Supporting Statement 0128

SUPPORTING STATEMENT FOR FORM SSA-8150

REPORTING EVENTS - SSI

20 CFR 416.701-.732

OMB No. 0960-0128

A. Justification

1. Introduction/Authoring Laws and Regulations - If Supplemental Security Income (SSI) recipients experience income, resource, living arrangement, medical, or other changes that could affect their SSI eligibility or SSI payment amounts, they or their representatives must report these changes to the Social Security Administration (SSA). They use Form SSA-8150, Reporting Events – SSI, to do so. Section 1631(e) of the Social Security Act gives SSA the right to collect information to determine SSI eligibility and amounts. Sections 20 CFR 416.701-416.732 of the Code of Federal Regulations describe the types of changes SSI recipients should report, the reporting modalities they may use, and the possible penalties for failing to report eligibility-changing events.

2. Description of Collection - SSI recipients or their representatives use Form SSA-8150 to report any relevant changes in their circumstances. SSA then uses this information to determine if SSI eligibility or the amount of payment should change.

3. Use of Information Technology to Collect the Information - SSA did not develop an electronic version of Form SSA-8150 under the agency’s Government Paperwork Elimination Act (GPEA) plan because the number of respondents is less than the 50,000 GPEA baseline. However, respondents do have alternatives to completing the paper form; including telephoning, writing, faxing, or visiting an SSA field office. SSA claims representatives capture approximately 85 percent of responses using the Modernized SSI Claims System (MSSICS) to key in directly the information from respondents.

4. 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. There are no other collection instruments SSA uses that collect similar data.

4. Minimizing Burden on Small Respondents - This collection does not affect small businesses or other small entities.

4. Consequence of Not Collecting Information or Collecting it Less Frequently - If SSA did not collect this information, we would have no means of re-determining SSI eligibility or payment amounts when SSI recipients experience circumstantial changes. This could result in 1) underpayment or overpayment of benefits or 2) suspension of benefits for SSI recipients who could not report eligibility-affecting changes. Because respondents only submit this form when a change occurs, we cannot collect the information less frequently.

There are no technical or legal obstacles that prevent burden reduction.

4. 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.

4. Solicitation of Public Comment and Other Consultations with the Public - SSA published the 60-day advance Federal Register Notice on November 12, 2010, at 75 FR 69515, and we did not receive any public comments. SSA published the 30-day Federal Register Notice on January 28, 2010 at 76 FR 5233. If we receive any public comments in response to the 30-day Notice, we will forward them to OMB. SSA did not consult with the public in the development or maintenance of this form.

4. Payment or Gifts to Respondents - SSA provides no payment or gifts to the respondents.

4. Assurance of Confidentiality – SSA protects and holds confidential the information we collect 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.

4. Justification for Sensitive Questions - The information collection does not contain any questions of a sensitive nature.

4. Estimates of Public Reporting Burden - Approximately 27,320 respondents spend 5 minutes each completing Form SSA-8150 annually. Accordingly, the burden is 2,276 hours. The total burden reflects burden hours, and we did not calculate a separate cost burden.

Collection Method	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Annual Burden (hours)
SSA-8150 (Paper form)	5,694	1	5	474
SSA-8150 (MSSICS)	21,626	1	5	1,802
Totals	27,320			2,276

4. Annual Cost to the Respondent s - There is no known cost burden to the respondents.

4. Annual Cost to Federal Government - The annual cost to the Federal Government is approximately $46,477. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.

4. Program Changes or Adjustments to the Information Collection Request – There are no changes to the public reporting burden.

4. Plans for Publication Information Collection Results - SSA will not publish the results of the information collection.

4. 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 useable forms with expired OMB approval dates avoiding Government waste.

4. 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).

2. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.

SSA-8150 (0960-0128)

2/1/2021

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