View Information Collection Request (ICR) Package

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: 0960-0037	ICR Reference No: 200812-0960-008
Status: Historical Active	Previous ICR Reference No: 200705-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Waiver of Overpayment Recovery or Change in Repayment Rate
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: 05/03/2009
	Date Received in OIRA: 02/26/2009
Terms of Clearance: This ICR is approved for 2 years. SSA should review whether this form should be included in their next review of forms for electronic implementation prior to resubmission for OMB approval.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2011	36 Months From Approved	04/30/2009
Responses	500,000	0	500,000
Time Burden (Hours)	916,666	0	875,000
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	500,000	500,000	0
Annual Time Burden (Hours)	916,666	875,000	41,666
Annual Cost Burden (Dollars)	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: There is no change in the burden data for the usage of the Form SSA-632-BK. However, we inadvertently did not include the burden data for the instructions which appear on the Internet for the paper SSA-632-BK. These instructions which are accessible from the www.ssa.gov website, help those respondents who are filling out the form without help from field office representatives. We believe that since all of the respondents for the SSA-632-BK have the potential to review these instructions, we have an increase in burden hours of 5 minutes per respondent or 41,666 total burden hour increase.

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