Internet Social Security Benefits Application (iClaim) - Domestic Applicants First Party (SSA-1)

Social Security Benefits Application

Documents and Forms

Document Name Document Type
iClaim Screen Package - 2020 Update.pdf www.ssa.gov Other-Internet Screens
iClaim Screen Package - 2020 Update.pdf www.ssa.gov Other-Internet Screens
iClaim Screen Package - Current Screens.pdf Current iClaim Screens IC Document
iClaim Screen Package - Current Screens.pdf Current iClaim Screens IC Document

Information Collection (IC) Details

IC Title:	Internet Social Security Benefits Application (iClaim) - Domestic Applicants First Party (SSA-1)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens			iClaim Screen Package - 2020 Update.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: 1,470,043	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,470,043	1,470,043
Annual IC Time Burden (Hours)	367,511	367,511
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current iClaim Screens	iClaim Screen Package - Current Screens.pdf	03/23/2021

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