Electronic Benefit Verification Information

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
9571	Electronic Benefit Verification Information	Migrated

ICR Details

OMB Control No: 0960-0595	ICR Reference No: 199810-0960-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Electronic Benefit Verification Information
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/30/1998
	Date Received in OIRA: 10/02/1998
Terms of Clearance: Approved on the condition, as described in SSA's 11/30/98 memoranda to OMB, that SSA continue efforts to develop digital certificate authentification for on-line transactions to introduce this technology as soon as feasible. OMB compliments SSA's participation in the Access America for Students pilot, and encourages SSA to continue moving toward automated exchange of information, including on-line responses to beneficiary questions. SSA will report on its progress and implmentation as part of the next request for clearance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2001	11/30/2001
Responses	133,920	0	0
Time Burden (Hours)	1,116	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: SSA provides verification of benefits to title II and/or title XVI benefit recipients. SSA proposes to allow recipients to request benefit verification by completing and electronic request screen and submitting the request through the Internet. The information collected on the electronic screens will be used by SSA to process the request for a benefit verification statement. The statement will be mailed to the address on record. The respondents are title II and title XVI recipients who use the Internet to request benefit verification.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Electronic Benefit Verification Information

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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	133,920	0	0	133,920	0	0
Annual Time Burden (Hours)	1,116	0	0	1,116	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 10/02/1998

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