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Federal forms, ICRs, and supporting documents

Information Collection

Work Activity Report - Self-Employment (returned via mail)

IC 9580 under ICR 202504-0960-004 · OMB 0960-0598.

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Work Activity Report - Self-Employment (returned via mail)
 
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
Form SSA-820-BK Work Activity Report (Self-Employment) SSA-820-BK - DRAFT (Revised Version).pdf www.socialsecurity.gov Yes No Fillable Printable

Income Security General Retirement and Disability

 

49,895 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 49,895 0 0 1,324 0 48,571
Annual IC Time Burden (Hours) 62,369 0 0 17,846 0 44,523
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-820-BK - Current Version SSA-820-BK (Current Version).pdf 01/08/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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