OMB control number

Application for Supplemental Security Income

OMB 0960-0444 · SSA.

OMB 0960-0444

SSA uses Form SSA-8001-BK to determine an applicant’s eligibility for SSI and SSI payment amounts. SSA employees also collect this information during interviews with members of the public who wish to file for SSI. SSA uses the information for two purposes: (1) to formally deny SSI for nonmedical reasons when information the applicant provides results in ineligibility; or (2) to establish a disability claim, but defer the complete development of non-medical issues until SSA approves the disability. The respondents are applicants for SSI payments.

The latest form for Application for Supplemental Security Income expires 2026-07-31 and is listed under ICR 202203-0960-008.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form SSA-8001-BK (Child Application for Supplemental Security Income For Children (under age 18)	Form
Form SSA-8001-BK (Adult Application For Supplemental Security Income for Adult Claimants (ages 18 - 64)	Form
4-22-23 - Community Legal Services of Philadelphia (advocacy organization).pdf	Public Comments
Addendum - 0444 (Final).docx	Supplementary Document
Supporting Statement - 0444 (Final).docx	Supporting Statement A
iSSI/iClaim - Internet Claim System	Other-iSSI First Party Screen
Application for Supplemental Security Income - Paper SSA-8001	Form
Application for Supplemental Security Income - Paper SSA-8001	Form
Application for Supplemental Security Income - CCE or SSI Claims System	Other-SSI Claims System Screens

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202605-0960-008	Revision of a currently approved collection	2026-05-28
202203-0960-008	Revision of a currently approved collection	2022-06-07	Approved without change
201908-0960-005	No material or nonsubstantive change to a currently approved collection	2019-09-04	Approved without change
201907-0960-002	No material or nonsubstantive change to a currently approved collection	2019-07-09	Approved without change
201809-0960-008	Revision of a currently approved collection	2019-02-20	Approved without change
201703-0960-016	No material or nonsubstantive change to a currently approved collection	2017-03-27	Approved without change
201604-0960-008	Revision of a currently approved collection	2016-12-02	Approved without change
201503-0960-005	Extension without change of a currently approved collection	2015-05-28	Approved without change
201112-0960-002	Revision of a currently approved collection	2012-05-02	Approved without change
200909-0960-004	No material or nonsubstantive change to a currently approved collection	2009-09-17	Approved without change
200907-0960-001	No material or nonsubstantive change to a currently approved collection	2009-07-01	Approved without change
200904-0960-004	Revision of a currently approved collection	2009-04-14	Approved without change
200902-0960-018	No material or nonsubstantive change to a currently approved collection	2009-02-19	Approved without change
200805-0960-013	No material or nonsubstantive change to a currently approved collection	2008-05-19	Approved without change
200705-0960-023	No material or nonsubstantive change to a currently approved collection	2007-06-07	Approved without change
200602-0960-003	Revision of a currently approved collection	2006-02-01	Approved with change
200212-0960-003	Revision of a currently approved collection	2002-12-18	Approved with change
199909-0960-025	No material or nonsubstantive change to a currently approved collection	1999-09-16	Approved without change
199909-0960-007	Extension without change of a currently approved collection	1999-09-17	Approved without change
199610-0960-004	No material or nonsubstantive change to a currently approved collection	1996-10-28	Approved without change
199608-0960-004	Revision of a currently approved collection	1996-08-13	Approved without change
199307-0960-003	Revision of a currently approved collection	1993-07-12	Approved without change
199206-0960-003	Revision of a currently approved collection	1992-06-17	Approved without change
198906-0960-004	Revision of a currently approved collection	1989-06-07	Approved without change
198709-0960-026	No material or nonsubstantive change to a currently approved collection	1987-09-30	Approved with change
198606-0960-001	New collection (Request for a new OMB Control Number)	1986-06-05	Approved without change

OMB Details

Application for Supplemental Security Income - SSI Claims System

Federal Enterprise Architecture: Income Security - General Retirement and Disability