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View ICR - OIRA Conclusion

OMB Control No: 0960-0037	ICR Reference No: 201904-0960-015
Status: Historical Active	Previous ICR Reference No: 201803-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Waiver of Overpayment Recovery or Change in Repayment Rate
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/31/2019
	Date Received in OIRA: 05/16/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	11/30/2021	11/30/2021
Responses	1,060,000	0	1,060,000
Time Burden (Hours)	979,166	0	979,166
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	1,060,000	1,060,000
Annual Time Burden (Hours)	979,166	979,166
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The decrease to the burden stems from the creation of a new form, the SSA-634. We created the SSA-634 to help eliminate unnecessary time, paperwork, and confusion when individuals are only requesting a change in the overpayment repayment rate. The burden change stems from two factors: (1) a decrease in the number of respondents for the Regional Application from 44,000 to 30,000, which creates a burden savings of 28,000 hours; and (2) an increase in the respondents for the Internet Instructions from 500,000 to 530,000, which would increase our burden by 2,500 hours. Even though we have an increase in burden for Internet Instructions, the burden hours saved from the decrease in Regional Applications creates our overall burden reduction. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change.

Annual Cost to Federal Government: $3,924,997

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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