View Information Collection Request (ICR) Package
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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:
0960-0782
ICR Reference No:
202205-0960-004
Status:
Historical Active
Previous ICR Reference No:
201908-0960-002
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Questionnaire About Special Veterans Benefits
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:
01/03/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/04/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2026
36 Months From Approved
12/31/2022
Responses
85
0
382
Time Burden (Hours)
55
0
127
Cost Burden (Dollars)
0
0
0
Abstract:
SSA regularly reviews individuals’ claims for SVB to determine their continued eligibility and the correct payment amounts. Individuals living outside of the United States who receive SVB must report to SSA any changes that may affect their benefits. We initiate this collection request by sending yearly notice with instructions (SSA 2010-F6 Cover Letter), which includes an SSA 2010 F6. Since we cannot rely on self-reporting, SSA uses Form SSA-2010-F6 to collect this required information from beneficiaries living outside the United States (U.S.) who are collecting SVB. All SVB beneficiaries have interviews with the Federal Benefits Unit (FBU) every year, who assist them in completing this form. Respondents are SVB beneficiaries living outside the U.S.
Authorizing Statute(s):
US Code:
42 USC 403
Name of Law: Social Security Act
US Code:
42 USC 405
Name of Law: Social Security Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
87 FR 39153
06/30/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 57551
09/20/2022
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Statement for Determining Continuing Entitlement for Special Veternans Benefits (SVB)
SSA-2010-F6
Questionnaire About Special Veterans Benefits
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
85
382
0
0
-297
0
Annual Time Burden (Hours)
55
127
0
0
-72
0
Annual Cost Burden (Dollars)
0
0
0
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 2019, the burden was 127 hours. However, we are currently reporting a burden of 28 hours. This change stems from a decrease in the number of responses from 382 to 85. As we mentioned in #3 above, the respondents are World War II veterans, so we expect the respondent pool to continue to decrease over the next several years. 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. These figures represent current Management Information data. Note: The total burden reflected in ROCIS is 55, while the burden cited in #12 of the Supporting Statement is 28. This discrepancy is because the ROCIS burden reflects the following components: teleservice center waiting time. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.
Annual Cost to Federal Government:
$4,315
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
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
10/04/2022
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