Information Collection

Determining Continuing Eligibility for Supplemental Security Income Payments SSA-8203-BK

IC 178984 under ICR 202209-0960-003 · OMB 0960-0416.

Documents and Forms

Document Name Document Type
Form SSA-8203 Determining Continuing Eligibility for Supplemental Security Income Payments SSA-8203-BK Form
SSA-8203 Statement Determining Continuing Eligibility for Supplem SSA-8203-BK (revised).pdf Form
SSA-8203-BK (current).pdf SSA-8203-BK Current Version IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Determining Continuing Eligibility for Supplemental Security Income Payments Â SSA-8203-BK	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 416.204

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-8203	Statement Determining Continuing Eligibility for Supplemental Security Income Payments	SSA-8203-BK (revised).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: 44,396	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	44,396	-90,961	135,357
Annual IC Time Burden (Hours)	36,997	-8,122	45,119
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-8203-BK Current Version	SSA-8203-BK (current).pdf	09/22/2022

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