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Federal forms, ICRs, and supporting documents

Information Collection

0960-0456 SSA-8011 (Paper Form)

IC 262447 under ICR 202403-0960-007 · OMB 0960-0835.

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

View Information Collection (IC)

0960-0456 SSA-8011 (Paper Form)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1100 20 CFR 416.1102 20 CFR 416.1104 20 CFR 416.1110 20 CFR 416.1120 20 CFR 416.1130-416.1148 20 CFR 416.1160-416.1161 20 CFR 416.1201

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-8011 Statement of Household Expense and Contributions (0960-0456) SSA-8011 (gender inclusive language revisions).pdf www.ssa.gov Yes No Fillable Printable
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 Yes No Fillable Printable

Income Security General Retirement and Disability

 

10,500 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 10,500 0 10,500 0 0 0
Annual IC Time Burden (Hours) 11,550 0 11,550 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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