Information Collection

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

IC 251448 under ICR 202605-0960-009 · OMB 0960-0066.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
oSSNAP Screen Package.pdf	Other-Internet Screens
oSSNAP Screen Package.pdf	Other-Internet Screens
Revised oSSNAP Screens - May 2026.pdf	Other-Revised oSSNAP Screens
Revised oSSNAP Screens - May 2026.pdf	Other-Revised oSSNAP Screens

IC Title:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens					Yes	Yes	Fillable Fileable Signable
Other-Revised oSSNAP Screens				www.ssa.gov (oSSNAP)	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: 37,820

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	37,820	37,820
Annual IC Time Burden (Hours)	25,213	25,213
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.

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