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Federal forms, ICRs, and supporting documents

Information Collection

Application for Supplemental Security Income--SSA-8000-BK (Paper Form)

IC 44924 under ICR 202109-0960-001 · OMB 0960-0229.

Documents and Forms
Document Name
Document Type
Form
Form
Other-Revised PA & PRA Statements
Other-Revised PA & PRA Statements
Form
Form
IC Document
IC Document
Information Collection (IC) Details

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Application for Supplemental Security Income--SSA-8000-BK (Paper Form)
 
No Modified
 
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
Form SSA-8000-BK Application for Supplemental Security Income (SSI) SSA-8000-BK - Revised.pdf No   Fillable Printable
Other-Revised PA & PRA Statements Revised PA & PRA Statements.pdf No   Fillable Printable

Income Security General Retirement and Disability

 

705 0
   
Individuals or Households
 
   0 %

  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 705 0 0 -20,236 0 20,941
Annual IC Time Burden (Hours) 470 0 0 -13,840 0 14,310
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-8000-BK - Current SSA-8000-BK - Current.pdf 11/30/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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