View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0960-0069
ICR Reference No:
200707-0960-001
Status:
Historical Active
Previous ICR Reference No:
200408-0960-007
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Representative Payee Evaluation Report
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
11/07/2007
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/23/2007
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2010
36 Months From Approved
11/30/2007
Responses
250,000
0
252,000
Time Burden (Hours)
125,000
0
126,000
Cost Burden (Dollars)
0
0
0
Abstract:
Sections 205(j) and 1631(a)(2) of the Social Security Act provide that a representative payee may be appointed to receive benefits on behalf of an individual entitled to Title II and/or Title XVI benefits when that individual is unable to manage or direct the management of those funds him/herself. The representative payee is required to report to SSA at least once per year on how those funds received have been used or conserved. When a representative payee fails to adequately report to SSA as required, SSA will conduct a face-to-face interview with the payee to complete an SSA-624, Representative Payee Evaluation Report, in order to determine the continued suitability of the representative payee to serve as a payee. The respondents are individuals and organizations who act as representative payees for Title II and Title XVI benefits who fail to comply with SSAs statutory annual reporting requirement.
Authorizing Statute(s):
US Code:
42 USC 405
US Code:
42 USC 1383
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
72 FR 26443
05/09/2007
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 44211
08/07/2007
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
Representative Payee Evaluation Report--Individuals/Households
SSA-624
Representative Payee Evaluation Report
Representative Payee Evaluation Report--Private Sector
SSA-624
Representative Payee Evaluation Report
Representative Payee Evaluation Report--State/Local Government
SSA-624
Representative Payee Evaluation Report
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
250,000
252,000
0
-360
-1,640
0
Annual Time Burden (Hours)
125,000
126,000
0
-180
-820
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:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
The decrease in the public reporting burden is due to the replacement of the SSA-624 with the SSA-639 for the 2000 random interviews which are conducted annually. The increases shown are due to the addition of the two ICs which were necessary in order to show the burden per type of respondent (Individuals, Businesses, and Local/State Government). Before ROCIS we did not have the ability to split the burden amongst these three types of respondents and, therefore, only reported one burden. Now that we have the ability to show the burden in this way, we have done so in ROCIS. Also, please note that in the two new ICs SSA was unable to accurately make the numbers for the program change negative and still show the correct amounts in the Change Due to Agency Discretion column (see the charts which show this change in the Supplementary Documents section). Please consider revising the ROCIS system to accommodate a fix for this issue.
Annual Cost to Federal Government:
$1,164,240
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)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Elizabeth Davidson 411-965-0454 liz.davidson@ssa.gov
Common Form ICR:
No
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:
08/23/2007
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