View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0719	ICR Reference No: 202010-0960-012
Status: Historical Active	Previous ICR Reference No: 201707-0960-011
Agency/Subagency: SSA	Agency Tracking No:
Title: Application to Collect A Fee for Payee Services
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: 07/28/2021
	Date Received in OIRA: 01/28/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2024	36 Months From Approved	07/31/2021
Responses	100	0	100
Time Burden (Hours)	22	0	17
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	100	100	0
Annual Time Burden (Hours)	22	17	5
Annual Cost Burden (Dollars)	0	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: When we last cleared this IC in 2017, the burden was 17 hours. However, we are currently reporting a burden of 22 hours. This change stems from an increase in the completion time for private sector businesses from 10 minutes to 13 minutes. This change is due to the proposed revision to request private sector businesses to include a letter describing that the organization meets the community-based criteria, which will help the agency determine whether the representative payee meets the community-based criteria for non-governmental social service agencies to charge a fee. Additionally, we have asked that the organizations provide documents, such as a copy of the bond or insurance policy that is required by 20 CFR 404.2040a & 416.640a.

Annual Cost to Federal Government: $735

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? No

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

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