Information Collection

L106, Letter to Custodian of School Records (Local/State/Tribal Government)

IC 182865 under ICR 202207-0960-002 · OMB 0960-0693.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0693 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-L106 L106, Letter to Custodian of School Records (Local/State/Tribal Government)	Form
Revised Privacy Act Statment - SSA-L106 and SSA-L706.pdf	Other-Revised PA Statement
Revised Privacy Act Statment - SSA-L106 and SSA-L706.pdf	Other-Revised PA Statement
SSA-L106 Letter to Custodian of Birth Records SSA-L106 - Revised Version.pdf	Form
SSA-L106 Letter to Custodian of Birth Records SSA-L106 - Revised Version.pdf	Form
SSA-L106 - Current Version.pdf SSA-L106 - Current	IC Document
SSA-L106 - Current Version.pdf SSA-L106 - Current	IC Document

IC Title:

L106, Letter to Custodian of School Records (Local/State/Tribal Government)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.802 20 CFR 404.704 20 CFR 404.716 20 CFR 422.107

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-L106	Letter to Custodian of Birth Records	SSA-L106 - Revised Version.pdf		No		Fillable Printable
Other-Revised PA Statement			Revised Privacy Act Statment - SSA-L106 and SSA-L706.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: 14

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-14	14
Annual IC Time Burden (Hours)	-2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-L106 - Current	SSA-L106 - Current Version.pdf	10/04/2019

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