Information Collection

Application for Supplemental Security Income--MISSICS/Signature Proxy

IC 9158 under ICR 201703-0960-018 · OMB 0960-0229.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0229 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-8000 Application for Supplemental Security Income--MISSICS/Signature Proxy Form
SSA-8000 Application for Supplemental Security Income (SSI) MSSICS screenshots.doc Form
SSA-8000 Application for Supplemental Security Income (SSI)--New MSSICS Screen Mock-up -- Additional Screen for Direct Express.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Supplemental Security Income--MISSICS/Signature Proxy	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.305-.335 20 CFR 416.207

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-8000	Application for Supplemental Security Income (SSI)	MSSICS screenshots.doc		Yes	Yes	Fillable Fileable Signable
Form	SSA-8000	Application for Supplemental Security Income (SSI)--New Screen for Direct Express	MSSICS Screen Mock-up -- Additional Screen for Direct Express.doc		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,373,401	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,373,401	1,373,401
Annual IC Time Burden (Hours)	801,151	801,151
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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