Application for a Social Security Card

Forms and Documents

Document Name	Status
Form SS-5 Application for a Social Security Card Form and Instruction	Modified
0960-0066_Change_request[1].docx Justification for No Material/Nonsubstantive Change	2011-04-21

IC Document Collections

IC ID	Document Title	Status
9002	Application for a Social Security Card Form and Instruction	Modified

ICR Details

OMB Control No: 0960-0066	ICR Reference No: 201104-0960-011
Status: Historical Active	Previous ICR Reference No: 200903-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Application for a Social Security Card
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/27/2011
	Date Received in OIRA: 04/22/2011
Terms of Clearance: SSA have agreed to change the term "Ethnic Description” to “Ethnicity".

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2012	05/31/2012	05/31/2012
Responses	13,584,000	0	13,584,000
Time Burden (Hours)	1,933,000	0	1,933,000
Cost Burden (Dollars)	8,367,000	0	8,367,000

---

Abstract: Individuals complete forms SS-5 (domestic residents) and SS-5-FS (U.S. nationals living abroad) to request a new or replacement Social Security Number card. In this ICR, we are making the following revisions: 1) We are making several minor changes to the forms SS-5, SS-5FS, and SSNAP screens instructions, and questions; 2) We are a Non U.S. Citizen 12 or Older interview Questions to 12 or Older Interview Questions in SNAPP; 3)We are also implementing a new Online Social Security Number Decision Tree to help guide users in determining which documents to submit to OMB. This will not collect any personally identifiable information, will not save the user's responses, and will not check any SSA master files. The Decision Tree is voluntary and for the user's convenience only.

---

Authorizing Statute(s): US Code: 42 USC 405 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 11185	02/29/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 8607	02/25/2009
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Application for a Social Security Card	SS-5, SS-5-FS	Application for a Social Security Card ,   Application for a Social Security Card (Foreign Service)

---

ICR Summary 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	13,584,000	13,584,000	0	0	0	0
Annual Time Burden (Hours)	1,933,000	1,933,000	0	0	0	0
Annual Cost Burden (Dollars)	8,367,000	8,367,000	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:

---

Annual Cost to Federal Government: $62,832,000

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

---

Common Form ICR:  No

---

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: 04/22/2011

---