Application for Supplemental Security Income--MISSICS

Application for Supplemental Security Income (SSI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0229 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-8000 Application for Supplemental Security Income--MISSICS Form
SSA-8000 Application for Supplemental Security Income (SSI) MSSICS screenshots.doc Form
SSA-8000 Application for Supplemental Security Income (SSI)--New MSSICS Screen Mock-up -- Additional Screen for Direct Express.doc Form

Information Collection (IC) Details

IC Title:	Application for Supplemental Security Income--MISSICS	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 416.305-.335 20 CFR 416.207

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-8000	Application for Supplemental Security Income (SSI)	MSSICS screenshots.doc		Yes	Yes	Fillable Fileable Signable
Form	SSA-8000	Application for Supplemental Security Income (SSI)--New Screen for Direct Express	MSSICS Screen Mock-up -- Additional Screen for Direct Express.doc		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 211,802	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	211,802	73,682	138,120
Annual IC Time Burden (Hours)	127,081	44,209	82,872
Annual IC Cost Burden (Dollars)	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.