Information Collection Request

Work Activity Report (Self-Employment)

ICR 202308-0960-003 · OMB 0960-0598 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-820-BK Work Activity Report (Self-Employment) Form Modified Available
Form SSA-820-BK Work Activity Report - Self-Employment (paper form) Form Modified Repair queued
Addendum - 0598.docx Supplementary Document Uploaded 2023-11-21 Repair queued
Supporting Statement - 0598.docx Supporting Statement A Uploaded 2023-11-21 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
9580 Work Activity Report - Self-Employment (paper form) Form ModifiedWork Activity Report (Self-Employment)
9580 Work Activity Report - Self-Employment (paper form) Form Modified
9580 Work Activity Report - Self-Employment (paper form) Other-Work CDR Sample Notice Modified
261605 Work Activity Report - Self-Employment (Telephone) Other-SSA-820-BK (revised) New
261603 Work Activity Report (Self-Employment) - In Office Other-SSA-820-BK (revised) New
261594 Work Activity Report (Self-Employment) SSA-820-APP Other-SSA-82-APP Screen Package (revised) New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2027 36 Months From Approved 07/31/2024
100,000 0 100,000
100,941 0 50,000
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Work Activity Report (Self-Employment) - In Office
Work Activity Report (Self-Employment) SSA-820-APP
Work Activity Report - Self-Employment (Telephone)
Work Activity Report - Self-Employment (paper form) SSA-820-BK

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100,000 100,000 0 0 0 0
Annual Time Burden (Hours) 100,941 50,000 0 0 50,941 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No