View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Work Activity Report (Self-Employment) - Submittable PDF Version via Upload Documents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.1584-404.1593 20 CFR 416.971-416.976 20 CFR 404.1520(b) 20 CFR 404.1571-404.1576

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Submited through the Upload Documents Portal			SSA-820-BK - DRAFT (Revised Version).pdf	www.ssa.gov (mySocial Security Account)	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,533	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	1,533	0	0	-1,324	0	2,857
Annual IC Time Burden (Hours)	1,916	0	0	-465	0	2,381
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-820-BK - Current Version	SSA-820-BK (Current Version).pdf	01/08/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.