OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Statement of Income and Resources

OMB 0960-0124 ยท SSA.

OMB 0960-0124

SSA uses Form SSA-8010-BK to collect income and resources information in Supplemental Security Income (SSI) claims and redeterminations. SSA uses the information to make initial or continuing eligibility determinations for SSI claimants/recipients who are subject to deeming. The respondents are persons whose income and resources SSA considers deemed to applicants or recipients of SSI payments.

The latest form for Statement of Income and Resources expires 2026-10-31 and is listed under ICR 202011-0960-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-8010-BK Statement of Income and ResourcesForm
Form SSA-8010 Statement of Income and Resources (Screens)Form
Form SSA-8010 Statement of Income and ResourcesForm
Supporting Statement - 0960-0124 (final).docxSupporting Statement A
Supporting Statement - 0124.docxSupporting Statement A
0124 Addendum.docxSupplementary Document
0124 Addendum.docx Supplementary Document
Statement of Income and Resources Form
Statement of Income and Resources Form
Statement of Income and Resources Form
Statement of Income and Resources Other-Revised PRA Statement

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202011-0960-002 Revision of a currently approved collection 2020-11-06
201702-0960-003 Revision of a currently approved collection 2017-05-17 Approved without change
201403-0960-009 Revision of a currently approved collection 2014-06-25 Approved without change
201103-0960-012 Revision of a currently approved collection 2011-06-02 Approved without change
200804-0960-004 Extension without change of a currently approved collection 2008-08-12 Approved with change
200506-0960-002 Revision of a currently approved collection 2005-06-28 Approved without change
200304-0960-001 Extension without change of a currently approved collection 2003-04-07 Approved without change
199911-0960-008 Extension without change of a currently approved collection 1999-11-12 Approved without change
199608-0960-001 Extension without change of a currently approved collection 1996-08-06 Approved without change
199606-0960-016 No material or nonsubstantive change to a currently approved collection 1996-06-14 Approved without change
199306-0960-003 Revision of a currently approved collection 1993-06-30 Approved without change
199304-0960-006 No material or nonsubstantive change to a currently approved collection 1993-04-29 Approved with change
199203-0960-003 Revision of a currently approved collection 1992-03-30 Approved without change
198904-0960-022 No material or nonsubstantive change to a currently approved collection 1989-04-13 Approved with change
198902-0960-003 Revision of a currently approved collection 1989-02-03 Approved without change
198601-0960-003 Extension without change of a currently approved collection 1986-01-28 Approved without change
198302-0960-005 Revision of a currently approved collection 1983-02-08 Approved without change
198201-0960-008 Reinstatement with change of a previously approved collection 1982-01-21 Approved without change
198101-0960-006 No material or nonsubstantive change to a currently approved collection 1981-01-24 Approved with change
198004-0960-003 Reinstatement without change of a previously approved collection 1980-04-21 Approved without change
197806-0960-012 Extension without change of a currently approved collection 1978-06-26 Approved without change
197806-0960-011 Extension without change of a currently approved collection 1978-06-26 Approved without change
197803-0960-008 Extension without change of a currently approved collection 1978-03-21 Approved without change