APPROVED WITH
THE FOLLOWING CONDITIONS: 1)QUESTION 1 WILL BE MODIFIED TO READ,
"GUARDIANSHIP STATUS," IS A GUARDIANSHIP NOW IN EFFECT? THE PHRASE
"...IF OTHER THAN PAYEES WILL BE ADDED AT THE END OF THE QUESTION
2) PRIOR TO USE OF THIS FORM, A SECOND MAILING OF SSA FORM623 C-2
MUST BE MADE, 3) A TEST WILL BE CONDUCTED CONCURRENT WITH THE
FOLLOW-UP MAILING OF THE SSA 623 C-2 TO DETERMINE THE EFFECT OF
INCLUDING A LETTER WITH THE SECOND MAILING. THE LETTER WILL SOLICIT
THE COOPERATION OF THE PAYEE AND INDICATE THAT FAILURE TO REPLY
WILL RESULT IN THE PAYEE BEING CONTACTED FOR A LENGTHY INTERVIEW
AND 4) THE RESULTS OF THE TEST MUST BE SUBMITTED WITH THE REQUEST
FOR EXTENSION OF THIS COLLECTION.
Inventory as of this Action
Requested
Previously Approved
12/31/1984
12/31/1984
12/31/1983
125,000
0
20,000
62,500
0
3,000
0
0
0
THE SOCIAL SECURITY ADMINISTRATION
NEEDS TO CONTACT INDIVIDUALS WHO HA EITHER FAILED TO RETURN FORM
SSA-623 OR DID NOT COMPLETE THE FORM PROPERLY IN ORDER TO DETERMINE
THE CONTINUING SUITABILITY OF A PAYEE. REPRESENTATIVE PAYEES
RECEIVE ON BEHALF OF THAT BENEFICIARY.
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:
(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;
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.