Information Collection

SSA-8510 – Title II and Title XVI general evidence (paper version)

IC 216303 under ICR 202606-0960-007 · OMB 0960-0801.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-8510 Authorization for the Social Security Administration to Obtain Personal Information SSA-8510 – Title II and Title XVI general evidence (paper version)	Form
Privacy Act Statement 0801 (revised).docx	Other-Privacy Act Statement (revised
SSA-8510 Authorization for the Social Security Administration to SSA-8510 (revised).pdf	Form
SSA-8510 (current).pdf SSA-8510 - Current	IC Document

IC Title:

SSA-8510 â Title II and Title XVI general evidence (paper version)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.704 20 CFR 404.1926 20 CFR 404.820 - 404.823 20 CFR 416.203 20 CFR 418.3001

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	SSA-8510				Yes	Yes	Fillable Printable
Other-Privacy Act Statement (revised)					No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,522

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	20,522	12,296	8,226
Annual IC Time Burden (Hours)	20,522	19,836	686
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-8510 - Current		07/31/2026

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

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