Application for Search of Census Records for Proof of Age

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-1535-U3 Application for Search of Census Records for Proof of Age	Form	Modified	Available
Form SSA-1535-U3 Application for Search of Census Records for Proof of Age	Form	Modified	Repair queued
Addendum - 0097.docx	Supplementary Document	Uploaded 2021-01-28	Repair queued
Supporting Statement - 0097.docx	Supporting Statement A	Uploaded 2021-01-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43694	Application for Search of Census Records for Proof of Age	Form	Modified	Application for Search of Census Records for Proof of Age
43694	Application for Search of Census Records for Proof of Age	Form	Modified
43694	Application for Search of Census Records for Proof of Age	Other-Revised PRA Statement	Modified

ICR Details

OMB Control No: 0960-0097	ICR Reference No: 202012-0960-007
Status: Historical Active	Previous ICR Reference No: 201706-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Application for Search of Census Records for Proof of Age
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/27/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/28/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2024	36 Months From Approved	07/31/2021
Responses	15	0	18,030
Time Burden (Hours)	11	0	3,606
Cost Burden (Dollars)	0	0	0

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Abstract: An applicant for Title II retirement benefits must provide proof of age to obtain a benefit. When preferred evidence of age is not available, and the available evidence is not convincing, census records offer other means to establish evidence of age. Therefore, SSA may ask the U.S. Department of Commerce, Bureau of the Census, to search its records to establish a claimant’s date of birth. SSA sends Form SSA-1535-U3, Application for Search of Census Records for Proof of Age, to the Bureau of the Census after a respondent who does not have preferred evidence of age completes the form. The SSA 1535-U3 provides the Bureau of the Census with sufficient identifying information about the respondent to allow an accurate search of census records to establish proof of age for the respondent. In addition, a completed SSA-1535-U3 is the formal request and, when signed by an authorized SSA employee, serves as the mechanism by which the Bureau of the Census bills SSA for the search. The respondents are applicants for Title II Social Security benefits who need to establish their age as a factor of entitlement.

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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:
	85 FR 76142	11/27/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 7446	01/28/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application for Search of Census Records for Proof of Age	SSA-1535-U3	Application for Search of Census Records for Proof of Age

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ICR Summary of Burden

table that charts list 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	15	18,030	0	0	-18,015	0
Annual Time Burden (Hours)	11	3,606	0	0	-3,595	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: When we last cleared this IC in 2017, the burden was 3,606 hours. However, we are currently reporting a burden of 3 hours. This change stems from a decrease in the number of responses from 18,030 to 15. Over the past several years, hospitals have been automatically reporting births to the state and generating birth certificates. In addition, SSA streamlined the proof of age policy so we are able to use the information previously established within our systems. Both of these actions significantly reduced the need for applicants to provide proof of age. There is no change to the burden time per response. These figures represent current Management Information data. In addition, we added 8 burden hours to the IC for estimated travel time to a field office as per the current request from OIRA.

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Annual Cost to Federal Government: $910

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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? No

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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: 01/28/2021

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