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 2283301 570825 0 Other-Internet Screens
Other-Internet Screen
Other-Revised iClaim Screens
1st Party Internet Social Security Benefits Application (iClaim) - Foreign Applicants Unchanged 11373 3412 0 Other-Internet Screens
Other-Internet Screen
Other-Revised iClaim Screens - TOS
3rd Party iClaim Modified 350519 87630 0 Other-Internet Screens
Other-Internet Screens
Medicare-only MCS SSA-1 screens Modified 204380 23844 0 Other-MCS screens for Medicare-only (will be modified in interview as necessary)
Other-Intranet Screens
Other-Privacy Act Statement for PCS
Medicare-only Paper Form SSA-1 Modified 173 20 0 Form and Instruction SSA-1 Application for Retirement Insurance Benefits
Medicare-only iClaim Modified 797709 132952 0 Other-Internet screens
Other-Internet Screens
Paper Form SSA-1 (Application for Retirement Insurance Benefits) Modified 1811 332 0 Form SSA-1 Application for Retirement Insurance Benefits
Paper Form SSA-16 (Application for Disability Insurance Benefits ) Unchanged 40346 13449 0 Form and Instruction SSA-16 Application for Disability Insurance Benefits
Other-Revised Privacy Act Statement
Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits) Unchanged 972 243 0 Form SSA-2 Application for Wife's or Husband's Insurance Benefits
Other-Revised Privacy Act Statement
SSA-1 MCS Signature Proxy Modified 1438058 239676 0 Other-MCS/Signature Proxy
Other-Intranet Screens
Other-Privacy Act Statement for PCS
SSA-16 MCS Signature Proxy Modified 1159121 367055 0 Other-MCS/Signature Proxy
Other-Intranet Screens
Other-Privacy Act Statement for PCS
SSA-2 MCS Signature Proxy Modified 447610 104442 0 Other-MCS Signature Proxy Screens
Other-Intranet Screens
Other-Privacy Act Statement for PCS
iAppointment Unchanged 17621 2937 0 Other-iAppointment Screens
iClaim Applicant After 3rd Party Completion Unchanged 350519 29210 0 Other-Notices to Beneficiaries with 3rd-party iClaim completion
Other-Revised iClaim Screens - TOS
Total burden requested under this ICR: 7103513 1576027 0  
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