0960-0174 - SSA-8006 (Paper Version)

Omitting Food From In-Kind Support and Maintenance Calculations

Documents and Forms

Document Name Document Type
Form SSA-8006 0960-0174 - SSA-8006 (Paper Version) Form and Instruction
SSA-8006 Statement of Living Arrangements, In-Kind Support and Ma SSA 8006 F4 - Revised Version.pdf www.ssa.gov Form and Instruction
SSA-8006 Statement of Living Arrangements, In-Kind Support and Ma SSA 8006 F4 - Revised Version.pdf www.ssa.gov Form and Instruction
SSA-8006 (to SSA-8 Statement of Living Arrangements, In-Kind Support and Ma Form SSA-8006 F4 change to Form SSA-8007 effective 9-30-2024.pdf www.ssa.gov Form and Instruction
SSA-8006 (to SSA-8 Statement of Living Arrangements, In-Kind Support and Ma Form SSA-8006 F4 change to Form SSA-8007 effective 9-30-2024.pdf www.ssa.gov Form and Instruction
SSA-8006 - Current Version.pdf Current SSA-8006 IC Document
SSA-8006 - Current Version.pdf Current SSA-8006 IC Document

Information Collection (IC) Details

IC Title:	0960-0174 - SSA-8006 (Paper Version)	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 416.1102-416.1104 20 CFR 416.1121 20 CFR 416.202 20 CFR 416.1130 20 CFR 416.1201(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-8006	Statement of Living Arrangements, In-Kind Support and Maintenance	SSA 8006 F4 - Revised Version.pdf	www.ssa.gov	Yes	No	Fillable Printable
Form and Instruction	SSA-8006 (to SSA-8007 Effective after 9/30/24)	Statement of Living Arrangements, In-Kind Support and Maintenance	Form SSA-8006 F4 change to Form SSA-8007 effective 9-30-2024.pdf	www.ssa.gov	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,160	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
Annual Number of Responses for this IC	12,160	12,160
Annual IC Time Burden (Hours)	6,080	6,080
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-8006	SSA-8006 - Current Version.pdf	02/21/2024

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