Data Exchange Request Form

ICR 201803-0960-005

OMB: 0960-0802

Federal Form Document

Forms and Documents
IC Document Collections
ICR Details
0960-0802 201803-0960-005
Historical Active 201704-0960-004
SSA
Data Exchange Request Form
Revision of a currently approved collection   No
Regular
Approved with change 12/06/2018
Retrieve Notice of Action (NOA) 07/26/2018
In accordance with 5 CFR 1320, the information collection is approved for three years.
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved 12/31/2018
146 0 146
73 0 73
0 0 0

SSA engages in various forms of data exchanges from Social Security number verifications to computer matches for benefit eligibility, depending on the requestor's business needs. Section 1106 of the Social Security Act requires we consider the requestor's legal authority to receive the data, our disclosure policies, systems' feasibility, systems' security, and costs before entering into a data exchange agreement. We will use Form SSA-157, Data Exchange Request Form, for this purpose. Respondents are Federal, State, local, and foreign governments, as well as private organizations seeking to share data electronically with SSA.

None
None

Not associated with rulemaking

  83 FR 17872 04/24/2018
83 FR 31987 07/10/2018
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 146 146 0 0 0 0
Annual Time Burden (Hours) 73 73 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$11,533
No
    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.
07/26/2018


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