Application for Access to SSA

Application for Access to SSA Systems

Documents and Forms

Document Name Document Type
Form SSA-120 Application for Access to SSA Form and Instruction
SSA-120 Application For Access to SSA Systems SSA-120 (revised).pdf Form and Instruction
SSA-120 (current).pdf Applicaiton For Access to SSA Systems IC Document

Information Collection (IC) Details

IC Title:	Application for Access to SSA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 401.45 26 CFR 31.6109-1 26 CFR 31.6011(b)2

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-120	Application For Access to SSA Systems	SSA-120 (revised).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 685	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	685	685
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Applicaiton For Access to SSA Systems	SSA-120 (current).pdf	04/28/2021

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