Notice2026-10439
Agency Information Collection Activities: Proposed Request
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
May 26, 2026
Issuing agencies
Social Security Administration
Full Text
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<title>Federal Register, Volume 91 Issue 100 (Tuesday, May 26, 2026)</title>
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[Federal Register Volume 91, Number 100 (Tuesday, May 26, 2026)]
[Notices]
[Pages 30774-30780]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-10439]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2026-0463]
Agency Information Collection Activities: Proposed Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions and one extension of OMB-approved information
collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and ways to minimize burden
on respondents, including the use of automated collection techniques or
other forms of information technology. Mail, email, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer at the following
addresses or fax numbers.
OMB) Office of Management and Budget, Attn: Desk Officer for SSA
(SSA) Social Security Administration, OLCA, Attn: Reports Clearance
Director, Mail Stop 3253 Altmeyer, 6401 Security Blvd., Baltimore, MD
21235, Fax: 833-410-1631, Email address: <a href="/cdn-cgi/l/email-protection#bbf4e995e9decbd4c9cfc895f8d7dedac9dad5d8defbc8c8da95dcd4cd"><span class="__cf_email__" data-cfemail="6b243945390e1b04191f184528070e0a190a05080e2b18180a450c041d">[email protected]</span></a>.
Or you may submit your comments online through <a href="https://www.reginfo.gov/public/do/PRAmain">https://www.reginfo.gov/public/do/PRAmain</a> by clicking on Currently under
Review--Open for Public Comments and choosing to click on one of SSA's
published items. Please reference Docket ID Number [SSA-2026-0463] in
your submitted response.
The information collections below are pending at SSA. SSA will
submit them to OMB within 60 days from the date of this notice. To be
sure we consider your comments, we must receive them no later than July
27, 2026. Individuals can obtain copies of the collection instruments
by writing to the above email address.
1. Certificate of Election for Reduced Spouse's Benefits--20 CFR
404.421--0960-0398. SSA cannot pay reduced Social Security benefits to
an already entitled spouse unless the spouse elects to receive reduced
benefits and is
(1) at least age 62, but under full retirement age; and (2) is no
longer caring for a child. In this situation, spouses who decide to
elect reduced benefits must file Form SSA-25, Certificate of Election
for Reduced Spouse's Benefits. SSA uses the information to pay
qualified spouses who elect to receive reduced benefits. Respondents
are entitled spouses seeking reduced Social Security benefits.
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Average
Average burden Estimated theoretical Average wait Total annual
Method of completion Number of Frequency of per response total annual hourly cost time in field opportunity cost
respondents response (minutes) burden (hours) amount office ** (dollars) ***
(dollars) *
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SSA-25 (paper)....................... 1,040 1 13 225 * $32.66 ** 22 *** $19,792
SSA-25 (Upload ocuments)............. 576 1 13 125 * 32.66 .............. *** 4,083
------------------------------------------------------------------------------------------------------------------
Totals........................... 1,616 .............. .............. 350 .............. .............. *** 23,875
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Type of Request: Revision of an OMB approved information collection.
* We based this figures on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data (Occupational Employment and Wage
Statistics).
** We based this figure on the average FY 2026 wait time for field offices (22 minutes), based on SSA's current management information data. This figure
reflects both data from our systems and the data posted on our public facing website (Social Security performance [verbar] SSA) on the date we drafted
this document. As the figures fluctuate daily, the wait times may be different on the website than they appear here. We continue to monitor our
website and management information data on call back times to ensure we report updated figures when possible. While we have included wait time for all
respondents using the paper form, we note that respondents are not required to complete the form in person and those who mail or drop off a completed
form do not experience any wait time.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
2. Appointment of Representative--20 CFR 404.1707, 404.1720,
408.1101, 416.1507, and 416.1520--0960-0527. Individuals claiming
rights or benefits under the Act must notify SSA in writing using our
prescribed appointment form, Form SSA-1696, or the submittable
electronic version, e1696, to appoint an individual to represent them
in dealing with SSA. In addition, as part of SSA's regulations, SSA
requires both claimants and representatives to sign our prescribed form
and file it with SSA before SSA will recognize the appointment.
Claimants use Form SSA-1696, or e1696, to appoint a representative to
handle their claim before SSA. They may also use the SSA-1696 (or
e1696) to name their principal representative. Their selected
representative(s) can use the SSA-1696, or e1696, to indicate whether
they will charge a fee, to show their eligibility for direct fee
payment, and to assign direct payment of their fee to an entity. In
addition, representatives also use the SSA-1696, or e1696, to inform
SSA of their disbarment; suspension from a court or bar in which they
previously admitted to practice; or their disqualification from
participating in or appearing before a Federal program or agency. SSA
uses the information on the SSA-1696, or e1696, to document the
appointment of the representative. We also use this form to collect the
representative's business affiliation and employer identification
number. In addition, claimants may use the SSA-1696-SUP1 to revoke
their appointment of a representative, and representatives may use the
SSA-1696-SUP2 to withdraw their acceptance of the appointment. SSA uses
the information on the SSA-1696-SUP1 and SSA-1696-SUP2 to document the
revocation and withdrawal of a representative. Respondents are
applicants for, or recipients of, Social Security disability benefits
(SSDI); SSI payments; or anyone pursuing a benefit or invoking a right
under SSA programs, who are notifying SSA they wish to appoint someone
to represent them in their dealings with SSA; representatives being
appointed by a claimant; as well as individuals revoking the
appointment of a representative, and representatives withdrawing from
an appointment.
[[Page 30775]]
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Method of completion Number of Frequency of per response total annual hourly cost opportunity cost
respondents response (minutes) burden (hours) amount (dollars) **
(dollars) *
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SSA-1696; e1696 (Appointed Representative)........... 1,852,171 1 5 154,347 * $85.37 ** $13,176,603
SSA-1696; e1696 (Claimants).......................... 1,852,171 1 7 216,087 * 14.27 ** 3,083,561
SSA-1696-SUP1 (Claimants)............................ 21,959 1 5 1,830 * 14.27 ** 26,114
SSA-1696-SUP2 (Appointed Representative)............. 252,000 1 5 21,000 * 85.37 ** 1,792,770
--------------------------------------------------------------------------------------------------
Totals........................................... 3,978,301 .............. .............. 393,264 .............. ** 18,079,048
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* We based these figures on the average Lawyers, Judges, and Related Workers, hourly salary, as reported by Bureau of Labor Statistics data
(Occupational Employment and Wage Statistics) and the average disability payments based on SSA's current FY 2026 data (Effect of COLA on Average
Social Security Benefits).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
3. Public Information Campaign--0960-0544. Periodically, SSA sends
various public information materials, including public service
announcements; news releases; and educational tapes, to public
broadcasting systems so they can inform the public about various
programs and activities SSA conducts. SSA frequently sends follow-up
business reply cards for these public information materials to obtain
suggestions for improving them. The respondents are broadcast sources.
Type of Request: Extension of an OMB-approved information
collection.
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Average
Average burden Estimated total theoretical Total annual
Method of completion Number of Frequency of per response annual burden hourly cost opportunity cost
respondents response (minutes) (hours) amount (dollars) **
(dollars)*
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Radio.......................................... 5,000 2 1 167 * $38.52 ** $6,433
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* We based this figure on average Broadcast Announcers and Radio Disc Jockey's hourly salary, as reported by Bureau of Labor Statistics data
(Occupational Employment and Wage Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
4. Medical Permit Parking Application--41 CFR 102-71.20 & 102-
74.305--0960-0624. SSA employees and contractors with a qualifying
medical condition who park at SSA-owned and leased facilities may apply
to receive a medical parking permit. SSA uses two forms for this
program: (1) the SSA-3192, the Application and Statement, which an
individual completes when first applying for the medical parking space;
and (2) the SSA-3193, the Physician's Report, which the applicant's
physician completes to verify the medical condition after the
individual completes the top portion and brings the form to the
physician. The respondents are SSA employees and contractors seeking
medical parking permits and their physicians. Because SSA employees are
Federal workers exempt from the requirements of the Paperwork Reduction
Act, the burden below is only for SSA contractors and physicians (of
both SSA employees and contractors).
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average Estimated theoretical Total annual
Method of completion Number of Frequency of burden per total annual hourly cost opportunity cost
respondents response response burden (hours) amount (dollars)**
(minutes) (dollars)*
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SSA-3192(Contractor Applicant)....................... 195 1 30 98 * $55.15 ** $5,405
SSA-3193(Contractor Applicant)....................... 195 1 \++\ 15 49 ** 55.15 ** 2,702
SSA-3193(Physician).................................. \+\ 233 1 90 350 * 130.92 ** 45,822
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Totals........................................... 623 .............. .............. 497 .............. ** 53,929
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\+\ This figure accounts for all of the forms the physicians complete (both from SSA employees and contractors).
\++\ This average figure includes both the time estimate for the contractor applicant completing the top portion of Form SSA-3193 (approximately 5
minutes) and the amount of time to bring the form to the physician (approximately 10 minutes).
* We based these figures on the average SSA contractor's hourly wages based on SSA's management information, and the average Physican's hourly wages, as
reported by Bureau of Labor Statistics data (Occupational Employment and Wage Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
5. Teacher Questionnaire and Request for Administrative
Information--20 CFR 404.1513, 416.913, and 416.924a(a)--0960-0646. When
determining the effects of a child's impairment(s), SSA obtains
information about the child's functioning from teachers; parents; and
others who observe the child on a daily basis. SSA requests teachers
complete the SSA-5665, Teacher's Questionnaire to obtain a report on
the child's daily overall functioning, comprehension, and known medical
conditions throughout the school day. SSA requests the school
administration to complete the SSA-5666, Request for Administrative
Information, to obtain formal testing results, other teacher
[[Page 30776]]
reports, therapy progress notes, individualized education program
documents, and other records of a child's educational aptitude and
achievements. The respondents are teachers, educational administrators,
and other education personnel.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Method of completion Number of Frequency of per response total annual hourly cost opportunity cost
respondents response (minutes) burden (hours) amount (dollars)**
(dollars)*
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SSA-5665-BK(Teachers)................................ 211,487 1 40 140,991 * $24.65 ** $3,475,428
SSA-5666 (Administrators)............................ 154,723 1 30 77,362 * 47.82 ** 3,699,45
--------------------------------------------------------------------------------------------------
Totals........................................... 366,210 .............. .............. 218,353 .............. ** 7,174,879
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* We based these figures on the average Teachers and Instructor's hourly wages, as well as on the average Education Administrator's hourly wages as
reported by Bureau of Labor Statistics data (Occupational Employment and Wage Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
6. Request for Accommodation in Communication Method--0960-0777.
SSA allows disabled or impaired Social Security applicants,
beneficiaries, recipients, and representative payees to choose one of
seven alternative methods of communication they want SSA to use when we
send them benefit notices and other related communications. The seven
alternative methods we offer are:
(1) standard print notice by first-class mail; (2) standard print
mail with a follow-up telephone call; (3) certified mail; (4) Braille;
(5) Microsoft Word file on data CD; (6) large print (18-point font); or
(7) audio CD. Respondents who want to receive notices from SSA through
a communication method other than the seven methods listed above must
explain their request to us. Those respondents use our iAccomodate
Intranet or mySNO internet screens, or the paper Form SSA-9000-F6 to:
(1) describe the type of accommodation they want from SSA; (2) disclose
their condition necessitating the need for a different type of
accommodation; and (3) explain why none of the seven methods described
above are sufficient for their needs. SSA uses our internet and
Intranet screens or Form SSA-9000-F6 to determine, based on applicable
law and regulation, whether to grant the respondents' requests for an
accommodation based on their impairment or disability. SSA collects
this information electronically through either an in-person telephone
interview during which the SSA employee keys in the information on our
iAccommodate Intranet screens, or through the mySNO internet screens
which respondents may complete for themselves using the application
available through their mySSA accounts. The respondents are disabled or
impaired Social Security or SSI applicants, beneficiaries, recipients,
and representative payees who ask SSA to send notices and other
communications in an alternative method besides the seven modalities we
currently offer.
Type of Request: Revision of an OMB-approved information
collection.
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Average Average
Average burden Estimated theoretical teleservice Total annual
Method of completion Number of Frequency of per response total annual hourly cost center wait opportunity cost
respondents response (minutes) burden (hours) amount time (minutes) (dollars) ***
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-9000/iAccommodate................ 128 1 20 43 * $14.27 ** 48 *** $2,069
mySNO................................ 20,524 1 20 6,841 14.27 .............. *** 97,621
------------------------------------------------------------------------------------------------------------------
Totals........................... 20,652 .............. .............. 6,884 .............. .............. *** 99,690
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* We based this figure on the average disability payments based on SSA's current FY 2026 data (Effect of COLA on Average Social Security Benefits)).
** We based this figure on the FY 2026 wait times for the teleservice centers (48 minutes which includes the average speed of answer of 7 minutes as
well as the average 41-minute wait time for a call back from an SSA technician), based on SSA's current management information data. This figure
reflects both data from our systems and the data posted on our public facing website (Social Security performance [verbar] SSA) on the date we drafted
this document. As the figures fluctuate daily, the wait times may be different on the website than they appear here. We continue to monitor our
website and management information data on call back times to ensure we report updated figures when possible.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
7. Waiver of Supplemental Security Income Payment Continuation--20
CFR 416.1400-416.1422--0960-0783. SSI recipients who wish to
discontinue their SSI payments while awaiting a determination on their
appeal complete Form SSA-263, Waiver of Supplemental Security Income
Payment Continuation, to inform SSA of this decision. SSA collects the
information to determine whether the SSI recipient meets the provisions
of the Social Security Act regarding waiver of payment continuation and
as proof respondents no longer want their payments to continue.
Respondents are recipients of SSI payments who wish to discontinue
receipt of payment while awaiting a determination on their appeal.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 30777]]
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Average wait
Average time in field
Number of Frequency of Average burden Estimated total theoretical office or Total annual
Method of completion respondents response per response annual burden hourly cost teleservice opportunity cost
(minutes) (hours) amount centers (dollars) ***
(dollars) * (minutes) **
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SSA-263....................... 1,662 1 5 139 * $14.27 ** 35 *** $15,825
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* We based this figure on the average disability payments based on SSA's current FY 2026 data (Effect of COLA on Average Social Security Benefits).
** We based this figure on the average combined FY 2026 wait times for field offices (22 minutes) and for teleservice centers (48 minutes which includes
the average speed of answer of 7 minutes as well as the average 41-minute wait time for a call back from an SSA technician), based on SSA's current
management information data. This figure reflects both data from our systems and the data posted on our public facing website (Social Security
performance [verbar] SSA) on the date we drafted this document. As the figures fluctuate daily, the wait times may be different on the website than
they appear here. We continue to monitor our website and management information data on call back times to ensure we report updated figures when
possible.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
8. Application for Access to SSA Systems--20 CFR 401.45--0960-0791.
SSA uses Form SSA-120, Application for Access to SSA Systems, to allow
limited access to SSA's information resources for SSA employees and
non-Federal employees (contractors). SSA requires supervisory approval,
and local or component Security Officer review prior to granting this
access. The respondents are SSA employees and non-Federal Employees
(contractors) who require access to SSA systems to perform their jobs.
Note: Because SSA employees are Federal workers exempt from the
requirements of the Paperwork Reduction Act, the burden below is only
for SSA contractors.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Method of completion Number of Frequency of per response total annual hourly cost opportunity cost
respondents response (minutes) burden (hours) amount (dollars) ***
(dollars) *
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SSA-120 (paper version).............................. 685 1 2 23 * $32.66 ** $751
SSA-120 (Internet version)........................... 1,482 1 2 49 * 32.66 ** 1,600
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Total............................................ 2,167 .............. .............. 72 .............. *** 2,351
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* We based this figure on the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (Occupational Employment and Wage
Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
9. Incoming and Outgoing Intergovernmental Personnel Act Assignment
Agreement--5 CFR part 334--0960-0792. The Intergovernmental Personnel
Act (IPA) mobility program provides for the temporary assignment of
civilian personnel between the Federal Government and State and local
governments; colleges and universities; Indian tribal governments;
federally funded research and development centers; and other eligible
organizations. The Office of Personnel Management (OPM) created a
generic form, the OF-69, for agencies to use as a template when
collecting information for the IPA assignment. The OF-69 collects
information about the assignment including: (1) the enrolled employee's
name, Social Security number, job title, salary, classification, and
address; (2) the type of assignment; (3) the reimbursement arrangement;
and (4) an explanation as to how the assignment benefits both SSA and
the non-federal organization involved in the exchange. OPM directs
agencies to use their own forms for recording these agreements.
Therefore, SSA modified the OF-69 to meet our needs, creating the SSA-
187 for incoming employees and the SSA-188 for outgoing employees. SSA
collects information on the SSA-187 and SSA-188 to document the IPA
assignment, and to act as an agreement between the agencies.
Respondents are personnel from State and local governments; colleges
and universities; Indian tribal governments; federally funded research
and development centers; and other eligible organizations who
participate in the IPA exchange with SSA.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Method of completion Number of Frequency of per response total annual hourly cost opportunity cost
respondents response (minutes) burden (hours) amount (dollars) ***
(dollars) *
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Non-Federal employee................................. 3 1 30 2 * $57.49 ** $115
Non-Federal employer signers......................... 12 1 5 1 * 57.49 ** 57
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Totals........................................... 15 .............. .............. 3 .............. ** 172
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* We based this figure on averaging the average of Postsecondary Education Administrators and Management Analysts hourly wages, as reported by Bureau of
Labor Statistics data (Occupational Employment and Wage Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
10. Authorization for the Social Security Administration to Obtain
Personal Information--20 CFR 404.704, 404.820--404.823, 404.1926,
416.203, & 418.3001--0960-0801. SSA uses Form SSA-8510 to contact a
public or private custodian of records on behalf of an applicant or
recipient of an SSA program to request evidence
[[Page 30778]]
information or proofs, which may support a benefit application or
payment continuation. SSA also uses this form to obtain evidence or
proof to determine the claimant's payment amount. We ask for
information such as the following:
<bullet> Age requirements (e.g., birth certificate, court documents)
<bullet> Insured status (e.g., earnings, employer verification)
<bullet> Marriage or divorce
<bullet> Pension offsets
<bullet> Wages verification
<bullet> Annuities
<bullet> Dividends, royalties, or other similar payments
<bullet> Property information
<bullet> Benefit verification from a State agency or third party
<bullet> Immigration status (rare instances)
<bullet> Income verification from public agencies or private
individuals
<bullet> Unemployment benefits
<bullet> Insurance policies
<bullet> Alimony or Child Support payments
If the custodian of the records requires a signed authorization
from the individual(s) whose information SSA requests, SSA may provide
the custodian with a copy of the SSA-8510. Once the respondent
completes the SSA-8510, either using the paper form or using the
Personal Information Authorization Intranet version, SSA uses the form
as the authorization to obtain personal information regarding the
respondent from third parties until the authorizing person (respondent)
withdraws their claim or revokes the permission of its use. The
collection is voluntary; however, failure to verify the individuals'
eligibility can prevent SSA from making an accurate and timely decision
for their benefits. The respondents are individuals who may file for,
or currently receive, Social Security benefits, SSI payments, or
Medicare Part D subsidies.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Average wait Total annual
Method of completion Number of Frequency of per response total annual hourly cost time in field opportunity cost
respondents response (minutes) burden (hours) amount office (dollars) ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-8510 (paper)..................... 20,522 1 5 1,710 $32.66 * 22 *** $301,615
SSA-8510 (Upload Documents).......... 2,849 1 5 237 32.66 .............. *** 7,740
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Totals........................... 23,371 .............. .............. 1,947 .............. .............. *** 309,355
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* We based this figure on the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (Occupational Employment and Wage
Statistics).
** We based this figure on the average FY 2026 wait times for field offices (22 minutes). This figure reflects both data from our systems and the data
posted on our public facing website (Social Security performance [verbar] SSA) on the date we drafted this document. As the figures fluctuate daily,
the wait times may be different on the website than they appear here. We continue to monitor our website and management information data on call back
times to ensure we report updated figures when possible. While we have included wait time for all respondents using the paper form, we note that
respondents are not required to complete the form in person and those who mail or drop off a completed form do not experience any wait time.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
11. Evidence From Excluded Medical Sources of Evidence--20 CFR
404.1503b and 416.903b--0960-0803. Section 812 of the Bipartisan Budget
Act of 2015 (BBA), ``Exclusion of certain medical sources of
evidence,'' mandates that SSA exclude evidence in disability decisions
from certain medical sources. BBA Section 812 amended section 223(d)(5)
of the Social Security Act (Act) by adding a subsection ``C.'' Section
223(d)(5)(C)(i) of the Act, as amended, requires SSA to exclude
evidence (except for good cause) from medical sources: (1) convicted of
a felony under sections 208 or 1632 of the Act; (2) excluded from
participating in any Federal health care program under section 1128 of
the Act; or (3) imposed with a civil monetary penalty (CMP),
assessment, or both, for submitting false evidence, under section 1129
of the Act. We also implemented section 223(d)(5)(C), as amended,
through regulations at 20 CFR 404.1503b and 416.903b of the Code of
Federal Regulations. These regulations require excluded medical sources
to self-report their excluded status, in writing, each time they submit
evidence related to a claim for benefits under Titles II or XVI of the
Act. Excluded medical sources' duty to self-report their excluded
status applies to evidence they submit to SSA directly, or through a
representative, claimant, or other individual or entity. As needed, SSA
informs the medical sources we suspect should be excluded of these
requirements through a Fact Sheet we send to them via mail, or which
they can find on our website where we list the regulatory requirements
under BBA section 812. In addition, along with the Fact Sheet and
website, we provide sample statements as templates the affected medical
sources can use to create their own written statements as required
under our regulations. The respondents for this collection are medical
sources that: (1) meet one of the exclusionary categories set forth in
section 223(d)(5)(C)(i) of the Act, as amended; (2) furnish evidence
related to a claim for benefits under Titles II or XVI of the Act; and
(3) had failed to self-identify as an excluded source of medical
evidence as required in section 223(d(5)(C)(i).
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Method of completion Number of Frequency of Number of per response total annual hourly cost theoretical
respondents response responses (minutes) burden (hours) amount opportunity cost
(dollars) * (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
404.1503b(c) (Fact Sheet)............ 2,670 1 2,670 20 890 *$50.59 **$45,025
416.903b(c) (Follow-up Notice)....... 10 4 40 20 13 $50.59 **658
------------------------------------------------------------------------------------------------------------------
Totals........................... 2,680 .............. 2,710 .............. 903 .............. **45,683
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* We based this figure on the average Healthcare Practitioners and Technical Occupations worker's hourly wages, as reported by Bureau of Labor
Statistics data (Occupational Employment and Wage Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
[[Page 30779]]
12. Request for Individual Access to Records Protected Under the
Privacy Act--20 CFR 401.30-401.95--0960-NEW.
The Creating Advanced Streamlined Electronic Services for
Constituents Act of 2019 (CASES Act), Public Law 116-50, 133 Stat. 1073
(2019), requires Federal agencies to establish a digital process for
identity-proofed and authenticated individuals to request access to
their records protected by the Privacy Act of 1974 (Privacy Act) (5
U.S.C. 552a of the United States Code). To comply with the CASES Act
and OMB Memorandum, M-21-04, and pursuant to authority under sections
702(a)(5) and 1106(a) of the Social Security Act (42 U.S.C. 902(a)(5),
1306(a)), the Social Security Administration (SSA) developed Form SSA-
2288-OP1, Request for Individual Access to Records Protected Under the
Privacy Act, a dynamic webform that guides respondents through the
information necessary to submit an electronic request for access to
agency records about themselves. Under SSA's regulations at 20 CFR
401.40 regarding individuals' access rights under the Privacy Act (5
U.S.C. 552a(f)), individuals may request access to their records by
visiting their local Social Security field office or writing to the
manager of the applicable system of records. Since SSA currently has no
special agency form available to the public to submit this type of
request, we are implementing Form SSA-2288-OP1 to comply with the CASES
Act, the Privacy Act, OMB M-21-04, and SSA's governing regulations at
20 CFR 401.30-401.95.
Form SSA-2288-OP1 is an electronic webform that respondents submit
online only via SSA's Upload Documents portal (OMB No. 0960-0830),
after the portal first appropriately identity-proofs and authenticates
respondents, consistent with requirements in the CASES Act and OMB M-
21-04. Respondents can use Form SSA-2288-OP1 to request access to
records or information about themselves from SSA's program files.
Pursuant to the Privacy Act and SSA's regulations, a special procedure
governs access requests that include medical records (5 U.S.C.
552a(f)(3) and 20 CFR 401.55). Therefore, respondents requesting
medical record requests via Form SSA-2288-OP1 must designate an
individual (such as a health professional or other responsible
individual) to receive and review the records and inform the respondent
of its contents. SSA may grant the respondent direct access to their
medical records if it determines direct access is not likely to have an
adverse effect on the respondent. Respondents who cannot (or do not
wish to) submit their request electronically or seek other types of
records can always avail themselves of SSA's existing service delivery
channels, such as visiting or calling their local Social Security
office, or submitting a written request by mail, fax, or hand-delivery.
Respondents can learn more about SSA's privacy program from its
privacy web page at <a href="http://www.ssa.gov/privacy">www.ssa.gov/privacy</a>, which contains sub-pages with
additional information about Privacy Act requests and a link to Form
SSA-2288-OP1. Respondents may also find Form SSA-2288-OP1 within the
Upload Documents portal, or on SSA's Forms web page at <a href="http://www.ssa.gov/forms">www.ssa.gov/forms</a>. Respondents are the subjects of the record(s) protected by the
Privacy Act, who request access to agency records about themselves.
Type of Request: Request for a new information collection.
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Average
Average burden Estimated total theoretical Total annual
Method of completion Number of Frequency of per response annual burden hourly cost opportunity cost
respondents response (minutes) (hours) amount (dollars) ***
(dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-2288-OP1................................... 1,097 1 12 219 * $32.66 ** $7,153
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* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (Occupational Employment and Wage
Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
13. Universal Benefits Application (UBA)--20 CFR 404.310-404.311,
404.315-404.322, 404.330-404.333, 404.601-404.603, and 404.1501-
404.1512--0960-NEW.
Background
Individuals who want to apply for Social Security benefits
electronically must currently use SSA's internet-based iClaim
application (OMB No. 0960-0618). Even when using iClaim, in some
circumstances they may also need to subsequently submit supplementary
documentation (by mail or via the Upload Documents portal, OMB No.
0960-0830) requested by an SSA technician who has reviewed the
claimants' applications. This process can be lengthy for respondents,
as it requires them to both navigate SSA's website and wait for a
technician to identify the documents or forms they need to complete,
some of which may be available online through Upload Documents, and a
few of which are only available as paper forms.
To improve the processes for filing for benefits and offer a more
efficient online experience, SSA is implementing the Universal Benefits
Application (UBA) platform, a common platform that will allow
individuals with different application needs to use one website to
complete their benefit applications online.
Universal Benefits Application (UBA)
The UBA is a single website offering a dynamic online process that
navigates individuals directly to the benefit applications and
supplemental forms they need to submit electronically to SSA, after
which an SSA technician supports (if needed) the individuals through
the development process to achieve a better customer experience. We
will be releasing UBA on a multiple-phase basis, with additional
benefit application types being added on an iterative basis. This
initial clearance is for the UBA concept website and for its initial
applications, the Lump-Sum Death Payment (OMB No. 0960-0013), and the
Retirement Insurance Benefits (OMB No. 0960-0618).
UBA reflects a smart, dynamic pathing process in which the site
only presents relevant questions to the user (e.g., individuals who
respond that they have never been married are not presented with
questions about marriage). The SSA website presents respondents with a
screener tool to determine the type of benefits for which they may be
eligible and whether they meet the criteria to file online. If the
individuals do not meet the criteria to apply online, the SSA screener
routes them to the Appointment Scheduling Calendar (OMB No. 0960-0828)
or directs them to the National 800 Number to schedule an in-person
appointment. Individuals who choose to file online access UBA through
their my
[[Page 30780]]
Social Security account and first authenticate using eAccess (OMB No.
0960-0789) which navigates them to <a href="http://Login.gov">Login.gov</a> or ID.me, thus identity
proofing the individuals so they can securely submit their benefits
requests to SSA through UBA. Once individuals authenticate, they arrive
at an information page that explains how the UBA online process works,
including the information we will ask, who can apply, and how long it
will take to complete the application. Since respondents filing via UBA
are authenticated, the identity core information they provided through
authentication automatically propagates into the UBA path, so
individuals do not need to re-enter that information. UBA also
leverages some of the proven information in SSA systems (i.e.,
earnings) to propagate within the UBA path for the individual to
confirm which streamlines the process. Once individuals answer the
questions for their specific benefit application and supplemental forms
(if needed), they can then review a summary of their responses,
electronically sign and submit their application. Individuals also have
an opportunity to view and print the benefit application summary and
receipt to keep for their records.
While SSA representatives in field offices and teleservice centers
are available to assist individuals throughout the benefit application
process, individuals who do not require assistance have the ability to
completely finish their applications using UBA, which provides built-in
help screens to aid the public in completing the applications behind
the UBA portal.
At this time, individuals can access the SSA-8, Lump Sum Death
Payment (LSDP) (OMB No. 0960-0013) through UBA, and we expect to expand
the system to include the Retirement Insurance Benefits (RIB)
Application, SSA-1 (OMB No. 0960-0618) within the next few months. We
will continue to roll out additional new benefit applications behind
the UBA portal beyond these two initial applications on a rolling
basis. Respondents will complete all of the applications we add to the
UBA portal using the dynamic pathing methodology. Eventually, the UBA
portal will replace iClaim and add additional types of benefit
applications to this new cloud-based platform. The respondents are
authenticated individuals filing for benefits on their own behalf who
choose to use the internet to conduct business with us.
Type of Request: Request for a new information collection already
in use.
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Average
Average burden Estimated total theoretical Total annual
Method of completion Number of Frequency of per response annual burden hourly cost opportunity cost
respondents response (minutes) (hours) amount (dollars) ***
(dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
UBA Informational Screens and Screener 2,223,305 1 7 259,386 * $32.66 ** $8,471,547
Questions \+\.................................
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\+\ After authenticating, respondents will need to read information regarding the UBA application, including the Terms of Service, then they will
complete a screener to help navigate to the appropriate benefit application.
* We based this figure on the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (Occupational Employment and Wage
Statistics).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
Mark Steffensen,
General Counsel, Chief of Law, Policy and Legislative Affairs, Social
Security Administration.
[FR Doc. 2026-10439 Filed 5-22-26; 8:45 am]
BILLING CODE 4191-02-P
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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.