OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Internet-Based Static or Dynamic Webform (through Upload Documents or CPAS)

IC 260288 under ICR 202604-0960-012 · OMB 0960-0830.

Documents and Forms
Document Name
Document Type
Other-Internet Screens
Other-Internet Screens
Other-Revised Privacy Act Statement
Other-Internet Screens
Other-Redesigned Landing Page
Other-Sample Conversational Dynamic
Other-Sample Conversational Dynamic
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Internet-Based Static or Dynamic Webform (through Upload Documents or CPAS)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.704 20 CFR 422.505 20 CFR 404.1512 20 CFR 416.200 20 CFR 416.912

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internet Screens Upload Documents (eSubmit) Screen Package.pdf www.ssa.gov Yes Yes Fillable Fileable Signable
Other-Internet Screens Upload Documents Screen Package - Customer Initiated and Credential Step-Up (Revised Screens - 3-20-25).pdf www.ssa.gov Yes Yes Fillable Fileable Signable
Other-Revised Privacy Act Statement Upload Documents - Revised Privacy Act Statement.pdf www.ssa.gov Yes No Printable Only
Other-Internet Screens Upload Documents IRP - Screen Package.pdf www.ssa.gov (mySocial Security Account) Yes Yes Fillable Fileable Signable
Other-Redesigned Landing Page Conversational Landing page sceens.pdf www.ssa.gov (Upload Documents) Yes Yes Fillable Fileable Signable
Other-Sample Conversational Dynamic Pathing Sample Conversational - Updated Screens (SSA-455).pdf www.ssa.gov (Upload Documents) Yes Yes Fillable Fileable Signable
Other-Sample Conversational Dynamic Pathing Sample Conversational - Updated Screens (SSA-821).pdf www.ssa.gov (Upload Documents) Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

115,369 0
   
Individuals or Households
 
   100 %

  Requested 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 115,369 0 0 0 0 115,369
Annual IC Time Burden (Hours) 365,335 0 0 0 0 365,335
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Previous Dynamic Pathing Screen (Sample) Current Sample Dynamic Forms Screen Package (SSA-4162).pdf 04/28/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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