Application for a Social Security Card

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0066 can be found here:

Documents and Forms

Document Name Document Type
SSNAP Screens.doc Filled and Filed within field office Other-SSA Field Office Internal-Use
Revised Privacy Act Statement.doc Other-Revised PA Statement
SS-5 Application for a Social Security Card Revised Form SS-5.pdf Form and Instruction
SS-5-FS Application for a Social Security Card (Foreign Service) Revised Form SS-5-FS.pdf Form and Instruction
SS-5 Application for Social Security Card SS-5 05-21-09.pdf Form
Current SS-5.pdf Current Form SS-5 IC Document
Current SS-5-FS.pdf Current SS-5-FS IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for a Social Security Card	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 422.103-.110

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Other-Revised PA Statement			Revised Privacy Act Statement.doc		No	Paper Only
Form	SS-5	Application for Social Security Card	SS-5 05-21-09.pdf		No	Paper Only
Form and Instruction	SS-5	Application for a Social Security Card	Revised Form SS-5.pdf		No	Paper Only
Form and Instruction	SS-5-FS	Application for a Social Security Card (Foreign Service)	Revised Form SS-5-FS.pdf		No	Paper Only
Other-SSA Field Office Internal-Use Screen Shots			SSNAP Screens.doc	Filled and Filed within field office	No	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,584,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	13,584,000	13,584,000
Annual IC Time Burden (Hours)	1,933,000	1,933,000
Annual IC Cost Burden (Dollars)	8,367,000	8,367,000

Documents for IC

Title	Document	Date Uploaded
Current Form SS-5	Current SS-5.pdf	03/09/2009
Current SS-5-FS	Current SS-5-FS.pdf	03/12/2009

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