Social Security Statement Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Social Security Statement Survey Non-Response Analysis (2).doc	Supplementary Document	Uploaded 2008-04-30	Available
Social Security Statement Survey Supporting Statement A.doc	Supporting Statement A	Uploaded 2008-01-18	Available
Social Security Statement Survey Supporting Statement B.doc	Supporting Statement B	Uploaded 2008-01-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
183406	Social Security Statement Survey	Other-Telephone Survey	New

ICR Details

OMB Control No: 0960-0770	ICR Reference No: 200801-0960-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Social Security Statement Survey
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 with change	Conclusion Date: 04/30/2008
	Date Received in OIRA: 01/18/2008
Terms of Clearance: This information collection request is approved as amended by SSA's memo of 04/22/2008, which included a non-response analysis plan. SSA will brief OMB on the results of this survey after the data are analyzed and explain how the results will feed into potential changes to the Social Security Benefits statement.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2011	36 Months From Approved
Responses	1,200	0	0
Time Burden (Hours)	200	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In response to a recommendation from the Government Accounting Office, SSA will conduct a series of surveys assessing customer satisfaction with the most recent versions of the Social Security Statement. The respondents are 1) wage earners who have an earnings history with both covered and non-covered earnings under Social Security, and 2) wage earners who only have earnings covered under Social Security.

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Authorizing Statute(s): US Code: 42 USC 1320b-13 Name of Law: Social Security Act
   US Code: 42 USC 1310 Name of Law: Social Security Act
  

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 62510	11/05/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 3307	01/17/2008
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
Social Security Statement Survey

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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	1,200	0	0	1,200	0	0
Annual Time Burden (Hours)	200	0	0	200	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Burden increase due to new, one-time survey.

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Annual Cost to Federal Government: $50,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 01/18/2008

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