Form SSA-9901 HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH

Cost Reimbursable Research Request

SSA-9901(revised)

Cost Reimbursable Research Request--Application Reporting

OMB: 0960-0754

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OMB Control No 0960-0754
Expiration Date: XX/XX/XXXX

HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH
To request SSA program data for research, you must complete and sign the application
below. We require that you provide us with both a printed version and an electronic
version of the completed application and other documentation to support your case for
approval.
1. Send the printed version of the completed application and support documentation to
the Associate Commissioner for Research, Evaluation, and Statistics (ORES) so that
we may evaluate our ability to authorize your use of the data for your research
project. Address the envelope to:
Office of Research, Evaluation,
and Statistics (ORES)
Office of Policy
Social Security Administration
Attn: Division of Earnings Statistics and Analysis
4-C-15 Operations/ c/o 4th Floor Meadows East Building
6401 Security Boulevard
Baltimore, Maryland 21235;
AND
2. Email the completed application and support documentation electronically to
[email protected].
NOTE: Generally, we can provide only aggregations, tabulations and/or statistical
outputs of SSA program data to qualified researchers. In rare instances, we release micro
data, i.e. individual data records with or without identifiers, to state and federal agencies
or their contractors/grantees. These data records may be used for research and statistical
purposes only. You may not use the records for programmatic or enforcement purposes.
Requestors of micro data must complete questions 9 through 14.
If you wish administrative data for specific individuals, we will require you to submit an
input file of the subjects. This input file must include the following information for each
subject: Social security number (SSN), full name, date of birth, and sex. To insure that
we do not give out inaccurate information, we use the full name, date of birth, and sex
information to validate each SSN. In turn, we provide information ONLY for those
records that pass validation. We do not provide information on non-validated SSNs, e.g.
a name that does not match the SSN or the SSN is alphanumeric.

SSA-9901

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HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH - continued
(1)

(2)

(3)

(4)

(5)

(6)

(7)
(8)

Your name, agency/organization, address, and phone number and the name,
organization, address, and phone number of the organization that will be receiving
the data (if different);
A description of your project, its purpose, and the intended outcome (that is, a
dissertation, research for publication, fulfillment of a grant or contract and the
grant/contract sponsor, etc.). Please note that you may not use SSA micro data
files for non-research purposes;
A description of the way in which this project will further SSA’s mission to
promote the economic security of the nation’s people through its administration of
the Old Age and Survivors Insurance Program, the Disability Insurance Program,
and/or the Supplemental Security Income Program;
A description of the types of data needed (that is, indication of receipt of benefits,
age, gender, average earnings, etc.). If you are requesting certain variables, please
list these as well as the number of cases in your study;
Indicate the form of data needed to accomplish the purposes of your study.
Options include tabulations, statistical outputs, micro data from SSA’s program
records for individuals, and SSA data for individuals that have been linked to
other sources of data. (Reminder: We normally release information in the form of
aggregates or individual data that cannot be associated with an individual, and
only in rare instances do we release micro data);
If data are needed for a particular cohort of individuals, describe the information
you have on these individuals (for example, social security numbers, names, and
dates of birth);
An indication of the time frame within which you need the data;
The Employer Identification Number (EIN) of your organization or the institution
supporting the research (and the Dun & Bradstreet Universal Numbering System
(DUNS) Number and Agency Locator Code (ALC) if you represent a federal
agency) and the specific person who will sign agreements to reimburse SSA for
expenses incurred in supplying the data;

For those requesting micro data:
(9)
(10)
(11)

A description of other sources of data to which you will be linking SSA data (if
applicable);
Plans to publish or release the research results including whether any supporting
documentation will be made available in identifiable form;
A list of all persons that will have access to identifiable data. In addition to the
staff of the requesting organization, include any "other party" receiving (or having
contractual or other rights to) any identifying information provided by SSA.
"Other parties" would include consultants, collaborators, contractors,
subcontractors, and sponsoring or participating agencies or organizations.
Persons of the requesting organization must sign the enclosed “Confidentiality
Agreement.” “Other parties” must sign the enclosed “Conditions of Use
Agreement”;

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HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH - continued
(12)

(13)
(14)

Your completed “SSA Data Protection Plan” (see enclosed “Guidance for
Preparing an SSA Data Protection Plan”) detailing the procedures and computer
configuration to ensure the confidentiality of the data supplied by SSA;
Length of time you need to retain the data in identifiable form and the location
where the data will be housed.
Planned final disposition of the SSA data to include the date when the data will be
destroyed.

Requestor’s Signature__________________________________ Date______________

This information will be forwarded to the Data Request Review Panel. The Review
Panel will address issues such as SSA’s legal authorization to release the data to you, the
types and format of the data to be released, and reimbursement issues.
See Revised Paperwork Reduction Act Staement
Paperwork Reduction Act Statement - This information collection meets the
requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer these questions unless we display a valid Office
of Management and Budget control number. We estimate that it will take about 4 hours
to read the instructions, gather the facts, and answer the questions.
If you have comments on our time estimate please send them to: SSA, 6400 Security Blvd.
Baltimore, MD 21235-0001. Send only comments relating to our time estimate to this
address, not the completed form.

SSA-9901

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SSA will insert the following revised PRA Statement into the form at its
next scheduled reprinting:
Paperwork Reduction Act Statement - This information collection meets the
requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer these questions unless we display a valid Office
of Management and Budget control number. We estimate that it will take about 4 hours
to read the instructions, gather the facts, and answer the questions. Send only comments
relating to our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 212356401.

SSA will insert the following revised Privacy Act Statement into the form
at its next scheduled reprinting:
Privacy Act Statement
Collection and Use of Personal Information

Section 205(a) of the Social Security Act as amended, [42 U.S.C. § 405(a)], authorizes us
to collect this information. We will use information you provide to respond to your
request for information or records we maintain. Your response is voluntary. However,
failure to provide the requested information may result in your application being denied
or a delay in processing.
We rarely use the information you provide on this form for any purpose other than for the
reasons explained above. However, we may use it for the administration and integrity of
Social Security programs. We may also disclose information to another person or to
another agency on accordance with approved routine uses, which include but are not
limited to the following:
1. To comply with Federal laws requiring the release of information from Social
Security records (e.g., to the Government Accountability Office, General
Services Administration, and National Archives Records Administration);
2. To facilitate statistical research, audit, or investigative activities necessary to
assure the integrity and improvement of Social Security programs.
Additional information regarding this form, and information regarding our systems and
programs, is available on-line at www.socialsecurity.gov.


File Typeapplication/pdf
File TitleRequest for SSA Data
Author271130
File Modified2010-06-23
File Created2010-06-22

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