View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
0960-0693
ICR Reference No:
201904-0960-011
Status:
Historical Active
Previous ICR Reference No:
201605-0960-003
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Letter to Custodian of Birth Records
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
01/28/2020
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/04/2019
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2023
36 Months From Approved
01/31/2020
Responses
1,774
0
7,200
Time Burden (Hours)
163
0
1,200
Cost Burden (Dollars)
0
0
0
Abstract:
SSA prepares Form SSA-L106 (Letter to Custodian of School Records)and SSA-L706 (Letter to Custodian of Birth Records) for individuals who need help in obtaining evidence of their age in connection with Social Security number (SSN) card applications and claims for benefits or Supplemental Security Income (SSI). SSA uses the SSA-L106 to determine the existence of primary evidence of age for SSN applicants. SSA also uses both letters to verify with the issuing entity, when necessary, the authenticity of the record submitted by the SSN applicant or claimant. The respondents are the beneficiaries and claimants who sign the letters; and the schools, State and local bureaus of vital statistics, and religious entities who submit the information regarding evidence of age for the beneficiary or claimant.
Authorizing Statute(s):
US Code:
42 USC 405
Name of Law: Social Security Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
84 FR 25891
06/04/2019
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 40121
08/13/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
L106, Letter to Custodian of School Records (Local/State/Tribal Government)
SSA-L106
Letter to Custodian of Birth Records
SSA-L106 Letter to Custodian of School Records (Beneficiary or Claimant Signature)
SSA-L106
Letter to Custodian of School Records
SSA-L106 Letter to Custodian of School Records (Private Sector)
SSA-L106
Letter to Custodian of Birth Records
SSA-L706 Letter to Custodian of Birth Records (Beneficiary or Claimant Signature)
SSA-L706
Letter to Custodian of Birth Records
SSA-L706 Letter to Custodian of Birth Records (Private Sector)
SSA-L706
Letter to Custodian of Birth Records
SSA-L706 Letter to Custodian of Birth Records (State & Local)
SSA-L706
Letter to Custodian of Birth Records
ICR Summary of Burden
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
1,774
7,200
0
0
-5,426
0
Annual Time Burden (Hours)
163
1,200
0
0
-1,037
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
There is a significant decrease in the public reporting burden. This change stems from a decrease in the number of respondents using these forms. The figures reported in 2016 were an estimate based on old data. In this ICR, we were able to obtain more accurate information data for the number of respondents. There is no change to the burden time per response for the respondents who complete these forms. SSA did not take any actions to cause this change. In addition, we are increasing the burden by including the one-minute burden for the claimants and beneficiaries for whom we complete this form to sign these forms before we send them. While we have always asked the claimants or beneficiaries to sign these forms, we only recently realized that we were no longer showing this minor burden in our burden estimates. This is an oversight, which we are correcting now.
Annual Cost to Federal Government:
$3,106
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
10/04/2019
An official website of the United States government
The .gov means it's official.
The site is secure.
