Information Collection

Waiver of Supplemental Security Income Payment Continuation

IC 191692 under ICR 202204-0960-009 · OMB 0960-0783.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0783 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-263 Waiver of Supplemental Security Income Payment Continuation	Form and Instruction
Revised PA & PRA Statements.pdf	Other-Revised PA & PRA Statements
Revised PA & PRA Statements.pdf	Other-Revised PA & PRA Statements
Sample NOPA.pdf	Other-Notice of Planned Action
SSA-263 Waiver of Supplemental Security Income Payment Continuat SSA-263 - Revised.pdf	Form and Instruction
SSA-263 Waiver of Supplemental Security Income Payment Continuat SSA-263 - Revised.pdf	Form and Instruction
SSA-263 - Current.pdf SSA-263 - Current	IC Document
SSA-263 - Current.pdf SSA-263 - Current	IC Document

IC Title:

Waiver of Supplemental Security Income Payment Continuation

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 416.1400 - 416.1422

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-263	Waiver of Supplemental Security Income Payment Continuation	SSA-263 - Revised.pdf	Yes	No	Fillable Printable
Other-Revised PA & PRA Statements			Revised PA & PRA Statements.pdf	Yes	No	Fillable Printable
Other-Notice of Planned Action			Sample NOPA.pdf	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,676

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,676	676	3,000
Annual IC Time Burden (Hours)	3,431	3,181	250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-263 - Current	SSA-263 - Current.pdf	08/25/2022

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