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: 0960-0288	ICR Reference No: 202606-0960-010
Status: Active	Previous ICR Reference No: 202107-0960-009
Agency/Subagency: SSA	Agency Tracking No:
Title: Notice Regarding Substitution of Party Upon Death of Claimant
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/25/2026
	Date Received in OIRA: 06/24/2026
Terms of Clearance: Previous terms of clearance remain in effect: Prior to triannual renewal, the agency will allow for electronic submission of this information collection or will upload a separate document in which the agency provides a fact-specific justification for why this information collection cannot be signed and filed electronically and why this is consistent with the agency's commitments under Sec. 4 (k)(iii) and (iv) of E.O. 14058.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2027	08/31/2027	08/31/2027
Responses	4,000	0	4,000
Time Burden (Hours)	333	0	333
Cost Burden (Dollars)	0	0	0

Annual Cost to Federal Government: $15,017

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. No

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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