TN 48 (09-25)

DI 39506.250 State Agency Schedule for Equipment Purchases for SSA Disability Programs - Form SSA-871

A. Purpose of Form SSA-871

Use Form SSA-871(State Agency Schedule for Equipment Purchases for SSA Disability Programs) to report equipment purchases utilizing SSA funds within a quarter.

B. How to file Form SSA-871

We require submission of the Form SSA-871 only if the Disability Determination Service (DDS) purchased equipment during the quarter reported.

Submit copies as follows:

  • Send the original (with signature) to NDD.

  • Send to the SSA NDD State Disability Resource Management Division mail box ^DCDA ODD SDRM Funding.

  • Copies due on the 25th of the month after the quarter ends. For example, for the quarter that ends 9/30/2025, reports will be due by 10/25/2025.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0439506250
DI 39506.250 - State Agency Schedule for Equipment Purchases for SSA Disability Programs - Form SSA-871 - 09/15/2025
Batch run: 09/15/2025
Rev:09/15/2025