Application for Mother's of Father's Insurance Benefits 20CFR 404.339-404.342; 20CFR404.601-404.603

ICR 200805-0960-004

OMB: 0960-0003

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2008-05-19
Supplementary Document
2008-05-12
ICR Details
0960-0003 200805-0960-004
Historical Active 200608-0960-022
SSA
Application for Mother's of Father's Insurance Benefits 20CFR 404.339-404.342; 20CFR404.601-404.603
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/20/2008
Retrieve Notice of Action (NOA) 05/19/2008
  Inventory as of this Action Requested Previously Approved
02/28/2009 02/28/2009 02/28/2009
50,000 0 50,000
12,105 0 12,105
0 0 0

SSA collects the information on the SSA-5-F6 to entitle an individual to his/her mother's and father's insurance benefits. The respondents are individuals apply for entitlement to their mothers' or fathers' benefits.

None
None

Not associated with rulemaking

No

  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 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 12,105 12,105 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The Application for Mother's of Father's Insurance Benefits is one of the collections cited under our ICB burden reduction Initiative Signature Proxy. The Signature Proxy Initiative is an alternative to the traditional pen and ink or “wet” signature, and it eliminates the need to retain paper applications in most circumstances by allowing the technician to process the application on the claimant’s behalf, without a signature. In most instances, Signature Proxy allows SSA to store and process the entire benefit application electronically, thus reducing costs associated with mailing and storing physical files. In addition, the adoption of Signature Proxy supports faster processing of claims and will improve service to the public by eliminating the need to mail the application to the claimant and wait for it to be signed and returned. Please see the attached Supplementary Documentation which outlines the burden saving achieved through this collection and all other application in the Signature Proxy Initiative.

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 [email protected]

  No

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.
05/19/2008


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