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
0960-0145 - SSA-8202 (Paper Form)
New
67698
49645
0
Form and Instruction
SSA-8202
Statement for Determining Continuing Eligibility for Supplemental Security Income Payment
Form and Instruction
SSA-8202 (Effective 9/30/24)
Statement for Determining Continuing Eligibility for Supplemental Security Income Payment
0960-0145 - SSA-8202 (SSI Claims System Screens)
New
1764207
1176138
0
Other-Intranet Screens
0960-0174 - SSA-8006 (Paper Version)
New
12160
6080
0
Form and Instruction
SSA-8006
Statement of Living Arrangements, In-Kind Support and Maintenance
Form and Instruction
SSA-8006 (to SSA-8007 Effective after 9/30/24)
Statement of Living Arrangements, In-Kind Support and Maintenance
0960-0174 - SSA-8006 (SSI Claims System Screens)
New
109436
49246
0
Other-Intranet Screens
0960-0229 - SSA-8000-BK (Paper Version)
New
705
705
0
Form and Instruction
SSA-8000-BK
Application for Supplemental Security Income
Form and Instruction
SSA-8000-BK (effective on 9/30/24)
Application for Supplemental Security Income
0960-0229 - SSA-8000-BK (SSI Claims System Screens)
New
1646520
1509310
0
Other-Intranet Screens
0960-0416 - SSA-8203 (Paper Version)
New
135357
90238
0
Form and Instruction
SSA-8203
Statement for Determining Continuing Eligibility for Supplemental Security Income Payments
Form and Instruction
SSA-8203 (Effective after 9/30/24)
Statement for Determining Continuing Eligibility for Supplemental Security Income Payment
0960-0416 - SSA-8203 (SSI Claims System Screens)
New
1468220
954343
0
Other-Intranet Screens
0960-0456 - SSA-8011 (Paper Version)
New
21000
4900
0
Form and Instruction
SSA-8011
Statement of Household Expense and Contributions
Form and Instruction
SSA-8011 (to Form SSA-8012 effective on 9/30/24)
Statement of Household Expense and Contributions
0960-0456 - SSA-8011 (SSI Claims System Screens)
New
398759
93044
0
Other-Intranet Screens
0960-0529 - SSA-5062 (Paper Version)
New
29026
14029
0
Form and Instruction
SSA-5062
Claimant's Statement About Loan Of Food Or Shelter
Form and Instruction
SSA-5062 (to SSA-5064 Effective on 9/30/24)
Claimant's Statement About Loan Of Food Or Shelter
0960-0529 - SSA-5062 (SSI Claims System Screens)
New
29026
9192
0
Other-Intranet Screens
0960-0529 - SSA-L5063 (Paper Version)
New
29026
14029
0
Form
SSA-L506
Statement about Food or Shelter Provided to Another
Form
SSA-L5063 (to SSA-L5065 Effective on 9/30/24)
Statement about Food or Shelter Provided to Another
SSA-L5063 (SSI Claims System Screens)
New
29026
9192
0
Other-Intranet Screens
Total burden requested under this ICR:
5740166
3980091
0
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