Data Exchange Request Form - State and Local Governments

Data Exchange Request Form

Requesting An Electronic Data Exchange With SSA - Revised Language to Include Epidemiological Requests

Data Exchange Request Form - State and Local Governments

OMB: 0960-0802

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Requesting An Electronic Data Exchange With SSA
If you wish to enter into a data exchange with SSA, we need specific information to
determine if we can approve your request.
You must provide:
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what information you are requesting and why,
what legal authority supports your request,
the anticipated volume and frequency of your request,
what security measures you have in place to protect the data you receive from us,
and
if you currently have, or previously had, a data exchange agreement with SSA.

All disclosures from SSA must be in accordance with applicable law, including the
Privacy Act of 1974, 5 U.S.C. 552a; section 1106 of the Social Security Act, 42 U.S.C. 1306;
and SSA’s disclosure regulations, 20 C.F.R. Part 401. We review all requests for
information to determine whether SSA has applicable legal authority for the disclosure
requested.
In addition, Federal laws require SSA to protect information in our records. Such laws
include but are not limited to the Privacy Act of 1974 and the Federal Information
Security Management Act, 44 U.S.C. Part 35. Thus, data security is often an essential
factor in evaluating data exchange requests. Where appropriate, we conduct ongoing
compliance reviews of our information exchange partners.
Finally, reimbursement for developing and maintaining the exchange is generally
required.
If your Federal, State, or local agency, tribal organization, or private entity is interested in
entering into a data exchange agreement with SSA for programmatic or research
purposes, complete the data exchange request form (SSA-157) and email it to
[email protected].
If you are interested in requesting the full Death Master File, refer to the instructions for
Requesting the Full Death Master File.
If you are interested in requesting vital status data for epidemiological research, please
refer to the information and instructions for our Service to Epidemiological Researchers
to Provide Vital Status Data on Subjects of Health Research as you complete the data
exchange request form (SSA-157).

All others, email us at [email protected]. Provide as much detailed
information as possible, to include; contact information (i.e., name, address, email, and
phone number), description and purpose of your data exchange request.
A Data Exchange Liaison will respond to your email as soon as possible.
NOTE
The timeframe to establish an exchange with SSA can vary significantly depending upon
the nature of your request and SSA priorities. Some exchanges are routine while others
may require additional time to be approved and implemented. During the review and
implementation stages, we will keep you apprised of the status of your request.


File Typeapplication/pdf
AuthorPaul Davies
File Modified2017-04-14
File Created2017-04-14

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