Information Collection

Cost Reimbursable Research Request--Application Reporting

IC 179744 under ICR 200704-0960-012 · OMB 0960-0754.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0754 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cost Reimbursable Research Request--Application Reporting	Form and Instruction
Confidentiality Agreement 04-23-07.doc	Other-Certification
Reimbursable Conditions of Use Agreement 04-23-07.doc	Other-AGREEMENT REGARDING CONDITIONS
HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH How to Request SSA Program Data - Final Version 04-23-07.doc	Form and Instruction
Guidance for Preparing an SSA Data Protection Plan (Sup) -04-23-07.doc GUIDANCE FOR PREPARING AN SSA DATA PROTECTION PLAN	IC Document
Users Manual 11-01-06.pdf SSA Program Data User's Manual	IC Document

IC Title:

Cost Reimbursable Research Request--Application Reporting

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR Pt. 401.165 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH	How to Request SSA Program Data - Final Version 04-23-07.doc	Yes	Yes	Fillable Fileable
Other-Certification			Confidentiality Agreement 04-23-07.doc	Yes	Yes	Fillable Fileable
Other-AGREEMENT REGARDING CONDITIONS FOR USE OF SSA DATA			Reimbursable Conditions of Use Agreement 04-23-07.doc	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GUIDANCE FOR PREPARING AN SSA DATA PROTECTION PLAN	Guidance for Preparing an SSA Data Protection Plan (Sup) -04-23-07.doc	04/23/2007
SSA Program Data User's Manual	Users Manual 11-01-06.pdf	04/23/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.