OMB control number
Information about Joint Checking/Savings Account
OMB 0960-0461 · SSA.
OMB 0960-0461
SSA uses Form SSA-2574 to collect information about checking or savings accounts from both the SSI applicants and recipients, and any other account holder(s) listed on the account. After receiving the completed form, SSA can determine if we should consider the account as a resource for the SSI applicant or recipient. We use Form SSA-2574, as needed, to obtain the information via personal interview, or by mail, from the SSI applicant or recipient, and from the joint owner of the account only when respondents rebut SSA’s assumptions about ownership of joint account funds. The respondents may complete the form by themselves or with help from SSA employees. While the form is voluntary, failure to provide the information may result in an unsuccessful rebuttal of account funds ownership. Respondents are SSI applicants and recipients, and individuals who list themselves as joint owners of financial accounts with SSI applicants and recipients.
The latest form for Information about Joint Checking/Savings Account expires 2027-10-31 and is listed under ICR 202204-0960-007.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
| Form | |
| Supporting Statement A | |
| Supplementary Document | |
| Form | |
| Other-SSI Claim System Screens |
All Historical Document Collections
OMB Details
Information About Joint Checking/Savings Account - Paper Version
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form SSA-2574 | Information About Joint Checking/Savings Accounts | Fillable Printable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.