OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Work Activity Report (Self-Employment) - In Office

IC 261603 under ICR 202504-0960-004 · OMB 0960-0598.

Documents and Forms
Document Name
Document Type
Other-SSA-820-BK (revised)
Other-SSA-820-BK (revised)
Other-Privacy Act Statement (revised
Other-Privacy Act Statement (revised
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Work Activity Report (Self-Employment) - In Office
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1520(b) 20 CFR 404.1571-404.1576 20 CFR 404.1584-404.1593 20 CFR 416.971-416.976

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-SSA-820-BK (revised) SSA-820-BK (revised).pdf No   Paper Only
Other-Privacy Act Statement (revised) 0960-0598 Privacy Act Statement (revised).docx No   Paper Only

Income Security General Retirement and Disability

 

12,144 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 12,144 0 0 0 0 12,144
Annual IC Time Burden (Hours) 23,478 0 0 8,298 0 15,180
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-820-BK (revised) SSA-820-BK (current).pdf 11/20/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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