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Determining Continuing Eligibility for Supplemental Security Income Payments Hardcopy Form
Statement for Determining Continuing Eligibility for Supplemental Security Income Payments
OMB: 0960-0416
IC ID: 178984
OMB.report
SSA
OMB 0960-0416
ICR 201807-0960-012
IC 178984
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0416 can be found here:
2022-10-19 - Revision of a currently approved collection
2019-08-07 - Revision of a currently approved collection
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 (revised).pdf
Form
SSA-8203 (current).pdf
SSA-8203-BK Current Version
IC Document
Information Collection (IC) Details
View Information Collection (IC)
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 (revised).pdf
No
Paper Only
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:
135,357
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
135,357
0
0
0
0
135,357
Annual IC Time Burden (Hours)
45,119
0
0
0
0
45,119
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA-8203-BK Current Version
SSA-8203 (current).pdf
07/24/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.