Application for a Social Security Card

Forms and Documents

Document Name	Status
Form SS-5 Application for a Social Security Card - no need to provide parent's SSN Form and Instruction	Unchanged
Form SS-5 Respondents Who Request an Extract of their SSN Record - National Implementation Form and Instruction	New
Form SSA-5 Respondents Who Request an Extract of their SSN Record - Pilot Form and Instruction	New
Form SS-5 Application for a Social Security Card - Asking for Replacement Card beyond allowable limits Form and Instruction	Unchanged
Form SS-5 Application for a Social Security Card - need to provide parent's SSN Form and Instruction	Unchanged
Form SSA-2935-OP1 Authorization to the Social Security Administration to Obtain Personal Information Form and Instruction	Unchanged
Form SSA-2935-OP1 Authorization to the Social Security Administration to Obtain Personal Information Form and Instruction	Unchanged
Justification for Non-Substantive Changes - 0066.doc Justification for No Material/Nonsubstantive Change	2012-05-14

IC Document Collections

IC ID	Document Title	Status
9002	Application for a Social Security Card - no need to provide parent's SSN Form and Instruction	Unchanged
202249	Respondents Who Request an Extract of their SSN Record - National Implementation Form and Instruction	New
202248	Respondents Who Request an Extract of their SSN Record - Pilot Form and Instruction	New
199949	Application for a Social Security Card - Asking for Replacement Card beyond allowable limits Form and Instruction	Unchanged
199948	Application for a Social Security Card - Age 12 or older, additional questions Other-Revised Internal Screens	Unchanged
199946	Application for a Social Security Card - need to provide parent's SSN Form and Instruction	Unchanged
198351	Authorization to the Social Security Administration to Obtain Personal Information Form and Instruction	Unchanged
198350	Authorization to the Social Security Administration to Obtain Personal Information Form and Instruction	Unchanged

ICR Details

OMB Control No: 0960-0066	ICR Reference No: 201205-0960-007
Status: Historical Active	Previous ICR Reference No: 201110-0960-012
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: 06/01/2012
	Date Received in OIRA: 05/14/2012
Terms of Clearance: OMB is approving this information collection with the understanding that SSA will provide OMB with a briefing on the results of the pilot program before proceeding to national rollout. OMB would like the opportunity to ask questions about the pilot and to weigh in before the program is expanded.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2015	02/28/2015	02/28/2015
Responses	14,709,730	0	12,001,600
Time Burden (Hours)	2,106,169	0	1,722,517
Cost Burden (Dollars)	9,500,000	0	9,500,000

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Abstract: The SS-5 and SSNAP System collect information to issue original or replacement Social Security cards. We are making minor changes to the SSNAP System to allow the new Social Security Number (SSN) printout. The SSN printout is a single-page document displaying a person's name and SSN. Currently our technicians print this out upon verbal request; however, we are modifying SSNAP to allow us to document these print-outs and record the identification proof the respondent supplies.

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Authorizing Statute(s): US Code: 42 USC 405 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:
	76 FR 71105	11/16/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 2114	01/13/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
Authorization to the Social Security Administration to Obtain Personal Information	SSA-2935-OP1	Authorization to SSA to Obtain Personal Information
Authorization to the Social Security Administration to Obtain Personal Information	SSA-2935-OP1	Authorization to SSA to Obtain Personal Information
Respondents Who Request an Extract of their SSN Record - Pilot	SSA-5, SS-5-FS	Application for a Social Security Card ,   Application for a Social Security Card
Respondents Who Request an Extract of their SSN Record - National Implementation	SS-5, SS-5-FS	Application for a Social Security Card ,   Application for a Social Security Card
Application for a Social Security Card - need to provide parent's SSN	SS-5-FS, SS-5	Application for a Social Security Card ,   Application for a Social Security Card (Foreign Service)
Application for a Social Security Card - Asking for Replacement Card beyond allowable limits	SS-5, SS-5-FS	Application for a Social Security Card ,   Application for a Social Security Card (Foreign Service)
Application for a Social Security Card - Age 12 or older, additional questions
Application for a Social Security Card - no need to provide parent's SSN	SS-5, SS-5-FS	Application for a Social Security Card ,   Application for a Social Security Card (Foreign Service)

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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	14,709,730	12,001,600	0	2,708,130	0	0
Annual Time Burden (Hours)	2,106,169	1,722,517	0	383,652	0	0
Annual Cost Burden (Dollars)	9,500,000	9,500,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: SSA is adding a new pilot program for individuals who wish to request an SSN printout. See Justification for the Non-Substantive Changes for more details.

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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

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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: 05/14/2012

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