Determining Continuing Eligibility for Supplemental Security Income Payments Hardcopy Form

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0416 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-8203 Determining Continuing Eligibility for Supplemental Security Income Payments Hardcopy Form Form
SSA-8203 Statement Determining Continuing Eligibility for Supplem SSA-8203-BK.pdf Form
SSA-8203-BK.pdf Currently Approved SSA-8203-BK IC Document

Information Collection (IC) Details

IC Title:	Determining Continuing Eligibility for Supplemental Security Income Payments Hardcopy Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.204

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-8203	Statement Determining Continuing Eligibility for Supplemental Security Income Payments	SSA-8203-BK.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 31,522	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	31,522	5,872	25,650
Annual IC Time Burden (Hours)	10,507	1,957	8,550
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Currently Approved SSA-8203-BK	SSA-8203-BK.pdf	10/23/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.