Information Collection

0960-0229 - SSA-8000 Internet SSI (iSSI) Screens

IC 270164 under ICR 202309-0960-004 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSA Journey screens.pdf www.ssa.gov	Instruction
Internet SSI screen package - First Party (Revised).pdf www.ssa.gov	Other-Internet Screens
Internet SSI screen package - Third Party (Revised).pdf www.ssa.gov	Other-Internet Screens

IC Title:

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 404.601-404.603 20 CFR 416.207 20 CFR 416.210 20 CFR 416.301 20 CFR 416.360, Subpart C

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	SSA Journey screens.pdf	www.ssa.gov	Yes	Yes	Printable Only
Other-Internet Screens	Internet SSI screen package - First Party (Revised).pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	Internet SSI screen package - Third Party (Revised).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: 1,080

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,080	1,080
Annual IC Time Burden (Hours)	864	864
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.