Addendum To The Supporting Statement for 0960-0462

Addendum to the Supporting Statement for Forms SSA-4588 and SSA-4589

You Can Make Your Payment by Credit Card

OMB Control No. 0960-0462

Terms of Clearance:

This ICR is approved on these conditions: 1) the PRA blurb--with updated burden estimates--will be revised when this form is next printed; 2) SSA should continue to explore ways to enable these forms to be submitted electronically, through Pay.gov or other secure means; 3) within the next year, SSA will submit a plan which details the steps it will take to make this form available electronically and how long it will take to make this form available electronically.

In compliance with the Terms of Clearance placed on this form in 2006, SSA has updated the PRA blurb to include the updated burden estimates. As mentioned in number three of the Supporting Statement, we are required to keep an original signature on hand for the SSA-4588 form as proof that the individual has requested the recurring credit card option. However, as mentioned in number two of the Supporting Statement, we will now only use the SSA-4589 internally when a debtor calls to make a payment by telephone. In this way, we are giving the public the option to call in a payment rather than fill out the SSA-4588. For these specific reasons, and due to the budgetary constraints, SSA is currently not continuing to explore ways to have these forms submitted electronically through www.pay.gov or any other secure means. When feasible technology becomes available, SSA will reexamine these forms in terms of electronic capability.

Revision to the Collection Instrument:

SSA is adding a recurring credit card payment option to the SSA-4588. Previously, the debtor had to call in each month to authorize credit card payment for their debt. The Mid-Atlantic Payment Service Center (MATPSC) processes all credit card payments for SSA. MATPSC completed an independent study of how many of the same individuals are calling to make a payment by credit card every month. The result was that approximately 53% of the individuals are recurring callers. Therefore, the authors of the SSA-4588 form would like to change the form to include the option for recurring credit card payments. To have the recurring credit card option, SSA will provide an additional authorization term to the individual. The individual must also provide more information regarding the credit card transactions such as, when they want to start and stop payments, etc. (see attached form).

We are making the following revisions to the SSA-4588:

• We are adding headings for each section to make it easier for the respondents to fill out the form

• Page 1:

  • We are adding a section that informs the respondent how to make one-time payments by phone, one-time payments by mail, or recurrent payments by mail.

    • This chart indicates the three options and explains how to complete them

• We are removing the language “Note: Please read Paperwork/Privacy Act Notice on back” from this section.

• Page 2:

  • We are adding the Frequency of Payments section as part of the recurring payment option.

  • We are adding the Date of First Payment/Date of Last Payment section as part of the recurring payment option.

  • We are adding the date of signature to the Authorization section.

  • We are revising the Office Use Only information to reflect current SSA practices.

• Page 3:

  • We are adding this page as a receipt for the respondent to maintain his/her records.

  • This page also serves as a summary of information regarding the credit card payment and option for recurring payment.

• SSA will translate all sections of the form into Spanish upon receipt of OMB approval for the revisions.

We are also in the process of developing internal screens to be used by the PSC employees to collect the information on the SSA-4589. These screens are filled out only by SSA employees during a telephone interview payment in lieu of using the paper SSA-4589. We believe these screens will expedite the payment process for those respondents who wish to call in their one-time payments rather than use the SSA-4588.

We are revising the PRA statements on both the SSA-4588 and SSA-4589 to reflect our updated boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.

SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on the first page of the form.

Upon approval of this revision, SSA’s Forms Management Team will add the additional language to the revised SSA-4588 and properly format the finalized version to reflect current SSA formatting standards. SSA will reprint the revised forms.

2