Request for Social Security Statement

ICR 201606-0960-003

OMB: 0960-0466

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2016-09-02
Supporting Statement A
2016-09-02
ICR Details
0960-0466 201606-0960-003
Historical Active 201302-0960-002
SSA
Request for Social Security Statement
Revision of a currently approved collection   No
Regular
Approved without change 10/13/2016
Retrieve Notice of Action (NOA) 09/02/2016
  Inventory as of this Action Requested Previously Approved
10/31/2019 36 Months From Approved 10/31/2016
40,091 0 2
3,341 0 1
0 0 0

SSA collects information on Form SSA-7004 to identify respondents' Social Security earnings records, extract posted earnings information, calculate potential benefit estimates, produce the resulting Social Security Statements and mail them to the requesters. Respondents are Social Security number holders requesting information about their Social Security earnings records and estimates of their potential benefits.

US Code: 42 USC 405 Name of Law: Social Security Act
   US Code: 42 USC 1320b-13 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  81 FR 39990 06/20/2016
81 FR 59261 08/29/2016
No

  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 40,091 2 0 40,089 0 0
Annual Time Burden (Hours) 3,341 1 0 3,340 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The decrease in the burden hours stems from increased online statement requests which people with my Social Security accounts make online. Since my SSA users need not fill out the SSA-7004, we do not count these request here. This form pertains to requests that people download, print, complete, and mail to SSA only.

$19,115
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/02/2016


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