Information Collection Request

Application for Supplemental Security Income

ICR 202605-0960-008 · OMB 0960-0444 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-8001-BK (Child Application for Supplemental Security Income For Children (under age 18) Form Modified Repair queued
Form SSA-8001-BK (Child Application for Supplemental Security Income For Children (under age 18) Form Modified Available
Form SSA-8001-BK (Adult Application For Supplemental Security Income for Adult Claimants (ages 18 - 64) Form Modified Repair queued
Form SSA-8001-BK (Adult Application For Supplemental Security Income for Adult Claimants (ages 18 - 64) Form Modified Available
4-22-23 - Community Legal Services of Philadelphia (advocacy organization).pdf Public Comments Uploaded 2026-04-22 Available
Addendum - 0444 (Final).docx Supplementary Document Uploaded 2026-05-28 Repair queued
Addendum - 0444 (Final).docx Supplementary Document Uploaded 2026-05-28 Available
Supporting Statement - 0444 (Final).docx Supporting Statement A Uploaded 2026-05-28 Repair queued
Supporting Statement - 0444 (Final).docx Supporting Statement A Uploaded 2026-05-28 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
224688 iSSI/iClaim - Internet Claim System Other-iSSI First Party Screen Modified
188727 Application for Supplemental Security Income - Paper SSA-8001 Form ModifiedApplication for Supplemental Security Income For Children (under age 18)
188727 Application for Supplemental Security Income - Paper SSA-8001 Form ModifiedApplication for Supplemental Security Income For Children (under age 18)
188727 Application for Supplemental Security Income - Paper SSA-8001 Form ModifiedApplication For Supplemental Security Income for Adult Claimants (ages 18 - 64)
188727 Application for Supplemental Security Income - Paper SSA-8001 Form ModifiedApplication For Supplemental Security Income for Adult Claimants (ages 18 - 64)
188726 Application for Supplemental Security Income - CCE or SSI Claims System Other-SSI Claims System Screens Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2029 36 Months From Approved 10/31/2026
1,135,549 0 962,475
1,436,961 0 1,138,929
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Application for Supplemental Security Income - CCE or SSI Claims System
Application for Supplemental Security Income - Paper SSA-8001 SSA-8001-BK (Adults), SSA-8001-BK (Children) ,  
iSSI/iClaim - Internet Claim System

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,135,549 962,475 0 0 173,074 0
Annual Time Burden (Hours) 1,436,961 1,138,929 0 0 298,032 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No