Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application for Widow's or Widower's Insurance Benefits--MCS/Signature Proxy Modified 162241 37856 0 Other-Modernized Claims System Version of the SSA-10-BK
Application for Widow's or Widower's Insurance Benefits--Modernized Claims System (MCS) Modified 162241 40560 0 Other-Modernized Claims System Version of the SSA-10-BK
Application for Widow's or Widower's Insurance Benefits--Paper Version Modified 17078 4270 0 Form SSA-10-BK
Total burden requested under this ICR: 341560 82686 0  
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