Information Collection Request

Work Activity Report (Self-Employment)

ICR 202504-0960-004 · OMB 0960-0598 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-820-BK Work Activity Report (Self-Employment) Form Modified Available
Form SSA-820-BK Work Activity Report - Self-Employment (returned via mail) Form Modified Repair queued
Justification for the Non-Substantive Changes - 0598.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-01-08 Available
Justification for the Non-Substantive Changes - 0598.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-01-08 Repair queued
Addendum - 0960-0598 (final).docx Supplementary Document Uploaded 2024-07-19 Available
Addendum - 0960-0598 (final).docx Supplementary Document Uploaded 2024-07-19 Missing upstream
Supporting Statement -0960- 0598 (final).docx Supporting Statement A Uploaded 2024-07-19 Available
Supporting Statement -0960- 0598 (final).docx Supporting Statement A Uploaded 2024-07-19 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
9580 Work Activity Report - Self-Employment (returned via mail) Form ModifiedWork Activity Report (Self-Employment)
9580 Work Activity Report - Self-Employment (returned via mail) Form Modified
261605 Work Activity Report - Self-Employment (Telephone) Other-SSA-820-BK (revised) Modified
261603 Work Activity Report (Self-Employment) - In Office Other-SSA-820-BK (revised) Modified
261594 Work Activity Report (Self-Employment) - Submittable PDF Version via Upload Documents Other-Submited through the Upload Documents Portal Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2027 07/31/2027 07/31/2027
100,000 0 100,000
159,405 0 100,941
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Work Activity Report (Self-Employment) - In Office
Work Activity Report (Self-Employment) - Submittable PDF Version via Upload Documents
Work Activity Report - Self-Employment (Telephone)
Work Activity Report - Self-Employment (returned via mail) SSA-820-BK

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100,000 100,000 0 0 0 0
Annual Time Burden (Hours) 159,405 100,941 0 0 58,464 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No