APPLICATION FOR SEARCH OF CENSUS RECORDS FOR PROOF OF AGE

ICR 197903-0960-050

OMB: 0960-0097

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0097 197903-0960-050
Historical Active 197712-0960-013
SSA
APPLICATION FOR SEARCH OF CENSUS RECORDS FOR PROOF OF AGE
No material or nonsubstantive change to a currently approved collection   No
Emergency 03/28/1979
Approved with change 03/28/1979
Retrieve Notice of Action (NOA) 03/28/1979
  Inventory as of this Action Requested Previously Approved
11/30/1982 11/30/1982 11/30/1982
120,000 0 120,000
24,000 0 24,000
0 0 0

THIS FORM IS NEEDED IN ORDER TO ASSURE A CORRECT DATE OF BIRTH DETERMINATION FROM THE CENSUS BUREAU. THE INFORMATION IS USED BY SSA TO RECORD IDENTIFYING DATA WHICH WILL AID THE CENSUS BUREAU IN FINDING THE CLAIMANT'S NAME SO THAT THE APPLICANT WILL BE ENTITLED TO SOCIAL SECURITY BENEFITS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR SEARCH OF CENSUS RECORDS FOR PROOF OF AGE SSA-1535-U3

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 120,000 120,000 0 0 0 0
Annual Time Burden (Hours) 24,000 24,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/28/1979


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