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TABLE OF CHANGES FORM I912, Request for Fee Waiver OMB Number: 16150116 04/15/2016Reason for Revision: Clarifications needed on head of household and flow of information and removing repetitious information.
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OMB number 1615-0116 is used for reporting information related to the Supplemental Security Income program.
Individuals who receive Supplemental Security Income are required to file OMB number 1615-0116.
OMB number 1615-0116 can be filled out online through the Social Security Administration's website or by completing the paper form and mailing it in.
The purpose of OMB number 1615-0116 is to collect information necessary to determine eligibility for Supplemental Security Income benefits.
Information such as income, assets, living arrangements, and other factors that may affect eligibility for Supplemental Security Income benefits must be reported on OMB number 1615-0116.
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