Private Printing and Modification of Prescribed Application and Other Forms

OMB 0960-0663

OMB 0960-0663

To obtain SSA's approval, entities must make their requests in writing using their company letterhead, providing the required information set forth in the regulation. SSA uses the information to: (1) ensure requests comply with the law and regulations, and (2) process requests from third-party entities who want to reproduce, duplicate, or privately print any SSA application or other SSA form. SSA employees review the requests and provide approval via email or mail to the third-party entities. The respondents are third-party entities who submit a request to SSA to reproduce, duplicate, or privately print an SSA-owned form.

The latest form for Private Printing and Modification of Prescribed Application and Other Forms expires 2022-10-31 and can be found here.


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