Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 8955-SSA Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits	Form	Modified	Repair queued
Supporting Statement.pdf	Supporting Statement A	Uploaded 2011-06-10	Available
Expiration Explanation.rtf	Supplementary Document	Uploaded 2010-08-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
194025	Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits	Instruction	Modified
194025	Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits	Form	Modified	Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits

ICR Details

OMB Control No: 1545-2187	ICR Reference No: 201101-1545-017
Status: Historical Active	Previous ICR Reference No: 201007-1545-064
Agency/Subagency: TREAS/IRS	Agency Tracking No: rt-2187-017
Title: Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/10/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/25/2011
Terms of Clearance: Agency revised supporting statement to address public comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2014	36 Months From Approved	06/30/2011
Responses	200,000	0	200,000
Time Burden (Hours)	166,000	0	166,000
Cost Burden (Dollars)	0	0	0

---

Abstract: In 2007, the Department of Labor (DOL) published a final rule requiring plans subject to the annual reporting requirements of Title I of Employee Retirement Income Security Act (ERISA) to electronically file the Form 5500, Annual Return/Report of Employee Benefit. In order to accommodate the DOL's mandate for electronic filing of the Form 5500 series, Schedule (SSA) has been eliminated and replaced with Form 8955-SSA. The information provided by plan sponsors on Form 8955-SSA will be transmitted to the Social Security Administration (SSA) who will provide it to separated participants when those participants file for social security benefits.

---

Authorizing Statute(s): US Code: 26 USC 6057 Name of Law: Annual registration, etc.
  

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 67163	11/01/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 10664	02/25/2011
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits	8955-SSA	Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits

---

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	200,000	200,000	0	0	0	0
Annual Time Burden (Hours)	166,000	166,000	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:

---

Annual Cost to Federal Government: $0

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]? No

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: 02/25/2011

---