Information Collection

Internet Social Security Benefits Application (iClaim) - Domestic Applicants Third Party (SSA-16)

IC 246413 under ICR 202411-0960-002 · OMB 0960-0618.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0618 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
iClaim Screens Package 2022 update (revised).pdf www.ssa.gov	Other-Internet Screens
iClaim Screen Package (current).pdf Current iClaim Screens	IC Document
iClaim Screen Package (current).pdf Current iClaim Screens	IC Document

IC Title:

Internet Social Security Benefits Application (iClaim) - Domestic Applicants Third Party (SSA-16)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.310-.311 20 CFR 404.1501-.1512 20 CFR 404.315-.322 20 CFR 404.330-.333 20 CFR 404.601-.603

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 528,474

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	528,474	528,474
Annual IC Time Burden (Hours)	132,119	132,119
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current iClaim Screens		08/09/2022

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

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