OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Supplemental Security Income Claim Information Notice

OMB 0960-0324 · SSA.

OMB 0960-0324

SSA uses Form SSA-–L8050-–U3 to collect information on whether an SSI recipient is using all sources of potential income (annuities, pensions, disability benefits, veteran's compensation, etc.) for their own support. SSI supplements other income an individual has available. SSA mails Form SSA-L8050-U3 to applicants or recipients when they apply for benefits. Respondents are SSI applicants or recipients who may be eligible for benefits from other public or private programs.

The latest form for Supplemental Security Income Claim Information Notice expires 2027-04-30 and is listed under ICR 202010-0960-010.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-L8050-U3 Supplemental Securrity Income Claim Information NoticeForm
Form SSA-L8050-U3 Supplemental Security Income Claim Information NoticeForm
Addendum - 0324.docxSupplementary Document
Addendum - 0324.docx Supplementary Document
Supporting Statement - 0324.docxSupporting Statement A
Supporting Statement - 0324.docxSupporting Statement A
Supplemental Security Income Claim Information Notice Form
Supplemental Security Income Claim Information Notice Form
Supplemental Security Income Claim Information Notice Other-Revised PA Statement

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202010-0960-010 Revision of a currently approved collection 2021-01-28 Approved without change
201708-0960-005 Revision of a currently approved collection 2017-12-28 Approved without change
201409-0960-012 Extension without change of a currently approved collection 2014-12-17 Approved without change
201110-0960-008 Revision of a currently approved collection 2012-02-02 Approved without change
200902-0960-004 Revision of a currently approved collection 2009-04-20 Approved without change
200602-0960-013 Extension without change of a currently approved collection 2006-02-28 Approved without change
200301-0960-001 Extension without change of a currently approved collection 2003-01-03 Approved without change
199911-0960-009 Extension without change of a currently approved collection 1999-11-24 Approved without change
199612-0960-002 Extension without change of a currently approved collection 1996-12-04 Approved without change
199606-0960-014 No material or nonsubstantive change to a currently approved collection 1996-06-14 Approved without change
199311-0960-004 Reinstatement with change of a previously approved collection 1993-11-04 Approved without change
199008-0960-005 Extension without change of a currently approved collection 1990-08-07 Approved without change
198707-0960-006 Extension without change of a currently approved collection 1987-07-31 Approved without change
198410-0960-010 Extension without change of a currently approved collection 1984-10-24 Approved without change
198212-0960-002 New collection (Request for a new OMB Control Number) 1982-12-03 Approved without change