0960-0618 - SSA-16 Internet Screens Third Party (iClaim)

Supplemental Security Income Simplification Process Phase I (iSSI)

Documents and Forms

Document Name Document Type
SSA-16 iClaim 3rd Party Screens (Revised).pdf www.ssa.gov Other-Internet Screens
iClaim Screen Package (Current full Screens).pdf www.ssa.gov Other-Internet Screens
iClaim Screens Package (Current updated screens - last OMB approval).pdf www.ssa.gov Other-Internet Screens

Information Collection (IC) Details

IC Title:	0960-0618 - SSA-16 Internet Screens Third Party (iClaim)	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 416.210 20 CFR 416.301 20 CFR 416.360, Subpart C 20 CFR 404.601-404.603 20 CFR 416.207

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens	SSA-16 iClaim 3rd Party Screens (Revised).pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	iClaim Screen Package (Current full Screens).pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	iClaim Screens Package (Current updated screens - last OMB approval).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: 561,014	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	561,014	561,014
Annual IC Time Burden (Hours)	224,406	224,406
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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