Report of Deceased Individual's Social Security Record

ICR 201607-0960-010

OMB: 0960-0665

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2016-08-12
ICR Details
0960-0665 201607-0960-010
Historical Active 201504-0960-010
SSA
Report of Deceased Individual's Social Security Record
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/17/2016
Retrieve Notice of Action (NOA) 08/12/2016
  Inventory as of this Action Requested Previously Approved
10/31/2018 10/31/2018 10/31/2018
50,000 0 50,000
5,833 0 5,833
0 0 0

SSA is changing a return address on the form and implementing a fillable PDF version of the form SSA-711. The Social Security Administration (SSA) needs the name and address of the member of the public who is requesting the information as well as a description of the record that member is requesting in order to process the request. SSA uses the information provided by the respondent on Form SSA-711 to verify that the wage earner is deceased and to access the correct Social Security record. Respondents are members of the public who are requesting deceased individuals' Social Security records. We are making non-substantive changes to the forms to update them with current SSA headquarter office names.

US Code: 5 USC 552 Name of Law: Public Information; agency rules, opinions, orders, records, and proceedings
  
None

Not associated with rulemaking

  80 FR 24307 04/30/2015
80 FR 51647 08/25/2015
No

  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 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 5,833 5,833 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$585,000
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/12/2016


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