Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
1st Party Internet Social Security Benefits Application (iClaim) - Domestic Applicants Modified 541851 135463 0 Other-Revised iClaim screens
Other-revised screens
1st Party Internet Social Security Benefits Application (iClaim) - Foreign Applicants New 8291 415 0 Other-Internet Screens
Other-Internet Screens
3rd Party iClaim Unchanged 28118 7030 0 Other-iClaim screens -- for 3rd parties
Medicare-only MCS screens Unchanged 299000 34883 0 Other-MCS screens for Medicare-only (will be modified in interview as necessary)
Medicare-only Paper Form SSA-1 Unchanged 1000 117 0 Form and Instruction SSA-1 Application for Retirement Insurance Benefits
Instruction
Medicare-only iClaim Unchanged 200000 33333 0 Other-Internet screens
Notices to Beneficiaries who Have Third Parties Applying for them Via iClaim Unchanged 28118 2343 0 Other-Notices to Beneficiaries with 3rd-party iClaim completion
Paper Form SSA-1 (Application for Retirement Insurance Benefits) Unchanged 20000 3667 0 Form SSA-1 Application for Retirement Insurance Benefits
Instruction
Paper Form SSA-16 (Application for Disability Insurance Benefits ) Unchanged 24161 8054 0 Form and Instruction SSA-16 Application for Disability Insurance Benefits
Instruction
Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits) Unchanged 3800 950 0 Form and Instruction SSA-2 Application for Wife's or Husband's Insurance Benefits
Instruction
SSA-1 MCS Screens Unchanged 172200 31570 0 Other-MCS Screens
SSA-1 MCS Signature Proxy Unchanged 1250800 208467 0 Other-MCS/Signature Proxy
SSA-16 MCS Screens Unchanged 218657 72886 0 Other-MCS Screens
SSA-16 MCS Signature Proxy Unchanged 1967913 623172 0 Other-MCS/Signature Proxy
SSA-2 MCS Screens Unchanged 36860 9215 0 Other-MCS Screens
SSA-2 MCS Signature Proxy Unchanged 331740 77406 0 Other-MCS Signature Proxy Screens
iAppointment Unchanged 200000 33333 0 Other-iAppointment Screens
Total burden requested under this ICR: 5332509 1282304 0  
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