Information Collection Request

Application for Parent's Insurance Benefits

ICR 202609-0960-012 · OMB 0960-0012 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-7-F6 Application for Parent's Insurance Benefits Form Modified Repair queued
Form SSA-7-F6 Application for Parent's Insurance Benefits Form Modified Available
Form SSA-7-F6 Application for Parent’s Insurance Benefits Form and Instruction New Repair queued
Form SSA-7-F6 Application for Parent’s Insurance Benefits Form and Instruction New Available
Supporting Statement - 0012 (Final).docx Supporting Statement A Uploaded 2026-09-29 Repair queued
Supporting Statement - 0012 (Final).docx Supporting Statement A Uploaded 2026-09-29 Available
Addendum - 0012 (Final).docx Supplementary Document Uploaded 2026-09-29 Repair queued
Addendum - 0012 (Final).docx Supplementary Document Uploaded 2026-09-29 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8887 Application for Parent's Insurance Benefits - Paper SSA-7-F6 (mailed in) Form ModifiedApplication for Parent's Insurance Benefits
8887 Application for Parent's Insurance Benefits - Paper SSA-7-F6 (mailed in) Other-Revised Privacy Act Statement Modified
8887 Application for Parent's Insurance Benefits - Paper SSA-7-F6 (mailed in) Form ModifiedApplication for Parent's Insurance Benefits
282664 Application for Parent's Insurance Benefits - MCS SSA-7-F6 (Personal Interview) Other-Internal Screens New
282663 Application for Parent's Insurance Benefits - Paper SSA-7-F6 (Upload Documents) Form and Instruction NewApplication for Parent’s Insurance Benefits
282663 Application for Parent's Insurance Benefits - Paper SSA-7-F6 (Upload Documents) Other-Revised Privacy Act Statement New
282663 Application for Parent's Insurance Benefits - Paper SSA-7-F6 (Upload Documents) Form and Instruction NewApplication for Parent’s Insurance Benefits

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
422 0 329
609 0 82
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Application for Parent's Insurance Benefits - MCS SSA-7-F6 (Personal Interview)
Application for Parent's Insurance Benefits - Paper SSA-7-F6 (Upload Documents) SSA-7-F6
Application for Parent's Insurance Benefits - Paper SSA-7-F6 (mailed in) SSA-7-F6

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 422 329 0 0 93 0
Annual Time Burden (Hours) 609 82 0 0 527 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No