillable Fileable Signable

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-APP (submittable PDF) SSA-820-APP Screen Package - Current Version.pdf 08/10/2021
Current SSA-820-APP (submittable PDF) SSA-820-APP Screen Package - Current Version.pdf 08/10/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.