Information Collection

Work Activity Report (Self-Employment) SSA-820-APP

IC 261594 under ICR 202308-0960-003 · OMB 0960-0598.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0598 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSA-820-APP Screen Package (revised).pdf	Other-SSA-82-APP Screen Package (rev
SSA-820-APP Screen Package (revised).pdf	Other-SSA-82-APP Screen Package (rev
SSA-820-APP Screens (current).pdf SSA-820-APP Screen (current)	IC Document
SSA-820-APP Screens (current).pdf SSA-820-APP Screen (current)	IC Document

IC Title:

Work Activity Report (Self-Employment) SSA-820-APP

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.1571-404.1576 20 CFR 404.1584-404.1593 20 CFR 416.971-416.976 20 CFR 404.1520(b)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-SSA-82-APP Screen Package (revised)			SSA-820-APP Screen Package (revised).pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,857

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,857	2,857
Annual IC Time Burden (Hours)	2,381	2,381
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-820-APP Screen (current)	SSA-820-APP Screens (current).pdf	11/20/2023

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