Addendum to Supporting Statement

Addendum 0754(revised).doc

Cost Reimbursable Research Request

Addendum to Supporting Statement

OMB: 0960-0754

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Addendum to Supporting Statement

Cost Reimbursable Research Request

20 CFR 401.165

OMB No. 0960-0754


Minor Revisions to the Collection Instrument


SSA is making the following revisions to SSA Form 9901 and SSA Form 9902.\


SSA Form 9901


Change 1We are adding Question #9


(9) To protect data from theft or modification, SSA recommends that requestors encrypt all input files submitted to SSA.  Submitting unencrypted data to SSA is not recommended and is done at the requestor’s own risk.  


Justification: We want to advise the requestor on recommended ways to submit input files for security reasons.


Change 2 We are adding Question #10


(10) Are you a State or Federal Agency or Affiliate of a State or Federal Agency? If yes, please explain relationship, e.g. University of XYZ owned by the State of XXXXX. Proof of affiliation may be required.  


Justification: We want to confirm that the requestor is State or Federal Agency or Affiliate because such entities can receive person-level SSA administrative data (excluding earnings, which are owned by IRS) for statistical purposes.


Change 3We are adding question #17


(17) SSA security policy requires that all data transmissions be completed using a secure electronic file transfer protocol such as Secure File Transfer Protocol (SFTPO or a secure Electronic Data Transmission (EDT) capability compliant with SSA standards. Many State and Federal Agencies already have existing electronic file transfer set-ups with SSA. Please describe in detail your current or suggested electronic capability for two data transmissions.


Justification: We want to make State and Federal agencies who request our data aware that SSA may require them to have in place an electronic transmission capability.


Change 4We are renumbering question #9 which will now become question #12


Justification: We added additional questions, so the numbers are now changing.


Change 5 We are renumbering question #10, which now becomes question #13


Justification: We added additional questions, so the numbers are now changing.



Change 6 – Add Print Requestor Name Title



______________________________________ ____________________________________

Print Requestor Name Clearly Title/Affiliation



Justification: Signature is not legible in many instances, so a printed name is requested to verify identity.



SSA Form 9902


Add Print Requestor Name Title and Description of Role



_______________________________ ___________________________________

Print User Name Clearly Title/Affiliation


___________________________________________________________________________

Clearly print a description of your role/function for this research (e.g. authorized user/analyst of the data received from SSA)


Justification: Signature is not legible in many instances, so a printed name is requested to verify identity; and needed a clear description for role/function of authorized user.



We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.


SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on the first page of the form.



File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified By889123
File Modified2013-05-13
File Created2013-05-13

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