PRA IC List
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Agenda
Reg Review
ICR
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
Unchanged
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
Unchanged
350519
87630
0
Other-Internet Screens
Other-Internet Screens
Enhanced Leads and Appointment System (eLAS) Screens
New
5157780
859630
0
Other-Intranet-Based Appontment Screens
Other-Intranet-Based Appointment Screens
Medicare Part B Online Application - COVID-related
Unchanged
10000
5000
0
Other-Internet Screens for COVID0-related collection
Other-Webform Version
Medicare-only MCS SSA-1 screens
Unchanged
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
Unchanged
173
20
0
Form and Instruction
SSA-1
Application for Retirement Insurance Benefits
Medicare-only iClaim
Unchanged
797709
132952
0
Other-Internet screens
Other-Internet Screens
Paper Form SSA-1 (Application for Retirement Insurance Benefits)
Unchanged
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
Unchanged
1438058
239676
0
Other-MCS/Signature Proxy
Other-Intranet Screens
Other-Privacy Act Statement for PCS
SSA-16 MCS Signature Proxy
Unchanged
1159121
367055
0
Other-MCS/Signature Proxy
Other-Intranet Screens
Other-Privacy Act Statement for PCS
SSA-2 MCS Signature Proxy
Unchanged
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:
12271293
2440657
0
To view an IC, click on IC Title