Information Collection

L106, Letter to Custodian of School Records (Local/State/Tribal Government)

IC 182865 under ICR 201007-0960-001 · OMB 0960-0693.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0693 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-L106 L106, Letter to Custodian of School Records (Local/State/Tribal Government)	Form
SSA-L106 Letter to Custodian of Birth Records SSA-L106-F3 (revised).pdf	Form
SSA-L106-F3(current).pdf SSA-L106 (current)	IC Document

IC Title:

L106, Letter to Custodian of School Records (Local/State/Tribal Government)

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 416.802 20 CFR 404.704 20 CFR 404.716 20 CFR 422.107

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-L106	Letter to Custodian of Birth Records	SSA-L106-F3 (revised).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,800

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,800	1,800
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-L106 (current)	SSA-L106-F3(current).pdf	07/22/2010

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