Information Collection

Request for Deceased Individual's Social Security Record

IC 189491 under ICR 202009-0960-013 · OMB 0960-0665.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0665 can be found here:

Documents and Forms

Document Name Document Type
SSA-711 - Internet Version (eFOIA).pdf www.socialsecurity.gov Other-Internet Screens

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Deceased Individual's Social Security Record	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 402.130

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens			SSA-711 - Internet Version (eFOIA).pdf	www.socialsecurity.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 49,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Previously Approved
Annual Number of Responses for this IC	49,800	49,800
Annual IC Time Burden (Hours)	5,810	5,810
Annual IC Cost Burden (Dollars)	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.