Information Collection

Application for Replacement Social Security Card - oSSNAP

IC 239280 under ICR 202512-0960-001 · OMB 0960-0066.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0066 can be found here:

Documents and Forms

Document Name Document Type
Express Interviews Pre-Screening Questions.docx Other-Pre-Screening Questions for Ex
Express Interviews Pre-Screening Questions.docx Other-Pre-Screening Questions for Ex
Race and Ethnicity Screen - Individual.pdf Other-Race and Ethnicity Screen for
Race and Ethnicity Screen - Individual.pdf Other-Race and Ethnicity Screen for
Race and Ethnicity Screen - Self.pdf Other-Race and Ethnicity Screen for
Race and Ethnicity Screen - Self.pdf Other-Race and Ethnicity Screen for
Race and Ethnicity Screen - Review and Edit Summary.pdf Other-Race and Ethnicity Summary Scr
Race and Ethnicity Screen - Review and Edit Summary.pdf Other-Race and Ethnicity Summary Scr
oSSNAP Screen Package - Revised Version.pdf www.ssa.gov Other-Revised oSSNAP Screens
oSSNAP Screen Package - Revised Version.pdf www.ssa.gov Other-Revised oSSNAP Screens
oSSNAP Screen Package - Current Version.pdf Current oSSNAP Screens IC Document
oSSNAP Screen Package - Current Version.pdf Current oSSNAP Screens IC Document
oSSNAP Screen Package - Current Version.pdf Current oSSNAP Screens IC Document
oSSNAP Screen Package - Current Version.pdf Current oSSNAP Screens IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Replacement Social Security Card - oSSNAP	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 422.103 - 422.110

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Pre-Screening Questions for Express Service Appointments	Express Interviews Pre-Screening Questions.docx		No		Printable Only
Other-Race and Ethnicity Screen for an Individual (other than Self)	Race and Ethnicity Screen - Individual.pdf		Yes	Yes	Fillable Fileable Signable
Other-Race and Ethnicity Screen for Individuals Applying on their own behalf	Race and Ethnicity Screen - Self.pdf		Yes	Yes	Fillable Fileable Signable
Other-Race and Ethnicity Summary Screen	Race and Ethnicity Screen - Review and Edit Summary.pdf		Yes	Yes	Fillable Fileable Signable
Other-Revised oSSNAP Screens	oSSNAP Screen Package - Revised Version.pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,334,386	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,334,386	1,512,282	822,104
Annual IC Time Burden (Hours)	3,345,953	2,126,499	1,219,454
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current oSSNAP Screens	oSSNAP Screen Package - Current Version.pdf	12/30/2025
Current oSSNAP Screens	oSSNAP Screen Package - Current Version.pdf	12/30/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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