OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Statement of Living Arrangements, In-Kind Support and Maintenance

OMB 0960-0174 · SSA.

OMB 0960-0174

SSA uses Form SSA-8006-F4 in the administration of the Supplemental Security Income (SSI) program. Recipients' need is the basis for determining SSI payments. Need is measured, in part, by the amount of income an individual receives. Income includes in-kind support and maintenance in the form of food and shelter provided by other persons. Form SSA-8006-F4 collects information to ensure that recipients are eligible to receive SSI payments and to determine the correct amount of payments due. The respondents are individuals who apply for SSI payments, or for SSI eligibility redeterminination.

The latest form for Statement of Living Arrangements, In-Kind Support and Maintenance expires 2027-07-31 and is listed under ICR 202103-0960-003.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-8006-F4 Statement of Living Arrangements, In-Kind Support and MaintenanceForm
Form SSA-8006-F4 Statement of Living Arrangements, In-Kind Support and MaintenanceForm
Addendum 0174.docxSupplementary Document
Addendum 0174.docx Supplementary Document
Supporting Statement 0960-0174.docxSupporting Statement A
Supporting Statement 0960-0174.docxSupporting Statement A
Statement of Living Arrangements, In-Kind Support and Maintenance Form
Statement of Living Arrangements, In-Kind Support and Maintenance Form
Statement of Living Arrangements, In-Kind Support and Maintenance Other-Paperwork Reduction Act Revised
Intranet version (SSI Claims System) Other-SSI claim system screens

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202103-0960-003 Revision of a currently approved collection 2021-04-12 Approved without change
201711-0960-005 Revision of a currently approved collection 2018-02-19 Approved without change
201409-0960-003 Revision of a currently approved collection 2014-12-09 Approved without change
201206-0960-003 No material or nonsubstantive change to a currently approved collection 2012-06-19 Approved without change
201111-0960-019 Revision of a currently approved collection 2012-03-26 Approved without change
200811-0960-007 Revision of a currently approved collection 2009-05-04 Approved without change
200603-0960-013 Revision of a currently approved collection 2006-03-31 Approved without change
200303-0960-003 Extension without change of a currently approved collection 2003-03-06 Approved with change
199911-0960-003 Extension without change of a currently approved collection 1999-11-04 Approved without change
199611-0960-001 Extension without change of a currently approved collection 1996-11-05 Approved without change
199606-0960-015 No material or nonsubstantive change to a currently approved collection 1996-06-14 Approved without change
199310-0960-002 Revision of a currently approved collection 1993-10-05 Approved without change
199008-0960-004 Extension without change of a currently approved collection 1990-08-07 Approved without change
198707-0960-004 Revision of a currently approved collection 1987-07-16 Approved without change
198408-0960-018 Revision of a currently approved collection 1984-08-30 Approved without change
198109-0960-005 Revision of a currently approved collection 1981-09-15 Approved without change
198102-0960-007 No material or nonsubstantive change to a currently approved collection 1981-02-05 Approved with change
198101-0960-007 No material or nonsubstantive change to a currently approved collection 1981-01-24 Approved with change
198009-0960-010 No material or nonsubstantive change to a currently approved collection 1980-09-19 Approved with change
198007-0960-001 Extension without change of a currently approved collection 1980-07-23 Approved without change
197907-0960-001 New collection (Request for a new OMB Control Number) 1979-07-13 Approved without change

OMB Details

Statement of Living Arrangements, In-Kind Support and Maintenance

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Information collection instruments
FormNameElectronic accessType
Form SSA-8006-F4Statement of Living Arrangements, In-Kind Support and MaintenancePaper OnlyForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.