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Application for Parent's Insurance Benefits / SSA-7-F6
Application for Parent's Insurance Benefits
OMB: 0960-0012
IC ID: 8887
OMB.report
SSA
OMB 0960-0012
ICR 201604-0960-002
IC 8887
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0012 can be found here:
2021-09-30 - Revision of a currently approved collection
2019-02-13 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form SSA-7-F6 (revised)
Application for Parent's Insurance Benefits / SSA-7-F6
Form and Instruction
SSA-7-F6 (revised) Application for Parent's Insurance Benefits
SSA-7-F6 - Revised (Fillable).pdf
Form and Instruction
SSA-7-F6 - Current.pdf
SSA-7-F6 Current Version
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Parent's Insurance Benefits / SSA-7-F6
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 404.370-.371
20 CFR 404.601-.603
20 CFR 404.373-.374
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
SSA-7-F6 (revised)
Application for Parent's Insurance Benefits
SSA-7-F6 - Revised (Fillable).pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
4
0
0
0
0
4
Annual IC Time Burden (Hours)
1
0
0
0
0
1
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA-7-F6 Current Version
SSA-7-F6 - Current.pdf
06/30/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.