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Information Collection

SSA-10 (Upload Documents)

IC 280625 under ICR 202605-0960-005 · OMB 0960-0004.

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Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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SSA-10 (Upload Documents)
 
No New
 
Voluntary
 
20 CFR 404.335-404.338 20 CFR 404.603

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-10 Application for Widow’s or Widower’s Insurance Benefits SSA 10 (current).pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

1,516 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 1,516 0 0 1,516 0 0
Annual IC Time Burden (Hours) 65,188 0 0 65,188 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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