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:
0960-0546
ICR Reference No:
200809-0960-008
Status:
Historical Active
Previous ICR Reference No:
200511-0960-004
Agency/Subagency:
SSA
Agency Tracking No:
Title:
SSI Notice of Interim Assistance Reimbursement (IAR)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
02/07/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/19/2008
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/29/2012
36 Months From Approved
02/28/2009
Responses
511,825
0
100,000
Time Burden (Hours)
46,363
0
16,666
Cost Burden (Dollars)
0
0
0
Abstract:
Forms SSA-8125 and SSA-L8125-F6 are used by SSA to obtain the amount of Interim Assistance Reimbursement (IAR) a State is due. When SSA releases the first retroactive SSI payment the SSA-8125 is filled out by the State for accounting and auditing purposes. The SSA-L8125-F6 is used in cases when SSA must ensure that an IAR State does not send a residual IAR payment to a recipient who may be affected by the dedicated account and installment provision as set forth in P.L. 100-203. Respondents are State IAR officers.
Authorizing Statute(s):
None
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:
73 FR 55585
09/25/2008
30-day Notice:
Federal Register Citation:
Citation Date:
73 FR 75488
12/11/2008
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
15
IC Title
Form No.
Form Name
a) State Notification of Receipt of Authorization (Electronic Process)
b) State Submission of Copy of Authorization (Manual Process)
c) State Notification to SSA of Amount of Reimbursement
d) State Request for Determination--Dispute Resolution
e) Paper Form SSA-8125
SSA-8125
Supplemental Security Income Notice of Interim Assistance Reimbursement
f) Paper Form SSA-L8125-F6
SSA-L8125-F6
Supplemental Security Income Notice of Interim Assistance Reimbursement
g) eIAR Process
N/A
eIAR Internet Screens
h) State Notification to SSA of Deceased Claimant
i) Review/Signing Agreements
j) Maintenance of Authorization Forms
k) Maintenance of Accounting Forms and Notices
l) Written Notice from State to Recipient Regarding Amount of Payment
m) Retrieve and Consolidate Authorization and Accounting Forms
n) Participate in Periodic Review
o) Correct Administrative and Accounting Discrepancies
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
511,825
100,000
0
411,825
0
0
Annual Time Burden (Hours)
46,363
16,666
0
29,697
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:
Changing Regulations
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The changes in the public reporting burden are due to several factors. Previously we cleared the burden information for only the SSA-8125 and SSA-L8125-F6; however, we inadvertently did not report the burden information for the business process. Therefore, we are now adding the business process to the clearance package to rectify the potential PRA violation. We are also adding a new eIAR process that will initially increase the overall public reporting burden. There is no burden change for the forms SSA-8125 and SSA-L8125-F6. However, ROCIS shows changes to due adjustments whenever we create ICs for the first time. The only change in burden is a program increase due to the addition of the business process and eIAR burdens.
Annual Cost to Federal Government:
$160,055
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:
John Biles 410 965-3758 John.Biles@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:
12/19/2008
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