SSA-L2765, Request for Self-Employment Information, SSA-L3365, Request for Employee Information, SSA-L4002, Request for Employer Information

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-L2765 SSA-L2765, Request for Self-Employment Information	Form	Unchanged	Available
Form SSA-L4002 SSA-L4002, Request for Employer Information	Form	Unchanged	Available
Form SSA-L3365 SSA-L3365, Request for Employee Information	Form	Unchanged	Available
DECOR Study Wage Report Questionnaire.doc	Supplementary Document	Uploaded 2010-06-18	Available
DECOR Study Earnings Report Questionnaire.doc	Supplementary Document	Uploaded 2010-06-18	Available
DECOR_Study_OQP_Ltr.doc	Supplementary Document	Uploaded 2010-06-18	Available
Justification for Non-Substantive Change to 0960-0508 (DECOR Notices Study).doc	Justification for No Material/Nonsubstantive Change	Uploaded 2010-06-18	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9413	SSA-L2765, Request for Self-Employment Information	Form	Unchanged
178763	SSA-L4002, Request for Employer Information	Form	Unchanged
178761	SSA-L3365, Request for Employee Information	Form	Unchanged

ICR Details

OMB Control No: 0960-0508	ICR Reference No: 201006-0960-009
Status: Historical Inactive	Previous ICR Reference No: 200702-0960-006
Agency/Subagency: SSA	Agency Tracking No:
Title: SSA-L2765, Request for Self-Employment Information, SSA-L3365, Request for Employee Information, SSA-L4002, Request for Employer Information
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 09/10/2010
	Date Received in OIRA: 06/21/2010
Terms of Clearance: Withdrawn at SSA's request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2010	10/31/2010	01/31/2011
Responses	844,500	0	844,500
Time Burden (Hours)	140,750	0	140,750
Cost Burden (Dollars)	0	0	0

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Abstract: Due to the large volume of wage and Self Employment reports that fail the identity matching processes of SSA and are placed into a special file known as the Earnings Suspense File, we intend to conduct a brief review to enhance our DECOR notices. The Office of Quality Performance, Division of Automated Solutions (OQP DAS) developed several processes to provide resolution to some of the reports that have remained in the Earnings Suspense File. We continue to review the files and analyze information in an effort to provide additional automation to improve the quality and quantity of earnings reports processing. We have designed a notice and two sets of questions to test potential changes that will allow expanded automation of the DECOR process.

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Authorizing Statute(s): US Code: 42 USC 405 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:
	72 FR 12244	03/15/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 26443	05/09/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
SSA-L2765, Request for Self-Employment Information	SSA-L2765	Request for Self-Employment Information
SSA-L3365, Request for Employee Information	SSA-L3365	Request for Employee Information
SSA-L4002, Request for Employer Information	SSA-L4002	Request for Employer Information

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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: There is not a increase in burden, when we separated the IC's the system is showing it as a increase. There is actually an decrease in the burden due to the decrease of the beneficiary population. The change in the public reporting burden is due to the following; The Social Security Number Verification Service (SSNVS) allows employers to verify employee names and SSNs via a secure Internet-based system. SSNVS may have somewhat of an impact on the decrease since it offers an immediate and efficient verification process. However, the burden reduction by SSNVS was probably minor since there are only 31,000+ employers registered. A contributing factor could be that since the DECOR process is not mandatory, our customers are not obligated to return their responses.

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Annual Cost to Federal Government: $4,833,000

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

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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: 06/21/2010

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