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OMB Control No: 0960-0189	ICR Reference No: 200801-0960-002
Status: Historical Active	Previous ICR Reference No: 200412-0960-012
Agency/Subagency: SSA	Agency Tracking No:
Title: Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/20/2008
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/28/2008
Terms of Clearance: Approved with addition of burden chart.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2011	36 Months From Approved	05/31/2008
Responses	12,075	0	5,475
Time Burden (Hours)	1,997	0	2,521
Cost Burden (Dollars)	0	0	0

Abstract: The information on Forms SSA2930, SSA2931 and SSA2932 is used by the SSA to establish a national payment accuracy rate for all cases in payment status and to serve as a source of information regarding problem areas in the Retirement and Survivors Insurance (RI) and Disability Insurance (DIY) programs. The information is also used to measure the accuracy rate for newly adjudicated RI/DIY cases. SSA uses the information on form SSA4659 to evaluate and determine the effectiveness of the annual earnings test and to use the results in developing ongoing improvements in the process. The respondents are a statistically valid sample of all RI/DIY beneficiaries in current pay status.

Authorizing Statute(s): US Code: 42 USC 405
   US Code: 42 USC 428
   US Code: 42 USC 1382c
   US Code: 42 USC 1395o

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 62510	11/05/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 10505	02/27/2008
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	12,075	5,475	9,400	-2,800
Annual Time Burden (Hours)	1,997	2,521	785	-1,309
Annual Cost Burden (Dollars)	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: Previously these forms were being used for two reviews: the Index of Dollar Accuracy (IDA) Review (2,500 cases selected) and the Stewardship Review (1,500 cases selected). The IDA review was for new awards and the Stewardship Review looks at any person in current pay on the record. We are no longer collecting information for the IDA Review which has caused a decrease in the number of respondents. Also, because the number of respondents for the Stewardship Review is dependent on how many individuals are on the current pay status record, the number of respondents for Stewardship Review can fluctuate. For instance, if a Number Holder (NH) and a spouse with a child were on the record, then one workbook would be used for the NH and another for the spouse and child (student). Therefore, two workbooks would be used for three respondents on the earnings statement. Because we cannot be certain that we will need more than one workbook per respondent at the time of selection, SSA has decided to report only the exact number of beneficiaries chosen for the Stewardship Review (1,500 cases) rather than add in the extra 300 cases which were previously added to account for the possibility that more than one individual may be listed on the record for any given respondent. We also show an increase due to a program change, as each respondent in current pay will receive an appointment notice for either a face-to-face review or a telephone review along with an SSA-85, an SSA-8552 and an SSA-2935. Previously, we did not include these notices as they did not request information from the public. Now that our notices request information, and we are also using three new forms to collect additional information, we are including them in this clearance request.

Annual Cost to Federal Government: $3,317

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

View ICR - OIRA Conclusion