Work Activity Report (Self-Employment) - Submittable PDF Version via Upload Documents

Work Activity Report (Self-Employment)

Documents and Forms

Document Name Document Type
SSA-820-BK - DRAFT (Revised Version).pdf www.ssa.gov (mySocial Security Account) Other-Submited through the Upload Do
SSA-820-BK (Current Version).pdf SSA-820-BK - Current Version IC Document

Information Collection (IC) Details

IC Title:	Work Activity Report (Self-Employment) - Submittable PDF Version via Upload Documents	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
Other-Submited through the Upload Documents Portal			SSA-820-BK - DRAFT (Revised Version).pdf	www.ssa.gov (mySocial Security Account)	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,533	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,533	-1,324	2,857
Annual IC Time Burden (Hours)	1,916	-465	2,381
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.