Information Collection Request

Data Exchange Request Form

ICR 202605-0960-003 · OMB 0960-0802 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-157 Data Exchange Request Form Form Modified Repair queued
Form SSA-157 Data Exchange Request Form Form Modified Available
Form SSA-157 Data Exchange Request Form Form Modified Repair queued
Form SSA-157 Data Exchange Request Form Form Modified Available
Form SSA-157 Data Exchange Request Form Form Modified Repair queued
Form SSA-157 Data Exchange Request Form Form Modified Available
Form SSA-157 Data Exchange Request Form Form Modified Repair queued
Form SSA-157 Data Exchange Request Form Form Modified Available
Justificaiton for Non-Substantive Changes - 0802.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-06-04 Available
Justificaiton for Non-Substantive Changes - 0802.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-06-04 Available
Supporting Statement - 0960-0802 (Final).docx Supporting Statement A Uploaded 2024-09-16 Repair queued
Supporting Statement - 0960-0802 (Final).docx Supporting Statement A Uploaded 2024-09-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
215703 Data Exchange Request Form - State and Local Governments Form ModifiedData Exchange Request Form
215703 Data Exchange Request Form - State and Local Governments Form ModifiedData Exchange Request Form
215703 Data Exchange Request Form - State and Local Governments Form ModifiedData Exchange Request Form
215703 Data Exchange Request Form - State and Local Governments Form ModifiedData Exchange Request Form
215635 Data Exchange Request Form - Private Sector Respondents Form ModifiedData Exchange Request Form
215635 Data Exchange Request Form - Private Sector Respondents Form ModifiedData Exchange Request Form
215635 Data Exchange Request Form - Private Sector Respondents Form ModifiedData Exchange Request Form
215635 Data Exchange Request Form - Private Sector Respondents Form ModifiedData Exchange Request Form

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2026 11/30/2026 11/30/2026
213 0 213
1,704 0 1,704
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Data Exchange Request Form - State and Local Governments SSA-157, SSA-157 ,  
Data Exchange Request Form - Private Sector Respondents SSA-157, SSA-157 ,  

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 213 213 0 0 0 0
Annual Time Burden (Hours) 1,704 1,704 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No