Cost Reimbursable Research Request

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-9903 SSA Agreement Regarding Conditions For Use of SSA Data	Form	Modified	Available
Form SSA-9902 Confidentiality Agreement	Form	Modified	Available
Form SSA-9901 HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH	Form and Instruction	Modified	Available
Addendum 0754.doc	Supplementary Document	Uploaded 2010-06-23	Repair queued
0754 supporting statement (revised).doc	Supporting Statement A	Uploaded 2010-09-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
179744	Cost Reimbursable Research Request--Application Reporting	Instruction	Modified
179744	Cost Reimbursable Research Request--Application Reporting	Form	Modified	SSA Agreement Regarding Conditions For Use of SSA Data
179744	Cost Reimbursable Research Request--Application Reporting	Form	Modified	Confidentiality Agreement
179744	Cost Reimbursable Research Request--Application Reporting	Form and Instruction	Modified	HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH

ICR Details

OMB Control No: 0960-0754	ICR Reference No: 201005-0960-002
Status: Historical Active	Previous ICR Reference No: 200704-0960-012
Agency/Subagency: SSA	Agency Tracking No:
Title: Cost Reimbursable Research Request
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/28/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/14/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2013	36 Months From Approved	10/31/2010
Responses	15	0	15
Time Burden (Hours)	60	0	60
Cost Burden (Dollars)	0	0	0

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Abstract: Qualified researchers need SSA administrative data for a variety of projects. To request SSA’s program data for research, a researcher must submit a completed research application. Form SSA-9901, How to Request SSA Program Data for Research for SSA’s evaluation. In the application, the requesting researcher must provide required basic project information and describe the way in which the proposed project will further SSA’s mission to promote the economic security of the nation’s people through its administration of the Old Age, Survivors, and Disability Insurance (OASDI) Programs, and/or the SSI Program. SSA reviews the application, and once we approve it, the researcher signs Form SSA-9903, SSA Agreement Regarding Conditions for Use of SSA Data, which outlines the conditions and safeguards for the research project data exchange. The researcher may use the data for research and statistical purposes only, and must complete Form SSA-9902, Confidentiality Agreement. SSA recovers all expenses incurred in providing this information as part of this reimbursable service. The respondents are Federal and State government agencies and/or their contractors, private entities, and colleges/universities.

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Authorizing Statute(s): US Code: 42 USC 1306 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 32231	06/07/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 54211	09/03/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Cost Reimbursable Research Request--Application Reporting	SSA-9901, SSA-9902, SSA-9903	HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH ,   Confidentiality Agreement ,   SSA Agreement Regarding Conditions For Use of SSA Data

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ICR Summary of Burden

table that charts list of burden

	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	15	15	0	0	0	0
Annual Time Burden (Hours)	60	60	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $228,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/14/2010

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