Report of Deceased Individual's Social Security Record

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-711 Request for Deceased Individual's Social Security Record	Form	Modified	Available
Form SSA-711 Deceased Individual's Social Security Records, SSA-711 (Paper Form)	Form	Modified	Repair queued
Supporting Statement - 0665 (Final).docx	Supporting Statement A	Uploaded 2024-11-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43711	Deceased Individual's Social Security Records, SSA-711 (Paper Form)	Form	Modified	Request for Deceased Individual's Social Security Record
43711	Deceased Individual's Social Security Records, SSA-711 (Paper Form)	Form	Modified
189491	Request for Deceased Individual's Social Security Record	Other-Internet Screens	Modified

ICR Details

OMB Control No: 0960-0665	ICR Reference No: 202405-0960-006
Status: Active	Previous ICR Reference No: 202304-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Report of Deceased Individual's Social Security Record
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: 03/10/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/14/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2028	36 Months From Approved	03/31/2025
Responses	50,000	0	50,000
Time Burden (Hours)	6,003	0	30,833
Cost Burden (Dollars)	1,450,000	0	0

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Abstract: When a member of the public requests a Social Security record, SSA needs the name and address of the requestor as well as a description of the requested record to process the request. SSA uses the information the respondent provides on Form SSA-711, or via an Internet request through SSA’s electronic Freedom of Information Act Xpress (FOIAXpress) website, to: (1) verify the wage earner is deceased; and (2) access the correct Social Security record. Respondents learn of the possibility for these requests via Agency mailers; multi-media commercials and advertising; SSA’s general website; a link from the mySocial Security landing page; as well as from other individuals. SSA is constantly reviewing our outreach tactics to assure maximum exposure and accessibility to all individuals who need this service. Our website and mailers list the information respondents need to apply for requests. Respondents are members of the public requesting deceased individuals’ Social Security Records.

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Authorizing Statute(s): US Code: 5 USC 552 Name of Law: Public Information; agency rules, opinions, orders, records, and proceedings
   PL: Pub.L. 114 - 185 337 Name of Law: Freedom of Information Act (FOIA)
  

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:
	89 FR 55666	07/05/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 88105	11/06/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Deceased Individual's Social Security Records, SSA-711 (Paper Form)	SSA-711	Request for Deceased Individual's Social Security Record
Request for Deceased Individual's Social Security Record

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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	50,000	50,000	0	0	0	0
Annual Time Burden (Hours)	6,003	30,833	0	0	-24,830	0
Annual Cost Burden (Dollars)	1,450,000	0	0	0	1,450,000	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: There are no changes to the public reporting burden. * Note: The total burden reflected in ROCIS is 6,003, while the burden cited in #12 of the Supporting Statement is 5,833. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30-minute, one-way, drive burden. In contrast, the chart in #12 of the Supporting Statement reflects actual burden. We are also showing a decrease in the total burden in ROCIS due to revisions to the wait time and one-way drive burdens for our information collections (we needed to remove the wait time and drive time which we inadvertently included for the Internet submissions and add them to the paper submissions. This caused an overall burden reduction of 24,830 hours, as respondents who use the Internet to submit their requests do not need to drive to a field office or wait for help from field office staff.

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Annual Cost to Federal Government: $143,420

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: 11/14/2024

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