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Federal forms, ICRs, and supporting documents

Information Collection

0960-0529 SSA-5062 (Paper version)

IC 262455 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)

0960-0529 SSA-5062 (Paper version)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1104 20 CFR 416.1102 20 CFR 416.1100 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-5062 Claimant's Statement About Loan Of Food Or Shelter (0960-0529) SSA 5062 (gender inclusive language revisions).pdf www.ssa.gov Yes No Fillable Printable
Form and Instruction SSA-5062 (to SSA-5064 Effective on 9/30/24) Claimant's Statement About Loan Of Food Or Shelter (0960-0529) Form SSA-5062 change to Form SSA-5064 effective 9-30-2024.pdf www.ssa.gov Yes No Fillable Printable

Income Security General Retirement and Disability

 

14,513 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 14,513 0 14,513 0 0 0
Annual IC Time Burden (Hours) 17,899 0 17,899 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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