OMB control number
Supplemental Security Income Claim Information Notice
OMB 0960-0324 · SSA.
OMB 0960-0324
SSA uses Form SSA-L8050-U3 to collect information on whether an SSI recipient is using all sources of potential income (annuities, pensions, disability benefits, veteran's compensation, etc.) for their own support. SSI supplements other income an individual has available. SSA mails Form SSA-L8050-U3 to applicants or recipients when they apply for benefits. Respondents are SSI applicants or recipients who may be eligible for benefits from other public or private programs.
The latest form for Supplemental Security Income Claim Information Notice expires 2027-04-30 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
Form |
Supplementary Document |
Supporting Statement A |
All Historical Document Collections