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SSA-L106 Letter to Custodian of School Records (Beneficiary or Claimant Signature)
Letter to Custodian of Birth Records
OMB: 0960-0693
IC ID: 238008
OMB.report
SSA
OMB 0960-0693
ICR 202207-0960-002
IC 238008
( )
Documents and Forms
Document Name
Document Type
Form SSA-L106
SSA-L106 Letter to Custodian of School Records (Beneficiary or Claimant Signature)
Form and Instruction
Revised Privacy Act Statment - SSA-L106 and SSA-L706.pdf
Other-Revised Privacy Act Statement
Revised Privacy Act Statment - SSA-L106 and SSA-L706.pdf
Other-Revised Privacy Act Statement
SSA-L106 Letter to Custodian of School Records
SSA-L106 - Revised Version.pdf
Form and Instruction
SSA-L106 Letter to Custodian of School Records
SSA-L106 - Revised Version.pdf
Form and Instruction
SSA-L106 - Current Version.pdf
SSA-L106 - Current Version
IC Document
SSA-L106 - Current Version.pdf
SSA-L106 - Current Version
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SSA-L106 Letter to Custodian of School Records (Beneficiary or Claimant Signature)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 404.704
20 CFR 416.802
20 CFR 404.716
20 CFR 422.107
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
SSA-L106
Letter to Custodian of School Records
SSA-L106 - Revised Version.pdf
No
Fillable Printable
Other-Revised Privacy Act Statement
Revised Privacy Act Statment - SSA-L106 and SSA-L706.pdf
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
32
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
0
0
0
-32
0
32
Annual IC Time Burden (Hours)
0
0
0
-1
0
1
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA-L106 - Current Version
SSA-L106 - Current Version.pdf
10/04/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.