Supporting Statement - SSA-263

Supporting Statement - SSA-263.doc

Waiver of Supplemental Security Income Payment Continuation

OMB: 0960-0783

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Supporting Statement for SSA-263-U2

Waiver of Supplemental Security Income Payment Continuation

20 CFR 416.1400-416.1422

OMB No. 0960-NEW



A. Justification


  1. Introduction/Authoring Laws and Regulations

Section 1631(a)(7) of the Social Security Act (the Act) allows a recipient of Supplemental Security Income (SSI) to continue receiving benefits at the same rate after SSA notifies them that we will suspend, terminate, or reduce their benefits, provided they file a timely appeal. When recipients appeal the cessation within ten (10) days, they can continue to receive the same benefit amount until SSA decides the appeal (reconsideration). If they decide they no longer want to continue to receive payment continuation during the appeal, they can file a waiver of their payment continuation by completing form SSA-263-U2, Waiver of Supplemental Security Income Payment Continuation. 20 CFR 416.1400-416.1422 of the Code of Federal Regulations sets forth the policies for implementing the pertinent sections of the Act.


  1. Description of Collection

SSA collects the information on form SSA-263-U2 to determine whether an individual meets the provisions listed above regarding waiver of payment continuation. SSA needs the information on the form to serve as proof that respondents no longer want their payments to continue. Recipients must use form SSA-263-U2 when they are awaiting determinations on their appeals and wish to inform SSA of their decision to stop payment continuation. Respondents are recipients of SSI payments who wish to discontinue receipt of payment while awaiting a determination on their appeal.


  1. Use of Information Technology to Collect the Information

SSA did not create an electronic version of the SSA-263-U2 due to our need to prioritize higher volume forms for electronic implementation under the agency’s Government Paperwork Elimination Act (GPEA) plan. Only 3,000 respondents complete the SSA-263-U2, which is significantly below the GPEA cut-off of 50,000.


  1. Why We Cannot Use Duplicate Information

The nature of the information we are collecting and the manner in which we are collecting it preclude duplication. SSA does not use another collection instrument to obtain similar data.


  1. Minimizing Burden on Small Respondents

This collection does not affect small businesses or other small entities.


6. Consequence of Not Collecting Information or Collecting it Less Frequently

If SSA did not collect information on the SSA-263 U2, recipients would have no way to stop receiving payments they no longer want to receive, possibly causing an overpayment on their record. This neglect would be a violation of regulations at 20 CFR 416.1400-416.1422. Because we collect the information on an as-needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.


7. Special Circumstances

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


  1. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on January 22, 2010 at 75 FR 3778, and SSA has received no public comments. The 30-day Notice published on March 30, 2010, at 75 FR 15761. If we receive any comments in response to the 30-day Notice, we will forward them to OMB. There have been no outside consultations with members of the public.


  1. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents.


  1. Assurances of Confidentiality

SSA protects and holds confidential the information it collects 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.


  1. Justification for Sensitive Questions

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


  1. Estimates of Public Reporting Burden

Approximately 3,000 respondents take 5 minutes each to complete form SSA‑263-U2 each year. Accordingly, the burden is 250 hours. This figure represents burden hours, and SSA did not calculate a separate cost burden.


  1. Annual Cost to the Respondents (Other)

This collection does not impose a known cost burden to the respondents.


  1. Annual Cost To Federal Government

The annual cost to the Federal Government is approximately $9,240. This estimate is a projection of the costs for printing and distributing the collection instrument, and for collecting the information.


15. Program Changes or Adjustments to the Information Collection Request

This form is unintentionally in use without OMB approval, which will increase the public reporting burden. See #12 above for the burden figures.


16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.


17. Displaying the OMB Approval Expiration Date

OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise usable forms with expired OMB approval dates, avoiding Government waste .


  1. Exceptions to Certification Statement

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 does not use statistical methods for this information collection.

File Typeapplication/msword
File TitleTitle of Information Collection and Form Number(s)
AuthorNaomi
Last Modified By666429
File Modified2010-04-19
File Created2010-04-08

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