0960-0456 SSA-8011 (Paper Form)

Expand the Definition of a Public Assistance Household (Final Rule) - RIN 0960-AI81

Documents and Forms

Document Name Document Type
Form SSA-8011 0960-0456 SSA-8011 (Paper Form) Form and Instruction
SSA-8011 Statement of Household Expense and Contributions (0960-0456) SSA-8011 (gender inclusive language revisions).pdf www.ssa.gov Form and Instruction
SSA-8011 (to Form SSA-8012 effective on 9/30/24) Statement of Household Expense and Contributions (0960-0456) Form SSA-8011 changes to Form SSA-8012 effective 9-30-2024).pdf www.ssa.gov Form and Instruction

Information Collection (IC) Details