OMB control number
Statement of Self-Employment Income
OMB 0960-0046 ยท SSA.
OMB 0960-0046
To qualify for insured status, and collect Social Security benefits, self employed individuals must demonstrate they earned the minimum amount of self employment income (SEI) in a current year. SSA uses Form SSA-766, Statement of Self-Employment Income, to collect the information we need to determine if the individual earned at least the minimum amount of SEI needed for one or more quarters of coverage in the current year. Based on the information we obtain, we may credit additional quarters of coverage to give the individual insured status, expediting benefit payments. Respondents are self-employed individuals potentially eligible for Social Security benefits. We are submitting this non-substantive change request to remove the signature requirement and update the Paperwork Reduction Act language.
The latest form for Statement of Self-Employment Income expires 2026-11-30 and is listed under ICR 202411-0960-014.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form SSA-766 Statement of Self-Employment Income | Form |
| Form SSA-766 Statement of Self-Employment Income | Form |
 Justification for the Non-Substantive Changes.docx | Justification for No Material/Nonsubstantive Change |
| Justification for the Non-Substantive Changes.docx | Justification for No Material/Nonsubstantive Change |
| Supporting Statement - 0046 (Final).docx | Supporting Statement A |
| Supporting Statement - 0046 (Final).docx | Supporting Statement A |
 Statement of Self-Employment Income |
Form |
| Statement of Self-Employment Income |
Form |
| Statement of Self-Employment Income |
Other-Revised Paperwork Reduction Act |