View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0025	ICR Reference No: 202404-0960-012
Status: Active	Previous ICR Reference No: 202012-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Partnership Questionnaire
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: 08/21/2024
	Date Received in OIRA: 07/10/2024
Terms of Clearance: Prior to the next renewal of this ICR, the agency will ensure it is available to be fully completed electronically via the Upload Documents platform or a successor platform. If the agency cannot achieve this, it will submit, as a part of the renewal package, a letter signed by the relevant Deputy Commissioner detailing why this form cannot be accommodated via the platform.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2027	36 Months From Approved	08/31/2024
Responses	6,462	0	12,350
Time Burden (Hours)	5,385	0	12,350
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	6,462	12,350	-5,888
Annual Time Burden (Hours)	5,385	12,350	-6,965
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 2021, the burden was 12,350 hours. However, we are currently reporting a burden of 2,154 hours. This change stems from both a decrease in the number of respondents using Form SSA-7104, as well as a change in the source of our management information (MI) data to a more accurate source, which shows that our old data showed overestimated numbers for this form. We are correcting for this issue now. These figures represent current MI data. 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. * Note: The total burden reflected in ROCIS is 5,385, while the burden cited in #12 of the Supporting Statement is 2,154. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30-minute, one-way, drive burden + learning costs. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

Annual Cost to Federal Government: $16,372

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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