Information Collection

Certification of Elections for Reduced Spouse's Benefits

IC 9256 under ICR 202607-0960-001 · OMB 0960-0398.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-25 Certificate of Election for Reduced Spouse’s Benefits Certification of Elections for Reduced Spouse's Benefits	Form
Privacy Act Statement 0398 (revised).docx	Other-Revised Privacy Act Statement
SSA-25 Certificate of Election for Reduced Spouse’s Benefits SSA-25 (revised).pdf www.ssa.gov	Form
SSA-25 (current).pdf SSA-25 (current)	IC Document

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 404.421

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-25			www.ssa.gov	Yes	No	Fillable Printable
Other-Revised Privacy Act Statement					Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,040

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,040	-28,960	30,000
Annual IC Time Burden (Hours)	1,439	-5,061	6,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-25 (current)		07/01/2026

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

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