OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Application for Supplemental Security Income--SSI Claims System/Signature Proxy and Preliminary Claims System (PCS)

IC 9158 under ICR 202105-0960-005 · OMB 0960-0229.

Documents and Forms
Document Name
Document Type
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-Internal Screens
Other-PCS Screen Package
Other-PCS Screen Package
Other-Updated Privacy Act Statement
Other-Updated Privacy Act Statement
Other-Internal Screens
Other-Internal Screens
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Application for Supplemental Security Income--SSI Claims System/Signature Proxy and Preliminary Claims System (PCS)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 416.207 20 CFR 416.305-.335

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internal Screens SSI Claims System - Benefit Leads Screens.pdf Yes Yes Fillable Fileable Signable
Other-Internal Screens SSI Claims System - General ID Screens.pdf Yes Yes Fillable Fileable Signable
Other-Internal Screens SSI Claims System - Income Screens.pdf Yes Yes Fillable Fileable Signable
Other-Internal Screens SSI Claims System - Living Arrangements Screens.pdf Yes Yes Fillable Fileable Signable
Other-Internal Screens SSI Claims System - Resources Screens.pdf Yes Yes Fillable Fileable Signable
Other-PCS Screen Package PCS Screen Package.pdf Yes No Fillable Printable
Other-Updated Privacy Act Statement for the PCS Screens PCS Privacy Act Statement.pdf Yes No Printable Only
Other-Internal Screens Person Information Marriage -Screen Package.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

1,212,512 0
   
Individuals or Households
 
   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 1,212,512 0 0 0 0 1,212,512
Annual IC Time Burden (Hours) 707,299 0 0 0 0 707,299
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSI Claims System Marriage Screens SSI Claims System Marriage Screens.pdf 07/09/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.