Information Collection

Application for a Social Security Card - with a name change (iSSNRC Internet Modality)

IC 251448 under ICR 202407-0960-004 · OMB 0960-0066.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ISSNRC OMB Screen Package - Current.pdf	Other-Internet Screens
ISSNRC OMB Screen Package - Current.pdf	Other-Internet Screens
iSSNRC Screens (Revised).pdf	Other-Internet Screens
iSSNRC Screens (Revised).pdf	Other-Internet Screens
iSSNRC - Revised Privacy Act Statement.pdf	Other-Internet Screens - Revised PA
iSSNRC - Revised Privacy Act Statement.pdf	Other-Internet Screens - Revised PA

IC Title:

Application for a Social Security Card - with a name change (iSSNRC Internet Modality)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 422.103 - 422.110

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens	ISSNRC OMB Screen Package - Current.pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	iSSNRC Screens (Revised).pdf		Yes	Yes	Fillable Fileable Signable
Other-Internet Screens - Revised PA Statement	iSSNRC - Revised Privacy Act Statement.pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,312

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,312	1,312
Annual IC Time Burden (Hours)	765	765
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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