Information Collection

Application for Lump-Sum Death Payment - Paper & Upload Documents Version

IC 8890 under ICR 202603-0960-003 · OMB 0960-0013.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-8 Application For Lump-Sum Death Payment Application for Lump-Sum Death Payment - Paper & Upload Documents Version	Form and Instruction
SSA-8 - Revised Privacy Act Statement.pdf	Other-Revised PA Statement
SSA-8 Application For Lump-Sum Death Payment SSA-8 - Revised Version.pdf www.ssa.gov (Upload Documents)	Form and Instruction
SSA-8 - Current Version.pdf SSA-8 - Current Version	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 404.390-404.392

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-8			www.ssa.gov (Upload Documents)	Yes	No	Fillable Printable
Other-Revised PA Statement					Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,829

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,829	1,082	5,747
Annual IC Time Burden (Hours)	2,618	1,660	958
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-8 - Current Version		06/22/2026

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

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