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: 0960-0013	ICR Reference No: 201603-0960-004
Status: Historical Active	Previous ICR Reference No: 201303-0960-013
Agency/Subagency: SSA	Agency Tracking No:
Title: Application for Lump-Sum Death Payment
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: 08/17/2016
	Date Received in OIRA: 07/04/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	36 Months From Approved	08/31/2016
Responses	670,248	0	587,000
Time Burden (Hours)	100,674	0	88,540
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	670,248	587,000	83,248
Annual Time Burden (Hours)	100,674	88,540	12,134
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: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: The change in the public reporting burden stems from combining the MCS and signature proxy collections. Since each method had a different response time by a minute, which changed the reported burden hours. We no longer require separate burden for our MCS collections, because we complete all MCS claims through signature proxy attestation, unless the applicant prefers to provide a wet signature. Therefore, we are combining the MCS and signature proxy collections.

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