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OMB Control No: 0960-0814	ICR Reference No: 202108-0960-010
Status: Historical Active	Previous ICR Reference No: 202002-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Advance Designation of Representative Payee
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: 09/02/2021
	Date Received in OIRA: 08/24/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	02/28/2023	02/28/2023
Responses	11,739,165	0	11,739,165
Time Burden (Hours)	1,173,917	0	1,173,917
Cost Burden (Dollars)	0	0	0

Abstract: On April 13, 2018, the President signed into law The Strengthening Protections for Social Security Beneficiaries Act of 2018, also known as Pub.L.115-165. Section 201 of the law allows SSA beneficiaries and applicants under Title II, Title VIII and Title XVI, of the Act to designate individuals to serve as a representative payee should the need arise in the future. Section 201(j)(2) of the Act provides the requirements for selecting a qualified representative payee. SSA only offers the option to advance designate to capable adults and emancipated minors. Beneficiaries who have an assigned representative payee, or have a representative application in process, cannot advance designate. Form SSA-4547, Advance Designation of Representative Payee, allows beneficiaries or applicants the option to designate individuals in order of priority, to serve as a representative. Beneficiaries or applicants can update or change the advance designee order of priority at any time. SSA uses the information on Form SSA-4547 to select a qualified representative payee in order of priority. If the selected representative payee is unable or unwilling to serve, or meet SSA requirements. SSA will select another representative payee to serve in the beneficiaries and applicants best interest. SSA will notify beneficiaries annually of the individuals they chose in advance to be their representative payee. The respondents are SSA beneficiaries and claimants who want to choose an advance designate representative. We are making non-substantive changes to change update Annual Notices and Receipts.

Authorizing Statute(s): PL: Pub.L. 115 - 165 201 Name of Law: The Strengthening Protections for Social Security Beneficiaries Act of 2018

Citations for New Statutory Requirements: PL: Pub.L. 115 - 165 201 Name of Law: Protections for Social Security Beneficiaries Act of 2018

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0960-AI33	Final or interim final rulemaking	85 FR 7661	02/11/2020

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 40121	08/13/2019
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Advance Designation of Representative Payee (SSA-4547 )	SSA-4547
I4547 (internet version)
SSA-4547 Intranet version (SSI Claims System; MCS; iMAIN)

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	11,739,165	11,739,165
Annual Time Burden (Hours)	1,173,917	1,173,917
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: To accommodate the new regulations, we created a new form, the SSA-4547. The new Form SSA-4547 increases the public reporting burden.

Annual Cost to Federal Government: $27,884,181

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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