Information Collection Request

Social Security Benefits Application

ICR 200805-0960-018 · OMB 0960-0618 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form SSA-16 Paper Form SSA-16 (Application for Disability Insurance Benefits ) Form and Instruction Modified Repair queued
Form SSA-2 Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits) Form and Instruction Modified Available
Form SSA-1 Paper Form SSA-1 (Application for Retirement Insurance Benefits) Form Modified Available
0960-0618 addendum.doc Supplementary Document Uploaded 2008-05-23 Available
0960-0618 supporting statement.doc Supporting Statement A Uploaded 2008-05-23 Available
IC Document Collections
IC IDCollectionTypeStatusForm
9628 1st Party Internet Social Security Benefits Application (ISBA) Other-ISBA Screens - 1st party respondents Modified
184984 Notices to Beneficiaries who Have Third Parties Applying for them Via ISBA Other-Notices to Beneficiaries with 3rd-party IBSA completion New
184982 3rd Party Internet Social Security Benefits Application (ISBA) Other-ISBA screens -- for 3rd parties New
179349 Paper Form SSA-16 (Application for Disability Insurance Benefits ) Form and Instruction Modified
179348 SSA-16 MCS Signature Proxy Other-MCS/Signature Proxy Modified
179347 SSA-16 MCS Screens Other-MCS Screens Modified
179344 Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits) Form and Instruction Modified
179343 SSA-2 MCS Signature Proxy Other-MCS Signature Proxy Screens Modified
179341 SSA-2 MCS Screens Other-MCS Screens Modified
179340 Paper Form SSA-1 (Application for Retirement Insurance Benefits) Form Modified
179338 SSA-1 MCS Signature Proxy Other-MCS/Signature Proxy Modified
179334 SSA-1 MCS Screens Other-MCS Screens Modified
ICR Details
0960-0618 200805-0960-018
Historical Active 200701-0960-020
SSA
Social Security Benefits Application
Revision of a currently approved collection   No
Regular
Approved without change 08/27/2008
Retrieve Notice of Action (NOA) 05/23/2008
This information collection request is approved for 3 years. Consistent with our 8/27 discussion, during the approval period, SSA will explore alternatives to the use of the SSN for log-in purposes. At the next submission of this package, SSA will report to OMB on the results of its exploration.
  Inventory as of this Action Requested Previously Approved
08/31/2011 36 Months From Approved 08/31/2010
4,924,218 0 3,843,369
1,230,239 0 963,056
0 0 0

The Social Security Administration (SSA) provides Retirement, Survivors’, and Disability benefits to members of the public who meet the required eligibility criteria and who file the correct application. This collection includes the three modalities the public can use to file for the appropriate benefit type: a paper form, an office interview with Modernized Claims System screen input, or the Internet Social Security Benefits Application. In this ICR, we are making two changes to the collection: 1) we are giving third parties the ability to complete applications in ISBA and 2) we are implementing design changes that will make the application easier and less time-consuming to complete. The respondents are applicants for Retirement, Disability, or Spouse’s Insurance Benefits or their third-party representatives.

US Code: 42 USC 402 Name of Law: Social Security Act
   US Code: 42 USC 423 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  73 FR 15252 03/21/2008
73 FR 29833 05/22/2008
No

  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 4,924,218 3,843,369 0 429,087 651,762 0
Annual Time Burden (Hours) 1,230,239 963,056 0 -5,837 273,020 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Burden Increases are due to 1) increased use (adjustments) and 2) re-adjustment of the number of respondents, which was accidentally under-estimated in the last ICR. Burden Decreases are due to 1) decreased use of certain collections in the ICR and 2) reduced burden time for the ISBA collection.

$3,372,000
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 [email protected]

  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.
05/23/2008