Data Exchange Request Form - State and Local Governments

Data Exchange Request Form

Documents and Forms

Document Name Document Type
Form SSA-157 Data Exchange Request Form - State and Local Governments Form
PRA 0802 (revised).docx Other-Revised Paperwork Reduction Ac
SSA-157 Data Exchange Request Form SSA-157 (revised).pdf Form
SSA-157 (current).pdf SSA-157 - Current IC Document

Information Collection (IC) Details

IC Title:	Data Exchange Request Form - State and Local Governments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-157	Data Exchange Request Form	SSA-157 (revised).pdf		Yes	Yes	Fillable Fileable Signable
Other-Revised Paperwork Reduction Act			PRA 0802 (revised).docx		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: 139	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	139	25	114
Annual IC Time Burden (Hours)	104	47	57
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-157 - Current	SSA-157 (current).pdf	11/15/2021

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