Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds/Report to U.S. SSA

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-7161-OCR-SM SSA-7161-OCR-SM--Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds/Report to U.S. SSA	Form and Instruction	Modified	Available
Form SSA-7162-OCR-SM SSA-7162-OCR-SM--Report to U.S. SSA	Form and Instruction	Modified	Available
Supporting Statement--0049.doc	Supporting Statement A	Uploaded 2010-06-02	Available
Addendum.doc	Supplementary Document	Uploaded 2010-06-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8961	SSA-7161-OCR-SM--Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds/Report to U.S. SSA	Form and Instruction	Modified
178733	SSA-7162-OCR-SM--Report to U.S. SSA	Form and Instruction	Modified

ICR Details

OMB Control No: 0960-0049	ICR Reference No: 201002-0960-022
Status: Historical Active	Previous ICR Reference No: 200805-0960-022
Agency/Subagency: SSA	Agency Tracking No:
Title: Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds/Report to U.S. SSA
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: 09/24/2010
	Date Received in OIRA: 06/02/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2013	36 Months From Approved	09/30/2010
Responses	301,702	0	275,597
Time Burden (Hours)	30,235	0	27,710
Cost Burden (Dollars)	0	0	0

---

Abstract: SSA uses information from Forms SSA-7161-OCR-SM and SSA-7162-OCR-SM to:1)determine continuing entitlement to Social Security benefits; 2)correct benefit amounts for beneficiaries outside the US; and 3)to monitor the performance of representative payees outside the United States. The respondents are individuals living outside the United States who are receiving benefits on their own (or for someone else) under Title II of the Social Security Act.

---

Authorizing Statute(s): US Code: 42 USC 403 Name of Law: Reduction of Insurance Benefits
   US Code: 42 USC 405 Name of Law: Evidence, Procedure, and Cetification for Payments
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 15761	03/30/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 30897	06/02/2010
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
SSA-7162-OCR-SM--Report to U.S. SSA	SSA-7162-OCR-SM	Report to U.S. SSA
SSA-7161-OCR-SM--Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds/Report to U.S. SSA	SSA-7161-OCR-SM	Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds/Report to U.S. SSA

---

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	301,702	275,597	0	0	26,105	0
Annual Time Burden (Hours)	30,235	27,710	0	0	2,525	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 burden increase is due to an increase in the beneficiary population living outside the United States.

---

Annual Cost to Federal Government: $36,760

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]? No

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

---

Common Form ICR:  No

---

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: 06/02/2010

---