SUPPORTING STATEMENT FOR FORM SSA-783
STATEMENT REGARDING CONTRIBUTIONS
20 CFR 404.360-.366 and 404-.736
OMB No. 0960-0020
A. Justification
1. When determining if child applicants for Social Security benefits are entitled to payments, the Social Security Administration (SSA) must first examine the child’s current sources of support. Specifically, SSA is required to collect information about the child’s one-half support and other regular/substantial contributions, and evaluate their effect on eligibility (as per Sections 202(d)- (h) and 216(e) of the Social Security Act and sections 20 CFR 404.360-.366 and 404-.736 of the Code of Federal Regulations). The Agency uses form SSA-783, the Statement Regarding Contributions, to complete this requirement.
2. SSA will ask adults who have information about a child applicant’s sources of support (including parents, guardians, Social Services agencies, etc.) to complete form SSA-783. SSA will then use the information provided on the form to determine if the child is receiving any form of regular or substantial payments, including one-half support, which would affect eligibility for SSA benefits.
3. Because of the relatively low number of respondents (below the cutoff of 50,000), SSA did not develop an electronic version of this form under the Agency’s Government Paperwork Elimination Act plan. However, there is a PDF version of the form on our website, which makes the process somewhat easier for respondents.
The nature of the information being collected and the manner in which it is collected preclude duplication. SSA does not use any other form to collect data similar to that collected here.
5. This collection does not significantly impact small businesses or other small entities.
6. If SSA did not conduct this information collection, it would have no way of confirming sources of support for child applicants who must meet certain requirements for entitlement to Social Security benefits. Because we only collect the information once, when the child applies for benefits, we cannot collect it less frequently.
There are no technical or legal obstacles to prevent burden reduction.
7. There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.
8. SSA published the 60-day Advance Federal Register Notice on April 28, 2008 at 73 FR 22989, and we did not receive any public comments. We published the 30-day Federal Register Notice on July 1, 2008, at 73 FR 37524. If we receive any public comments in response to the 30-day Notice, we will forward them to OMB.
SSA did not consult with outside members of the public in the development or maintenance of this form.
9. SSA provides no payment or gifts to the respondents.
10. SSA protects and holds confidential the information we are requesting 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 30,000 respondents take 17 minutes each to complete form SSA-783 annually. The total burden of 8,500 hours is reflected as burden hours, and we did not calculate a separate cost burden.
13. There is no known cost burden to the respondents.
14. The annual cost to the Federal government for this collection is approximately $38,000. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
15. There are no changes to the public reporting burden.
16. SSA will not publish the results of the information collection.
17. OMB granted SSA an exemption from the requirement that we print the expiration date for OMB approval 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). OMB granted us this exemption so that otherwise useable editions of forms would not be taken out of circulation because the expiration date had been reached. In addition, we avoid Government waste because we will not have to destroy and reprint stocks of forms.
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. Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
0960-0020 (Form SSA-783)
| File Type | application/msword |
| File Title | March 2002 |
| Author | OPB |
| Last Modified By | 666429 |
| File Modified | 2008-07-03 |
| File Created | 2008-07-03 |