OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

0960-0229 - SSA-8000-BK (Paper Version)

IC 265516 under ICR 202402-0960-006 · OMB 0960-0838.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

0960-0229 - SSA-8000-BK (Paper Version)
 
No New
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1102-416.1104 20 CFR 416.1121 20 CFR 416.1130 20 CFR 416.1201(a) 20 CFR 416.202

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-8000-BK Application for Supplemental Security Income SSA-8000-BK - Revised Version.pdf No   Paper Only
Form and Instruction SSA-8000-BK (effective on 9/30/24) Application for Supplemental Security Income Form SSA-8000-BK - Revisions effective 9-30-2024.pdf No   Paper Only

Income Security General Retirement and Disability

 

705 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 705 705 0 0 0 0
Annual IC Time Burden (Hours) 705 705 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-8000-BK SSA-8000-BK - Current Version.pdf 02/21/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.