International Direct Deposit

Forms and Documents

Document Name	Status
Form SSA-1199(Canada) International Direct Deposit Form	Modified
Supporting Statement 0686.doc Supporting Statement A	2010-03-04
List_of_Variable_Information_for_the_SSA-1199_(Country)[1].doc Supplementary Document	2010-01-06
Country_&_Language_Chart_for_SSA-1199_(Country)(1)(2).xls Supplementary Document	2010-01-06
Addendum.doc Supplementary Document	2010-01-06

IC Document Collections

IC ID	Document Title	Status
9739	International Direct Deposit Form	Modified

ICR Details

OMB Control No: 0960-0686	ICR Reference No: 200912-0960-001
Status: Historical Active	Previous ICR Reference No: 200701-0960-010
Agency/Subagency: SSA	Agency Tracking No:
Title: International Direct Deposit
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: 04/20/2010
	Date Received in OIRA: 03/11/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2013	36 Months From Approved	06/30/2010
Responses	5,000	0	5,000
Time Burden (Hours)	417	0	417
Cost Burden (Dollars)	0	0	0

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Abstract: This form captures the direct deposit information for an account at a foreign financial institution. Our International Direct Deposit (IDD) program allows beneficiaries living abroad to have their benefits deposited to an account at a financial institution outside the U.S. Routing account number information varies slightly for each country, so we use a variation of the SF-1199 A for each country. The respondents are Social Security beneficiaries residing abroad.

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Authorizing Statute(s): US Code: 31 USC 335 Name of Law: Timely Disbursement of Federal funds
   US Code: 31 USC 3332 Name of Law: Required Direct Deposit
   US Code: 31 USC 3302 Name of Law: Custodians of Money
   US Code: 31 USC 3720 Name of Law: Collection of Payments
  

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 67945	12/21/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 9992	03/04/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
International Direct Deposit	SSA-1199(Canada), SSA-1199-XXXX	Direct Deposit Sign-Up Form (Canada) ,   Direct Deposit Sign-Up Form

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ICR Summary 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	5,000	5,000	0	0	0	0
Annual Time Burden (Hours)	417	417	0	0	0	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:

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Annual Cost to Federal Government: $7,700

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: 03/11/2010

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