Application for Access to SSA

Application for Access to SSA Systems

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0791 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-120 Application for Access to SSA Form and Instruction
SSA-120 Application For Access to SSA Systems SSA-120 Revised Version.pdf Form and Instruction
SSA-120 Current Version.pdf Applicaiton For Access to SSA Systems (SSA-120) current IC Document

Information Collection (IC) Details

IC Title:	Application for Access to SSA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 31.6011(b)2 26 CFR 31.6109-1 20 CFR 401.45

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-120	Application For Access to SSA Systems	SSA-120 Revised Version.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,148	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,148	-2,165	4,313
Annual IC Time Burden (Hours)	72	-72	144
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Applicaiton For Access to SSA Systems (SSA-120) current	SSA-120 Current Version.pdf	07/16/2014

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