Information Collection

Application for a Social Security Card

IC 9002 under ICR 200903-0960-003 · OMB 0960-0066.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSNAP Screens.doc	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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.