TN 31 (08-17)

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 disbursements for electronic data processing (EDP) and non-EDP equipment purchases within a quarter.

B. How to file Form SSA-871

We require Form SSA-871 only if the Disability Determination Service (DDS) purchased and upgraded EDP equipment or purchased other equipment during the quarter reported.

Submit copies as follows:

  1. SSA Headquarters

    • Send one copy, no later than day 30, after close of the quarter.

    • Email SSA Headquarter, Office of Disability Determination, ^DCO ODD DDRWM Controls.

  2. SSA Regional Office

    • Send one copy via email.

    • Contact the Regional Office for the correct email address.


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 - 08/14/2017
Batch run: 08/14/2017
Rev:08/14/2017