Information Collection

Statement for Determining Continuing Entitlement for Special Veternans Benefits (SVB)

IC 189024 under ICR 202509-0960-001 · OMB 0960-0782.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-2010 Statement for Determining Continuing Entitlement for Special Veternans Benefits (SVB)	Form
Form SSA-2010 Questionnaire About Special Veterans Benefits Statement for Determining Continuing Entitlement for Special Veternans Benefits (SVB)	Form
Sample letter.pdf	Other-Cover Letter
Sample letter.pdf	Other-Cover Letter
0960-0782 Privacy Act Statement (revised).docx	Other-Privacy Act Statement revised
0960-0782 Privacy Act Statement (revised).docx	Other-Privacy Act Statement revised
Sample Follow-Up Letter.pdf	Other-Follow-up Letter
Sample Follow-Up Letter.pdf	Other-Follow-up Letter
SSA-2010 Questionnaire About Special Veterans Benefits SSA-2010 (revised).pdf	Form
SSA-2010 Questionnaire About Special Veterans Benefits SSA-2010 (revised).pdf	Form
SSA-2010 (current).pdf SSA-2010-F6 - Current	IC Document
SSA-2010 (current).pdf SSA-2010-F6 - Current	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 408.712

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-2010	Yes	No	Paper Only
Other-Cover Letter		No		Paper Only
Other-Privacy Act Statement revised		Yes	No	Paper Only
Other-Follow-up Letter		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 27

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	27	-58	85
Annual IC Time Burden (Hours)	23	-32	55
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-2010-F6 - Current		12/17/2025

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

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