This information
collection is approved under the following conditions: As discussed
with SSA, the agency will immediately reword the instruction on
question 8 of the form to solicit information on individuals that
have "provided substantial support and/or have a significant
involvement with the claimant." The wording should also be changed
to make it clear that the respondent only need provide information
on "up to three individuals."
Inventory as of this Action
Requested
Previously Approved
04/30/2001
04/30/2001
04/30/1998
1,709,657
0
1,709,657
299,190
0
299,190
0
0
0
The information collected on form
SSA-11-BK is needed to determine the proper payee for a social
security beneficiary. The information is used to establish an
applicant's relationship to the beneficiary, his/her justification
and concern for the beneficiary, and the manner in which the
benefits will be used. The respondents are applicants for
representative payee of individuals receiving title II, title XVI,
and Black Lung benefits.
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.