Statement of Living Arrangements, In-Kind Support and Maintenance

OMB 0960-0174

OMB 0960-0174

SSA uses Form SSA-8006-F4 in the administration of the Supplemental Security Income (SSI) program. Recipients' need is the basis for determining SSI payments. Need is measured, in part, by the amount of income an individual receives. Income includes in-kind support and maintenance in the form of food and shelter provided by other persons. Form SSA-8006-F4 collects information to ensure that recipients are eligible to receive SSI payments and to determine the correct amount of payments due. The respondents are individuals who apply for SSI payments, or for SSI eligibility redeterminination.

The latest form for Statement of Living Arrangements, In-Kind Support and Maintenance expires 2021-05-31 and can be found here.

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Extension without change of a currently approved collection 1999-11-04
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No material or nonsubstantive change to a currently approved collection 1996-06-14
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Revision of a currently approved collection 1993-10-05
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Extension without change of a currently approved collection 1990-08-07
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Revision of a currently approved collection 1987-07-16
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Revision of a currently approved collection 1984-08-30
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Revision of a currently approved collection 1981-09-15
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No material or nonsubstantive change to a currently approved collection 1981-02-05
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No material or nonsubstantive change to a currently approved collection 1981-01-24
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No material or nonsubstantive change to a currently approved collection 1980-09-19
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Extension without change of a currently approved collection 1980-07-23
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New collection (Request for a new OMB Control Number) 1979-07-13

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