Information Collection Request
Statement of Claimant or Other Person
ICR 202502-0960-016 · OMB 0960-0045 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form SSA-795 Statement of Claimant or Other Person (Paper /in-office interview) |
Form | Modified | Missing upstream |
 Supporting Statement - 0045.docx |
Supporting Statement A | Uploaded 2025-04-17 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 43690 |  Statement of Claimant or Other Person (Paper /in-office interview) |
Form | Modified | |
| 250002 | Statement of Claimant or Other Person (Telephone interviews) |
Other-SSI Claim System Remarks Screen | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | SSA |
| OMB Control No | 0960-0045 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202110-0960-001 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |