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Paper Form SSA-1 (Application for Retirement Insurance Benefits)

IC 179340 under ICR 202502-0960-015 · OMB 0960-0618.

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Paper Form SSA-1 (Application for Retirement Insurance Benefits)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.310-404.311 20 CFR 404.315-404.322 20 CFR 404.330-404.333 20 CFR 404.601-404.603 20 CFR 404.1501-404.1512

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-1 Application for Retirement Insurance Benefits SSA-1 (Revised Version).pdf www.ssa.gov (Upload Documents) No   Fillable Fileable Signable

Income Security General Retirement and Disability

 

17,604 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 17,604 0 0 15,258 0 2,346
Annual IC Time Burden (Hours) 14,670 0 0 13,067 0 1,603
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current Version of the SSA-1 SSA-1 (Current Version).pdf 03/17/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.