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OMB Control No: 0960-0004	ICR Reference No: 202605-0960-005
Status: Received in OIRA	Previous ICR Reference No: 202503-0960-004
Agency/Subagency: SSA	Agency Tracking No:
Title: Application for Widow's or Widower's Insurance Benefits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 06/26/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2026
Responses	567,964	572,656
Time Burden (Hours)	927,851	286,328
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	567,964	572,656	-4,692
Annual Time Burden (Hours)	927,851	286,328	641,523
Annual Cost Burden (Dollars)	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: When we last cleared this IC in 2023, the burden was 286,328 hours. However, we are currently reporting a burden of 283,983 hours. This change stems from a decrease in the number of responses from 572,656 to 567,964. Although the number of responses changed, SSA did not take any actions to cause this change. There is no change to the burden time per response. These figures represent current Management Information data. * Note: The total burden reflected in ROCIS is 1,023,853, while the burden cited in #12 of the Supporting Statement is 283,983. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30-minute, one-way, drive burden + learning costs. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

Annual Cost to Federal Government: $12,289,959

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? No

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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