Supporting Statement for Form SSA-8-F4,
A. Justification
1. Title II of the Social Security Act (the Act) provides for payment of a lump-sum death payment (not to exceed $255) upon the death of an insured individual. Section 202(i) of the Act sets out the conditions of eligibility for this payment, including the filing of an application and Form SSA-8-F4 meets this requirement. Regulations at 20 CFR 404.390-404.392 of the Code of Federal Regulations set the procedures and policies for implementing Section 202(i) of the Act. 20 CFR 404.392 requires the filing of an application to collect the information needed to determine the eligibility of the applicant. The SSA-8-F4 elicits the information about the applicant and their relationship to the deceased needed to make this determination of eligibility.
2. The Social Security Administration (SSA) needs the information collected on Form SSA-8-F4 to authorize payment of the lump-sum death payment (LSDP) to a widow, widower, or children as defined in Section 202(i) of the Act. Respondents are applicants for LSDP.
3. In 95 percent of the cases, SSA collects the LSDP information using the electronic Modernized Claims System (MCS) during personal interviews without completion of the paper application. However, an individual may complete the paper LSDP application before visiting or calling a field office. The information from the paper application will then be input into MCS during the personal interview. In most cases the collection of this information through MCS meets the guidelines for electronic implementation as set forth in the Government Paperwork Elimination Act.
Electronic submission of application/form data through the Internet is an Agency goal as an alternative means of doing business with SSA. However the SSA-8-F4 cannot compete with other legislative mandates that are currently driving the use of the limited funds SSA has for electronic implementation of applications. Also, based on recurring Congressional proposals to eliminate the LSDP one-time payment, SSA expenditure of systems resources on a process with an uncertain program life would be counter to Agency fiscal goals. Until Congress proposes that the LSDP be kept indefinitely, SSA will not be using our limited resources to create an entirely electronic Internet version of the SSA-8-F4.
4. The nature of the information being collected and the manner in which it is collected preclude duplication. There is no other collection instrument used by SSA that collects data similar to that collected here.
5. This collection does not have a significant impact on a substantial number of small businesses or other small entities.
6. If this information were not collected, SSA would be unable to determine eligibility for LSDP, and, therefore, would not be able to authorize payments to the widow, widower or children of the deceased beneficiary. Also, as this information is only collected on an as needed basis, it cannot be collected less frequently. There are no technical or legal obstacles that prevent burden reduction.
7. There are no special circumstances that would cause this information collection to be conducted in a manner that is not consistent with 5 CFR 1320.5.
8. The 60-day advance Federal Register Notice was published on September 18, 2006 at 71 FR 54705, and SSA has received no public comments. The second Notice was published on February 14, 2007, at 72 FR 7107. There have been no outside consultations with members of the public.
9. SSA provides no payment or gifts to the respondents.
10. The information requested is protected and held confidential in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974) and OMB Circular No. A-130.
11. The information collection does not contain any questions of a sensitive nature.
12. Approximately 587,000 respondents file the SSA-8-F4 annually. Of this total 95% (557,650) are completed through MCS and 50% of the MCS respondents will use Signature Proxy (278,825). The estimated average response time is 10 minutes for MCS and Paper responses, and 9 minutes for Signature Proxy responses, for a total of 93,187 burden hours.
Collection Method |
Number of Respondents |
Estimated Completion time |
Burden Hours |
MCS |
278,825 |
10 minutes |
46,471 |
MCS/Signature Proxy |
278,825 |
9 minutes |
41,824 |
Paper |
29,350 |
10 minutes |
4,892 |
Totals: |
587,000 |
|
93,187 |
The total burden is reflected as burden hours, and no separate cost burden has been calculated.
13. There is no known cost burden to the respondents.
14. The annual cost to the Federal Government is approximately $89,841. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
15. The decrease in the burden is twofold: 1) more claimants are living longer, and 2) more individuals are dually entitled on the accounts of their spouses, and, therefore, the LSDPs are automatically paid when spouses’ benefits are converted to widow’s/widower’s benefits. In this second situation, the LSDP is paid without an application.
16. Results from the collection of this information will not be published.
17. OMB has granted SSA an exemption from the requirement that the expiration date for OMB approval be printed on its program forms. SSA produces millions of public-use forms, many of which have a life cycle longer than that of an OMB approval. SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis). This exemption was granted so that otherwise useable editions of forms would not be taken out of circulation because the expiration date had been reached. In addition, Government waste has been avoided because stocks of forms will not have to be destroyed and reprinted.
18. SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
B. Collection of Information Employing Statistical Methods
Statistical methods for collection of information are not used.
| File Type | application/msword |
| File Title | Supporting Statement for Form SSA-8-F4, |
| Author | Teresa Robinson |
| Last Modified By | 177717 |
| File Modified | 2007-02-15 |
| File Created | 2007-01-30 |