Work Activity Report - Self-Employment (returned via mail)

Work Activity Report (Self-Employment)

Documents and Forms

Document Name Document Type
Form SSA-820-BK Work Activity Report - Self-Employment (returned via mail) Form
SSA-820-BK Work Activity Report (Self-Employment) SSA-820-BK - DRAFT (Revised Version).pdf www.socialsecurity.gov Form
SSA-820-BK (Current Version).pdf SSA-820-BK - Current Version IC Document

Information Collection (IC) Details

IC Title:	Work Activity Report - Self-Employment (returned via mail)	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 404.1520(b) 20 CFR 404.1571-404.1576 20 CFR 404.1584-404.1593 20 CFR 416.971-416.976

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-820-BK	Work Activity Report (Self-Employment)	SSA-820-BK - DRAFT (Revised Version).pdf	www.socialsecurity.gov	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 49,895	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	49,895	1,324	48,571
Annual IC Time Burden (Hours)	62,369	17,846	44,523
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-820-BK - Current Version	SSA-820-BK (Current Version).pdf	01/08/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.