Information Collection

Waiver of Supplemental Security Income Payment Continuation

IC 191692 under ICR 202607-0960-005 · OMB 0960-0783.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-263 Waiver of Supplemental Security Income Payment Continuation Waiver of Supplemental Security Income Payment Continuation	Form and Instruction
Form SSA-263 Waiver of Supplemental Security Income Payment Continuation Waiver of Supplemental Security Income Payment Continuation	Form and Instruction
Sample NOPA.pdf	Other-Notice of Planned Action
Revised PA Statement-SSA-263.docx	Other-Revised PA Statement
Revised PA Statement-SSA-263 (Upload Documents-Dynamic Pathing Webform).docx	Other-Revised PA Statement
SSA-263 Waiver of Supplemental Security Income Payment Continuat SSA-263 - Revised.pdf	Form and Instruction
SSA-263 Waiver of Supplemental Security Income Payment Continuat Screen shots from the Upload Documents-0783 - Revised.docx	Form and Instruction
SSA-263-Current.pdf SSA-263 - Current	IC Document
Screen shots from the Upload Documents-0783 - Current.docx Screen shots from the Upload Documents -Current	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 416.1400 - 416.1422

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-263	Yes	No	Fillable Printable
Other-Notice of Planned Action		No		Paper Only
Other-Revised PA Statement		Yes	No	Fillable Printable
Form and Instruction	SSA-263	Yes	Yes	Fillable Fileable Signable
Other-Revised PA Statement		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,662

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	1,662	-2,014	3,676
Annual IC Time Burden (Hours)	1,607	-1,824	3,431
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-263 - Current		07/03/2026
Screen shots from the Upload Documents -Current		07/29/2026

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

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