Claimant Statement About Loan of Food or Shelter; Statement about Food or Shelter Provided to Another

SSA bases an SSI claimant or recipient’s eligibility on need, as measured by the amount of income an individual receives. Per our calculations, income includes other people providing in-kind support and maintenance in the form of food and shelter to SSI applicants or recipients. SSA uses Forms SSA-5062 and SSA-L5063 to obtain statements about food or shelter provided to SSI claimants or recipients. SSA uses this information to determine whether food or shelters are bona fide loans or income for SSI purposes. This determination may affect claimants’ or recipients’ eligibility for SSI as well as the amounts of their SSI payments. The respondents are claimants and recipients for SSI payments, and individuals who provide loans of food or shelter to them.

The latest form for Claimant Statement About Loan of Food or Shelter; Statement about Food or Shelter Provided to Another expires 2021-10-31 and can be found here.

Claimant Statement About Loan of Food or Shelter

Federal Enterprise Architecture: Income Security - General Retirement and Disability

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