Information Collection

Internet Social Security Benefits Application (iClaim) - Third Party (SSA-1)

IC 184982 under ICR 202502-0960-015 · OMB 0960-0618.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
iClaim Screen- Apply for Benefits.pdf	Other-Internet Screens
iClaim Screen- Apply for Benefits.pdf	Other-Internet Screens
iClaim Screen - Other Pensions and Annuities.pdf	Other-Revised
iClaim Screen - Other Pensions and Annuities.pdf	Other-Revised
iClaim Screen Package (current).pdf Current iClaim Screens	IC Document
iClaim Screen Package (current).pdf Current iClaim Screens	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 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

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
Other-Internet Screens				www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Revised				www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 81,810

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	81,810	56,104	25,706
Annual IC Time Burden (Hours)	32,724	26,297	6,427
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current iClaim Screens		03/17/2025

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

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