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: 0960-0014	ICR Reference No: 202203-0960-007
Status: Active	Previous ICR Reference No: 201812-0960-004
Agency/Subagency: SSA	Agency Tracking No:
Title: Request to be Selected as a Payee
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: 05/03/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/02/2022
Terms of Clearance: Upon triannual renewal, the agency will expand upon the supporting statement to provide additional discussion regarding the need to conduct this information collection predominantly through in-person interviews. The agency will also discuss any supplemental interactions or form submissions that are commonly associated with the process of requesting to serve as a representative payee.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2026	36 Months From Approved	05/31/2023
Responses	2,034,847	0	1,975,580
Time Burden (Hours)	2,070,420	0	395,116
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,034,847	1,975,580	59,267
Annual Time Burden (Hours)	2,070,420	395,116	1,675,304
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 2018 the burden was 395,116 hours. However, we are currently reporting a burden of 406,969. This change stems from the increase in the number of responses from 1,975,580 to 2,034,847. There is no change to the burden time per response. *Note: The total burden reflected in ROCIS is 2,070,420, while the burden cited in #12 above is 406,969. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + telephone call system wait times + a rough estimate of a 30-minute, one-way, drive burden. In contrast, the chart in #12 above reflects actual burden.

Annual Cost to Federal Government: $8,989,304

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