Application for a Social Security Card - Asking for Replacement Card beyond allowable limits

Application for a Social Security Card

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0066 can be found here:

Documents and Forms

Document Name Document Type
Form SS-5 Application for a Social Security Card - Asking for Replacement Card beyond allowable limits Form and Instruction
SSNAP Screens.pdf Other-Internal Screens
SSNAP Screens.pdf Other-Internal Screens
SS-5 and SS-5 FS - Revised Privacy Act and PRA Statements.pdf Other-SS-5 and SS-5-FS Revised Priva
SS-5 and SS-5 FS - Revised Privacy Act and PRA Statements.pdf Other-SS-5 and SS-5-FS Revised Priva
Express Interviews Pre-Screening Questions.docx Other-Pre-Screening Questions for Ex
Express Interviews Pre-Screening Questions.docx Other-Pre-Screening Questions for Ex
SS-5 Application for a Social Security Card SS-5 - Revised Version.pdf Form and Instruction
SS-5 Application for a Social Security Card SS-5 - Revised Version.pdf Form and Instruction
SS-5-FS Application for a Social Security Card (Foreign Service) SS-5-FS - Revised Version.pdf Form and Instruction
SS-5-FS Application for a Social Security Card (Foreign Service) SS-5-FS - Revised Version.pdf Form and Instruction
SS-5-FS - Current Version.pdf SS-5-FS - Current IC Document
SS-5-FS - Current Version.pdf SS-5-FS - Current IC Document
SS-5 - Current Version.pdf SS-5 (current) IC Document
SS-5 - Current Version.pdf SS-5 (current) IC Document

Information Collection (IC) Details

IC Title:	Application for a Social Security Card - Asking for Replacement Card beyond allowable limits	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 422.103-422.110

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SS-5	Application for a Social Security Card	SS-5 - Revised Version.pdf	No		Paper Only
Form and Instruction	SS-5-FS	Application for a Social Security Card (Foreign Service)	SS-5-FS - Revised Version.pdf	Yes	No	Fillable Printable
Other-Internal Screens			SSNAP Screens.pdf	Yes	Yes	Fillable Fileable Signable
Other-SS-5 and SS-5-FS Revised Privacy Act and PRA Statements			SS-5 and SS-5 FS - Revised Privacy Act and PRA Statements.pdf	No		Printable Only
Other-Pre-Screening Questions for Express Service Appointments			Express Interviews Pre-Screening Questions.docx	No		Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	7,250	7,250
Annual IC Time Burden (Hours)	12,083	12,083
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SS-5-FS - Current	SS-5-FS - Current Version.pdf	04/07/2020
SS-5 (current)	SS-5 - Current Version.pdf	04/07/2020

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