Supporting Statement

SUPPORTING STATEMENT
1. CIRCUMSTANCES NECESSITATING COLLECTION OF INFORMATION
In 2007, the Department of Labor (DOL) published a final rule requiring plans subject to the annual rporting
requirements of Title I of ERISA to electronically file the Form 5500 annual return/report. In order to accomodate the
DOL's mandate for electronic filing of the Form 5500 series, Schedule (SSA) has been eliminated.
For plan years begining on or after January 2009, the Form 8955-SSA must be used to comply with the reporting
requirement of IRC Section 5067(a). The IRS will no longer accept Scheudle SSA (Form 5500) that is filed for a 2009
or later plan year. The general due date for filing Form 8955-SSA is the last day of the seventh month following the last
day of that plan year. It is urgent that the new Form 8955-SSA be available to plan administrators as we past the due
date (July 31, 2010) for filing information required by section 6057(a) for calander year plans for 2009 plan years.

2. USE OF DATA
The information provided by plan sponsors on Form 8955-SSA will be transmitted to the Social Secuirty Administration
(SSA) who will provide it to separated participants when those participants file for social security benefits.

3. USE OF IMPROVED INFORMATION TECHNOLOGY TO REDUCE BURDEN
IRS anticipates that electronic filing system will be available for the 2010 plan year.

4. EFFORTS TO IDENTIFY DUPLICATION
We have attempted to eliminate duplication within the agency wherever possible.

5. METHODS TO MINIMIZE BURDEN ON SMALL BUSINESSES OR OTHER SMALL ENTITIES
Not applicable.

6. CONSEQUENCES OF LESS FREQUENT COLLECTION ON FEDERAL PROGRAMS OR
POLICY ACTIVITIES
Not applicable.

Form 14029 (Rev. 4-2009) Catalog Number 51944B Page 4

Department of the Treasury–Internal Revenue Service

7. SPECIAL CIRCUMSTANCES REQUIRING DATA COLLECTION TO BE INCONSISTENT
WITH GUIDELINES IN 5 CFR 1320.5(d)(2)
There are no special circumstances that would cause this information collection to be conducted in a manner
inconsistent with 5 CFR 1320.5(d)(2).

8. CONSULTATION WITH INDIVIDUALS OUTSIDE OF THE AGENCY ON AVAILABILITY
OF DATA, FREQUENCY OF COLLECTION, CLARITY OF INSTRUCTIONS AND FORMS,
AND DATA ELEMENTS
Periodic meetings were held between IRS personell and representatives from Social Security Administration and
Department of Labor to discuss the tax law and Form 8955-SSA. During this meetings the attendants were able to
make comments regarding the form 8955-SSA In response to the Federal Register Notice (75 FR 67163) dated
November 1, 2010, the agency received 13 comments during the comment period for form 8955-SSA. Draft copies of
the form were provided via email, in response to 7 requests. The substantive comments regarding additional
changes to the forms were forwarded to the originating office for consideration and response. Since this form is still in
the early development stages of the forms development cycle, the originating office in concurrence with the office of
Chief Counsel will evaluate and respond to all comments throughout this development cycle and as specific
determinations are issued by the IRS. Commenter's will be notified of the timeframes and decisions of the Agency
through the agency correspondence process. This process will be completed at various times depending on the
complexity of the comments submitted. All comments were still under review at the time of this renewal submission.

9. EXPLANATION OF DECISION TO PROVIDE ANY PAYMENT OR GIFT TO RESPONDENTS
Not applicable.

10. ASSURANCE OF CONFIDENTIALITY OF RESPONSES
Generally, tax returns and tax return information are confidential as required by 26 USC 6103.

11. JUSTIFICATION OF SENSITIVE QUESTIONS
Not applicable.

12. ESTIMATED BURDEN OF INFORMATION COLLECTION
Form 8955-SSA

Number of
Hours
200,000

Time per
Response
.83

Form 14029 (Rev. 4-2009) Catalog Number 51944B

Total
Hours
166000

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Department of the Treasury–Internal Revenue Service

13. ESTIMATED TOTAL ANNUAL COST BURDEN TO RESPONDENTS
Estimates of the capital or start-up costs and cost of operation, maintenance, and the purchase of services to provide
information not available at this time.

14. ESTIMATED ANNUALIZED COST TO THE FEDERAL GOVERNMENT
After consultation with various functions within the service, we have determined the cost of developing, printing,
processing, distribution and overhead for the form is $10,000.

15. REASONS FOR CHANGE IN BURDEN
There is no change burden on this form.

16. PLANS FOR TABULATION, STATISTICAL ANALYSIS AND PUBLICATION
Not applicable.

17. REASONS WHY DISPLAYING THE OMB EXPIRATION DATE IS INAPPROPRIATE
See attachment.

18. EXCEPTIONS TO THE CERTIFICATION STATEMENT ON OMB PRA SUBMISSION FORM
Not applicable.

19. REASON FOR EMERGENCY SUBMISSION
Not applicable.

Form 14029 (Rev. 4-2009) Catalog Number 51944B

Page 6

Department of the Treasury–Internal Revenue Service