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:
0960-0105
ICR Reference No:
202406-0960-005
Status:
Active
Previous ICR Reference No:
202005-0960-003
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Advanced Notice of Termination of Child's Benefits, and Student's Statement Regarding School Attendance
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:
07/22/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/27/2024
Terms of Clearance:
Previous TOC remain in effect. Previous TOC: Prior to resubmission, the agency will ensure this form can be signed (including via typed signature) by all parties and submitted by the respondent electronically via Document Submission or a successor platform. If the agency determines this is not feasible, it will upload as part of the supplemental documentation a fact-specific explanation for why, from a policy, statutory, and operational perspective, this information collection cannot accommodate electronic signature. This letter should be signed by a Deputy Commissioner. The agency will also evaluate, including a quantified analysis of the potential trade-offs, whether it can remove the school official's certification requirement for most recipients and instead use the respondent's self-allegation. If the agency determines it is unable to remove the requirement for a school official's certification, it will explain via a supplemental document a fact-specific analysis of the risks or trade-offs that informed the agency's decision to retain the requirement.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2026
04/30/2026
04/30/2026
Responses
467,850
0
467,850
Time Burden (Hours)
286,344
0
286,344
Cost Burden (Dollars)
0
0
0
Abstract:
SSA uses the information collected on Forms SSA-1372-BK and SSA-1372-BK-FC to determine whether children of an insured worker are eligible for student benefits. The data allows SSA to determine student entitlement and whether entitlement will end. The respondents are student claimants for Social Security benefits, their respective schools and, in some cases, their representative payees. We are making non-substantive changes to change the font of the form to meet the agency’s accessibility standards.
Authorizing Statute(s):
US Code:
42 USC 402
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:
85 FR 34703
06/05/2020
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 51536
08/20/2020
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
SSA-1372-BK (Domestic)- Representative Payees
SSA-1372-BK
Advanced Notice of Termination of Child's Benefits
SSA-1372-BK (Domestic)- Students
SSA-1372-BK
Advanced Notice of Termination of Child's Benefits
SSA-1372-BK (Domestic)--State/Local/Tribal Government
SSA-1372-BK
Advanced Notice of Termination of Child's Benefits
SSA-1372-BK (Foreign)- Representative Payees
SSA-1372-BK-FC
Student's Statement Regarding School Attendance
SSA-1372-BK-FC (Foreign Claims)--State/Local/Tribal Government
SSA-1372-BK-FC
Student's Statement Regarding School Attendance
SSA-1372-FC (Foreign Claims)-Students
SSA-1372-BK-FC
Student's Statement Regarding School Attendance
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
467,850
467,850
0
0
0
0
Annual Time Burden (Hours)
286,344
286,344
0
0
0
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:
Annual Cost to Federal Government:
$107,042
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:
06/27/2024
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