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SSA-8000-BK - Application for Supplemental Security Income
SSA-8000-BK - 20 CFR, 416.207 & Subpart C, 416.305-.335
OMB: 0960-0229
IC ID: 44924
OMB.report
SSA
OMB 0960-0229
ICR 200608-0960-015
IC 44924
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0229 can be found here:
2021-12-03 - Revision of a currently approved collection
2021-05-07 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SSA-8000-BK - Application for Supplemental Security Income
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 416.207
20 CFR 416.305-.335
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
33,851
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
33,851
0
33,851
0
0
0
Annual IC Time Burden (Hours)
23,132
0
23,132
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.