Application for a Social Security Card - Age 12 or older, additional questions

Application for a Social Security Card

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0066 can be found here:

Documents and Forms

Document Name Document Type
SSNAP Screens.pdf Other-Internal Screens
12 or Older SSNAP Screens.pdf Other-Internal Screens
Privacy Act Statement for Applicants Interviewed using SSNAP Screens.pdf Instruction

Information Collection (IC) Details

IC Title:	Application for a Social Security Card - Age 12 or older, additional questions	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 422.103-422.110

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Screens	SSNAP Screens.pdf	Yes	Yes	Fillable Fileable Signable
Other-Internal Screens	12 or Older SSNAP Screens.pdf	Yes	Yes	Fillable Fileable Signable
Instruction	Privacy Act Statement for Applicants Interviewed using SSNAP Screens.pdf	No		Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,500,000	400,000	1,100,000
Annual IC Time Burden (Hours)	237,500	63,333	174,167
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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