Notification of a Social Security Number (SSN) to an Employer for Wage Reporting

Forms and Documents

Document Name	Status
Form SSA-112 Notification of a Social Security Number (SSN) to an Employer for Wage Reporting Form	New
Supporting Statement 0960-New.doc Supporting Statement A	2010-02-23

IC Document Collections

IC ID	Document Title	Status
191619	Notification of a Social Security Number (SSN) to an Employer for Wage Reporting Form	New

ICR Details

OMB Control No: 0960-0778	ICR Reference No: 200912-0960-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Notification of a Social Security Number (SSN) to an Employer for Wage Reporting
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/20/2010
	Date Received in OIRA: 03/02/2010
Terms of Clearance: SSA should report this collection as a violation is OMB's annual ICB report.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2013	36 Months From Approved
Responses	375,000	0	0
Time Burden (Hours)	12,500	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Form SSA-112 allows SSA to send, at the individual's request, the individual's SSN to his or her employer. SSA mailing this information to the employer ensures the employer has the correct information for wage reporting purposes. Respondents are individuals who are applying for an initial SSN and request to have the information mailed to their employer.

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Authorizing Statute(s): US Code: 42 USC 405 Name of Law: Evidence, procedure and certification for payments
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 59336	11/17/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 3778	01/22/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Notification of a Social Security Number (SSN) to an Employer for Wage Reporting	SSA-112	Notification of a Social Security Number (SSN) to an Employer for Wage Reporting Purposes

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	375,000	0	0	375,000	0	0
Annual Time Burden (Hours)	12,500	0	0	12,500	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Form SSA-112 allows SSA to accommodate an individual's request to have their Social Security Number mailed to their employer upon initial assignment. Although a burden on the public, the form allows SSA to provide a service to the public at their request; completing the form is voluntary and is not required to obtain/retain benefits.

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Annual Cost to Federal Government: $131,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/02/2010

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