Application for Special Benefits for World War II Veterans

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-2000-F6 Application for Special Benefits for World War II Veterans	Form and Instruction	Modified	Available
Form SSA-2000-F6 Application for Special Benefits for World War II Veterans	Form and Instruction	New	Available
addendum 0615.doc	Supplementary Document	Uploaded 2009-06-25	Available
Supporting Statement-0615 Revised.doc	Supporting Statement A	Uploaded 2009-06-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43705	Application for Special Benefits for World War II Veterans	Form and Instruction	Modified	Application for Special Benefits for World War II Veterans
187952	20 CFR 408.435(a),(b),(c)		New
187951	20 CFR 408.430-408.432		New
187950	20 CFR 408.420(a) & (b)		New
187937	20 CFR 408.202(d) (SSA-2000-F6)	Form and Instruction	New	Application for Special Benefits for World War II Veterans

ICR Details

OMB Control No: 0960-0615	ICR Reference No: 200902-0960-002
Status: Historical Active	Previous ICR Reference No: 200606-0960-008
Agency/Subagency: SSA	Agency Tracking No:
Title: Application for Special Benefits for World War II Veterans
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/10/2009
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/30/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2012	36 Months From Approved	11/30/2009
Responses	1,394	0	1,086
Time Burden (Hours)	461	0	359
Cost Burden (Dollars)	0	0	0

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Abstract: Title VIII of the Social Security Act (Special Benefits for Certain World War II Veterans) allows for the payment of a monthly benefit to a qualified World War II veteran who resides outside the United States. The regulations set out the requirements an individual must meet in order to qualify for and become entitled to Special Veterans Benefits (SVB). SSA-2000-F6 is the application used to elicit the information necessary to determine entitlement to SVB. The respondents are individuals who are applying for SVB under Title VIII of the Social Security Act.

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Authorizing Statute(s): US Code: 42 USC 1001 Name of Law: Social Security Act
   US Code: 42 USC 1002 Name of Law: Social Security Act
   US Code: 42 USC 1003 Name of Law: Social Security Act
   US Code: 42 USC 1004 Name of Law: Social Security Act
   US Code: 42 USC 1006 Name of Law: Social Security Act
  

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:
	74 FR 18782	04/24/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 30353	06/25/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
20 CFR 408.202(d) (SSA-2000-F6)	SSA-2000-F6	Application for Special Benefits for World War II Veterans
20 CFR 408.420(a) & (b)
20 CFR 408.430-408.432
20 CFR 408.435(a),(b),(c)
Application for Special Benefits for World War II Veterans	SSA-2000-F6	Application for Special Benefits for World War II Veterans

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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	1,394	1,086	0	0	308	0
Annual Time Burden (Hours)	461	359	0	0	102	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: The total number of respondents and burden hours has decreased. There is a decrease in the annual reporting burden for this collection, because there is a decrease in the number of respondents who apply for SVB. The universe of potential applicants is limited, declining because most applicants who meet the eligibility requirements have already filed for benefits under this provision, and there are fewer applicants who meet the requirement of having attained age 65 or older in 12/99. We expect the decreasing trend in the annual reporting burden to continue.

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Annual Cost to Federal Government: $902

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: 06/30/2009

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