Coverage of Employees of State and Local Governments

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Addendum--0425 with changes.doc	Supplementary Document	Uploaded 2009-02-27	Available
Filing Electronic and Instructions for W2C.doc.pdf	Supplementary Document	Uploaded 2009-02-27	Available
supporting statement--with changes[1].doc	Supporting Statement A	Uploaded 2009-02-27	Available
Filing Electronic and Instructions for W2C.doc.pdf	Supplementary Document	Uploaded 2009-01-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9277	20 CFR 404.1203 Evidence		Modified
188194	20 CFR 404.1239 Wage Reports for Employees Performing Services in More than One Coverage Group - for Wages Paid Prior to 1987.		New
187841	20 CFR 404.1292 How to Request Review for Wages Paid Prior to 1987		New
187840	20 CFR 404.1272 Refund or Recomputation of Overpayments which are Not Adjustable		New
187839	20 CFR 404.1271 Adjustment of Overpayment of Contributions		New
187838	20 CFR 404.1265 Addition of Interest to Contributions		New
187837	20 CFR 404.1249 When and Where to Make Deposits of Contributions and to File Contribution Returns and Wage Reports - for Wages Paid Prior to 1987		New
187836	20 CFR 404.1247 When to Report Wages - for Wages Paid Prior to 1987		New
187835	20 CFR 404.1237, Wage Reports.		New
187834	20 CFR 404.1225 Records - for Wages Paid Prior to 1987		New
187832	20 CFR 404.1216 Modification of Agreement to Correct an Error		New
187831	20 CFR 404.1215 Modification of Agreement		New
187830	20 CFR 404.1214 Agreement for Coverage		New
187829	20 CFR 404.1204 Designating Officials to Act on Behalf of the State		New

ICR Details

OMB Control No: 0960-0425	ICR Reference No: 200809-0960-004
Status: Historical Active	Previous ICR Reference No: 200512-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Coverage of Employees of State and Local Governments
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/28/2009
	Date Received in OIRA: 02/27/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2012	36 Months From Approved	04/30/2009
Responses	173	0	482
Time Burden (Hours)	159	0	434
Cost Burden (Dollars)	0	0	0

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Abstract: The Code of Federal Regulations at 20 CFR 404 prescribe the rules for States submitting reports of deposits and related recordkeeping to SSA. States (and interstate instrumentalities) are required to provide wage information and deposit- related contribution information for pre-1987 periods. The respondents are State and local governments or interstate instrumentalities.

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Authorizing Statute(s): US Code: 42 USC 405 Name of Law: null
   US Code: 42 USC 410 Name of Law: null
   US Code: 42 USC 418 Name of Law: null
   US Code: 42 USC 902 Name of Law: null
  

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:
	73 FR 53919	09/17/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 2643	01/15/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 14

table that charts list of burden

IC Title	Form No.	Form Name
20 CFR 404.1203 Evidence
20 CFR 404.1239 Wage Reports for Employees Performing Services in More than One Coverage Group - for Wages Paid Prior to 1987.
20 CFR 404.1216 Modification of Agreement to Correct an Error
20 CFR 404.1204 Designating Officials to Act on Behalf of the State
20 CFR 404.1214 Agreement for Coverage
20 CFR 404.1215 Modification of Agreement
20 CFR 404.1225 Records - for Wages Paid Prior to 1987
20 CFR 404.1237, Wage Reports.
20 CFR 404.1247 When to Report Wages - for Wages Paid Prior to 1987
20 CFR 404.1249 When and Where to Make Deposits of Contributions and to File Contribution Returns and Wage Reports - for Wages Paid Prior to 1987
20 CFR 404.1265 Addition of Interest to Contributions
20 CFR 404.1271 Adjustment of Overpayment of Contributions
20 CFR 404.1272 Refund or Recomputation of Overpayments which are Not Adjustable
20 CFR 404.1292 How to Request Review for Wages Paid Prior to 1987

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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	173	482	0	0	-309	0
Annual Time Burden (Hours)	159	434	0	0	-275	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Because ROCIS now allows us to separate the regulations into separate information collections, we are reporting the burdens per Regulation Section. In addition, we have removed several of the Reglation’s Sections that are coverd under other OMB information collections/SSA forms (see Addendum for specific information). Finally, Internal Revenue Service (IRS) forms (i.e., information collections cleared by IRS), are used to collect the information under several of the Regulation’s Sections (see Addundum for specific Sections); we have adjusted the burden to reflect this, placing a 1-hour place holder burden on those Sections.

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Annual Cost to Federal Government: $10,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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)? No

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: 02/27/2009

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