Supporting Statement SSA 8006 for 2008 revised

Supporting Statement for SSA-8006-F4

Statement of Living Arrangements,

In-Kind Support and Maintenance

20 CFR 416.1130-416.1148

(OMB No. 0960-0174)

A.Justification

1. Section 1612(a)(2)(A) of the Social Security Act (the Act) provides that the benefits of an eligible individual who receives support and maintenance in-kind shall be reduced by 33 and 1/3 percent. Section1631(e)(1)(B)(i) of the Act requires that information used to determine eligibility for SSI benefits must be verified by independent or collateral sources. 20 CFR 416.1130- 416.1148 of the Code of Federal Regulations provide the policies and procedures for implementing Section 1612(a)(2)(A) of the Act.

2. SSA uses Form SSA-8006-F4 in the administration of the Supplemental Security Income (SSI) program. Recipients’ need is the basis for determining SSI benefits eligibility. Need is measured, in part, by the amount of income an individual receives. Income includes in-kind support and maintenance in the form of food and shelter provided by other persons. Form SSA-8006-F4 collects information to ensure that recipients are eligible to receive SSI payments and to determine the correct amount of payments due. The information permits SSA to determine the income value, if any, of in-kind support and maintenance received by SSI applicants and recipients. The respondents are individuals who apply for SSI payments, or for SSI eligibility redetermination.

3. The SSA-8006-F4 is not available to the public as an electronic form. However, an SSA claims representative collects and inputs the information during a personal interview in its electronic Modernized Supplemental Security Income Claims System (MSSICS). SSA currently processes about 90% of all SSI initial claims and redeterminations in MSSICS. SSA only uses the paper version of the SSA-8006-F4 when MSSICS is not available.

3. Some of the questions on this form are duplicate questions asked on Form SSA-8011-F3 (OMB control number 0960-0456). However, the questions on the SSA-8011-F3 are answered by a different person—the householder. SSA needs the householder’s statement on the SSA-8011-F3 to corroborate the information provided by the applicant or recipient on the SSA-8006-F4. In no case should the same person answer the SSA-8006-F4 and SSA-8011-F3 forms.

5. This collection does not significantly affect a substantial number of small businesses or other small entities

6. Collection of the information takes place based upon the need of the applicant to apply for, or reaffirm eligibility for SSI payments. If SSA did not collect this information there would be a high risk of incorrect SSI eligibility and payment determinations. SSA will only collect the information on an as needed basis, in order to determine the correct SSI payments. Collecting the information less frequently would increase the risk of making incorrect payments. There are no technical or legal obstacles that prevent burden reduction.

5. There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.

5. The 60-day advance Federal Register Notice published on January 15, 2009, at 74 FR 2642, and SSA received no public comments. The second Notice published on March 19, 2009, at 74 FR 11804. SSA did not consult members of the public in the development of this form.

5. SSA provides no payment or gifts to the respondents.

5. SSA protects and holds confidential the information it is 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.

5. The information collection does not contain any questions of a sensitive nature.

5. Approximately 173,380 respondents use this form. The estimated completion time is 7 minutes. Thus, the total burden is 20,228 hours. The total burden represents burden hours, and SSA did not calculate a separate cost burden.

13. There is no known cost burden to the respondents.

13. The annual cost to the Federal government is approximately $534,010. This estimate is a projection of the costs for printing and distributing the paper version of the collection instrument and for collecting the information.

15. There are no changes in the public reporting burden.

16. SSA will not publish the results of the information collection.

16. OMB exempted SSA from the requirement to print the OMB approval expiration date 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 this exemption so the agency would not have to discontinue using otherwise useable editions of forms with outdated expiration dates. In addition, SSA avoids government waste, because we will not have to destroy and reprint stocks of forms.

16. 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 is not using statistical methods for this collection.