Application for a Social Security Card - Asking for Replacement Card beyond allowable limits

Application for a Social Security Card

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0066 can be found here:

Documents and Forms

Document Name Document Type
SSNAP Screens.pdf Other-Internal Screens
Privacy Act Statement for Applicants Interviewed using SSNAP Screens.pdf Instruction
SS-5- FS Privacy Act Statement (revised).doc Other-SS-5 Revised Privacy Act State
SS-5- FS Privacy Act Statement (revised).doc Other-SS-5-FS Revised Privacy Act St
SSNAP PA Statement.docx Other-SSNAP privacy act statement
SS-5 Application for a Social Security Card SS-5.pdf Form and Instruction
SS-5-FS Application for a Social Security Card (Foreign Service) SS-5-FS - Revised.pdf Form and Instruction
SS-5-FS - Current.pdf SS-5-FS - Current IC Document
SS-5 (revised).pdf SS-5 (current) IC Document
SSNAP Screens (current).pdf SSNAP screens current IC Document

Information Collection (IC) Details

IC Title:	Application for a Social Security Card - Asking for Replacement Card beyond allowable limits	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 422.103-422.110

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-SS-5 Revised Privacy Act Statement			SS-5- FS Privacy Act Statement (revised).doc	No		Printable Only
Other-SS-5-FS Revised Privacy Act Statement			SS-5- FS Privacy Act Statement (revised).doc	No		Printable Only
Other-SSNAP privacy act statement			SSNAP PA Statement.docx	No		Printable Only
Instruction			Privacy Act Statement for Applicants Interviewed using SSNAP Screens.pdf	No		Printable Only
Form and Instruction	SS-5	Application for a Social Security Card	SS-5.pdf	No		Paper Only
Form and Instruction	SS-5-FS	Application for a Social Security Card (Foreign Service)	SS-5-FS - Revised.pdf	Yes	No	Fillable Printable
Other-Internal Screens			SSNAP Screens.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,000	3,100	900
Annual IC Time Burden (Hours)	4,000	3,100	900
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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