International Direct Deposit

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-1199(Canada) International Direct Deposit	Form	Modified	Available
Supporting Statement--0686[1].doc	Supporting Statement A	Uploaded 0000-00-00	Available
Country & Language Chart for SSA-1199 (Country)(1).xls	Supplementary Document	Uploaded 2007-03-23	Available
SSA-1199--Current Form.pdf	Supplementary Document	Uploaded 2003-08-31	Available
List of Variable Information for the SSA-1199 (Country).doc	Supplementary Document	Uploaded 2007-02-14	Available
Addendum--0686.doc	Supplementary Document	Uploaded 2006-11-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9739	International Direct Deposit	Form	Modified

ICR Details

OMB Control No: 0960-0686	ICR Reference No: 200701-0960-010
Status: Historical Active	Previous ICR Reference No: 200402-0960-006
Agency/Subagency: SSA	Agency Tracking No:
Title: International Direct Deposit
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: 06/06/2007
	Date Received in OIRA: 03/26/2007
Terms of Clearance: OMB approves this collection consistent with the e-mail from SSA on 5/14/07, including word from SSA that they will convert the various country forms into the same format as that of Canada.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2010	36 Months From Approved	06/30/2007
Responses	5,000	0	5,000
Time Burden (Hours)	417	0	417
Cost Burden (Dollars)	0	0	0

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Abstract: This form captures the direct deposit information for an account at a foreign financial institution. Our International Direct Deposit (IDD) program allows beneficiaries living abroad to have their benefits deposited to an account at a financial institution outside the U.S. Routing account number information varies slightly for each country, so we use a variation of the SF-1199 A for each country. The respondents are Social Security beneficiaries residing abroad.

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Authorizing Statute(s): US Code: 5 USC 5525 Name of Law: null
   US Code: 12 USC 391 Name of Law: null
   US Code: 31 USC 321; 3301; 3302; 3321; 3332 Name of Law: null
   US Code: 31 USC 3335; 3720 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 2081	01/17/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 13851	03/23/2007
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
International Direct Deposit	SSA-1199(Canada), SSA-1199-XXXX	Direct Deposit Sign-Up Form (Canada) ,   Direct Deposit Sign-Up Form

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ICR Summary of Burden

table that charts list 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	5,000	5,000	0	0	0	0
Annual Time Burden (Hours)	417	417	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:

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Annual Cost to Federal Government: $7,700

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: 03/26/2007

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