Addendum to the Supporting Statement for 0960-0648

Addendum to the Supporting Statement for Form SSA-1414

Credit Card Payment Form

OMB No. 0960-0648

Terms of Clearance:

SSA has addressed the previous terms of clearance for this collection. At this point in time, SSA is not required to offer web-based payment for this credit card payment form or to use a standard form for the purposes of this specific collection. However, SSA should continue to explore ways to consolidate credit card payment forms and provide electronic payment for affected parties.

In compliance with the Terms of Clearance, SSA has added the payment for FOIA requests to this form, which further consolidates credit card payments. At this time we are continuing to use separate credit card payment forms as the creation of one form which would encompass all of our credit card payment needs, would require the inclusion of all the variable data elements, imposing a burden not necessarily needed or used by SSA for the purposes of all the payments.

While SSA has reviewed the possibility of creating an electronic version of this form, due to the low volume of usage and budgetary constraints, SSA does not currently have the means to make this form available electronically. When feasible technology becomes available, SSA will reassess the possibility of implementing an electronic version of this form.

Revisions to the Collection Instrument:

We are revising the PRA statement to reflect our current 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  The current language, which dates back to the last reprint of the form, is now outdated.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 form.

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