SSA-820-APP Screen Package (revised)

Work Activity Report (Self-Employment)

SSA-820-APP Screen Package (revised)

OMB: 0960-0598

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SSA820 Online Application
Screen Package
August 9, 2021

SSA820 Screen Package

1

Application Landing Page:

SSA820 Screen Package

3

Email Landing Page:

SSA820 Screen Package

4

Email Confirmation Page:

SSA820 Screen Package

5

First Email:

SSA820 Screen Package

6

SSA820 Cover Sheet:

SSA820 Screen Package

8

SSA820 Adobe Form:

Red asterisks notate a required field. Note that some required fields are conditional, based upon how the
prior question was answered. Please see page 16 for an example.

SSA820 Screen Package

9

SSA820 Adobe Form:

SSA820 Screen Package

10

SSA820 Adobe Form:

SSA820 Screen Package

11

SSA820 Adobe Form:

SSA820 Screen Package

12

SSA820 Adobe Form:

SSA820 Screen Package

13

SSA820 Adobe Form:

SSA820 Screen Package

14

Attachment Fields:

SSA820 Screen Package

15

Example of Conditional Required Fields:

The SSA820's questions are based on conditional values. The example displayed above shows that by
selecting "YES" to question 1, question 2 is not available to enter information in, and the user can move
onto question 3.
SSA820 Screen Package

16

Signature:

By clicking in the Signature field the user can type their name to sign the document.

SSA820 Screen Package

17

Completed Signature:

Signature now appears on the form with the date it was signed appearing below signature. If all required fields
are filled out, user can "Click to Sign".

SSA820 Screen Package

18

SSA820 Adobe Form Completion Page:

SSA820 Screen Package

19

Final Email:

SSA820 Screen Package

20


File Typeapplication/pdf
AuthorKao, Christopher Contractor
File Modified2021-08-10
File Created2021-01-21

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