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Federal forms, ICRs, and supporting documents

Information Collection

SSA-1026-SCE - Reporting a Change That May Affect Your Extra Help

IC 187637 under ICR 202012-0960-009 · OMB 0960-0723.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-i1026 Intranet Screens
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

SSA-1026-SCE - Reporting a Change That May Affect Your Extra Help
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 418.3125

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-1026-SCE SSA - Reporting a Change That May Affect Your Extra Help SSA-1026-SCE - Revised.pdf No   Fillable Printable
Other-i1026 Intranet Screens i1026 Application Screen Shots.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

3,462 0
   
Individuals or Households
 
   0 %

  Requested 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 3,462 0 0 -805 0 4,267
Annual IC Time Burden (Hours) 1,039 0 0 -241 0 1,280
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-1026-SCE - Current Version SSA-1026 SCE - Current.pdf 03/08/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.