Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Enhanced Leads and Appointment System (eLAS) Screens Removed 0 0 0 Other-Intranet-Based Appontment Screens
Other-Intranet-Based Appointment Screens
Internet Social Security Benefits Application (iClaim SSA-2) Modified 124499 31125 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Domestic Applicants First Party (SSA-1) Modified 1470043 367511 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Domestic Applicants First Party (SSA-16) New 503567 125892 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Domestic Applicants Third Party (SSA-1) Modified 25706 6427 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Domestic Applicants Third Party (SSA-16) New 528474 132119 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Foreign Applicants First Party (SSA-1) Modified 7993 2398 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Foreign Applicants First Party (SSA-16) New 781 234 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Foreign Applicants Third Party (SSA-1) New 645 194 0 Other-Internet Screens
Internet Social Security Benefits Application (iClaim) - Foreign Applicants Third Party (SSA-16) New 123 37 0 Other-Internet Screens
Medicare Part B Online Application - COVID-related Removed 0 0 0 Other-Internet Screens for COVID0-related collection
Other-Webform Version
Medicare-only MCS SSA-1 screens Removed 0 0 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 Removed 0 0 0 Form and Instruction SSA-1 Application for Retirement Insurance Benefits
Medicare-only iClaim Removed 0 0 0 Other-Internet screens
Other-Internet Screens
Paper Form SSA-1 (Application for Retirement Insurance Benefits) Modified 2346 1603 0 Form SSA-1 Application for Retirement Insurance Benefits
Paper Form SSA-16 (Application for Disability Insurance Benefits ) Modified 29485 24571 0 Form and Instruction SSA-16 Application for Disability Insurance Benefits
Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits) Modified 779 584 0 Form SSA-2 Application for Wife's or Husband's Insurance Benefits
SSA-1 MCS Signature Proxy Modified 1925180 1283453 0 Other-MCS/Signature Proxy
SSA-16 MCS Signature Proxy Modified 920938 752099 0 Other-MCS/Signature Proxy
SSA-2 MCS Signature Proxy Modified 407415 298771 0 Other-MCS Signature Proxy Screens
iAppointment Removed 0 0 0 Other-iAppointment Screens
Total burden requested under this ICR: 5947974 3027018 0  
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