View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0960-0778	ICR Reference No: 200912-0960-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Notification of a Social Security Number (SSN) to an Employer for Wage Reporting
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/20/2010
	Date Received in OIRA: 03/02/2010
Terms of Clearance: SSA should report this collection as a violation is OMB's annual ICB report.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2013	36 Months From Approved
Responses	375,000	0	0
Time Burden (Hours)	12,500	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	375,000	375,000
Annual Time Burden (Hours)	12,500	12,500
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Form SSA-112 allows SSA to accommodate an individual's request to have their Social Security Number mailed to their employer upon initial assignment. Although a burden on the public, the form allows SSA to provide a service to the public at their request; completing the form is voluntary and is not required to obtain/retain benefits.

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