Nonsubstantive Change

Justification for Non-Substantive Change for

SSA-9308 (Request for Information), SSA-9310(Request for Documents),

SSA-2935-U3-OP1 (Authorization to the Social Security Administration to Obtain Personal Information), SS-5 (Application for a Social Security Card) and SS-5-FS (Application for a Social Security Card (Foreign Service)

OMB No. 0960-0066

Background

The Office of Quality Performance (OQP) Enumeration Quality Review (EQR) provides feedback on the accuracy of the agency’s enumeration process. EQR measures the accuracy of the enumeration process in the assignment of SSNs and verification of the Numident record.

OQP reviewers request certified records from the Bureau of Vital Statistics (BVS) and the Custodian of Records to verify that the applicant was eligible to receive the SSN card and to verify the accuracy of the Numident record. However, there are a number of states that require authorization from applicants/parents/guardians before they release documents to SSA.

Currently the EQR does not involve contact with applicants. To verify the applicant’s eligibility to the SSN as well as the accuracy of the Numident record, OQP has changed the Enumeration review to include applicant/parent/guardian contact to request the evidentiary documents or request permission to allow the state to release documents to SSA. We believe this is necessary to maintain the integrity of the review. Our goal is to use existing OMB approved forms with minor changes tailored to the EQR to accomplish this.

SSA-9308

Description of SSA-9308 Request for Information and SSA-2935-OP1 Authorization to the Social Security Administration to Obtain Personal Information

We are adding Form SSA-2935-OP1 (Authorization to the Social Security Administration to Obtain Personal Information) to OMB 0960-0066. SSA cleared Form SSA-2935 under OMB 0960-0189 for beneficiary use. We will use Form SSA-2935-OP1 for applicants. Form SSA-2935-OP1 is a disclosure form that the applicant signs, which allows SSA to obtain information from the custodian of record to verify the accuracy of the Numident record.

Form SSA-9308 is under OMB 0960-0707, Medicare Subsidy Quality Review Case Analysis; we are revising the cover letter to include the applicant contact. SSA sends the SSA-9308 as a cover letter to request evidence or request a signed form SSA-2935-OP1 from the applicant/parent/guardian/custodian of record.

Timeframe for mailing the SSA-9308 Request for Information

OQP selects cases for review at the beginning of each month. These cases represent SSN transactions that occurred in the prior month. SSA will mail the SSA-9308 Request for Information notice to the applicant when OQP reviews the case.

Burden Information:

Number of requests for documents: 500 (estimated).

Response time: 15 minutes

Burden: 125 hours.

SSA-9310

Description of SSA-9310 Request for Documents

Form SSA-9310 is cleared under OMB 0960-0707, Medicare Subsidy Quality Review Case Analysis; we are revising the cover letter to include the applicant contact. The SSA-9310 serves as a follow-up to the SSA-9308 Request for Information requesting evidence and the signed form SSA-2935-OP1 Authorization to the Social Security Administration to Obtain Personal Information” from the applicant/parent/guardian/custodian of record.

Timeframe for mailing the SSA-9310 Request for Documents

If the applicant/parent/guardian does not provide OQP with the documents requested in the SSA-9308 cover notice, we will mail the SSA-9310 to the applicant 30 days later.

Burden Information:

Number of requests for documents: 500 (estimated).

Response time: 15 minutes

Burden: 125 hours.

Minor Revisions to the Collection Instrument

SSA-9308

Change 1: We are changing the language in the over letter from Beneficiary to Applicant

Justification1:

With the implementation of the SSN Application Process (SSNAP), it has become necessary for OQP to expand the Enumeration Quality Review to include applicant contact via mail to obtain a signed authorization and other documents if needed.

Change 2: We are changing the language in the second sentence of the letter

• Old Language: The following information is needed for our review for the above named individual.

• New Language: The following information is needed for our review for the above named applicant.

Justification 2:

OQP has expanded the Enumeration Quality Review to include applicant contact via mail to obtain a signed authorization and other documents if needed.

Change 3: We are changing the language in the third sentence.

• Old Language: We have included a signed authorization for release of the information and a self-addressed stamped envelope for your convenience.

• New Language: We have also included a signed authorization for release of the information and a self-addressed stamped envelope for your convenience.

Justification 3:

OQP expanded the Enumeration Quality Review to include applicant contact via mail to obtain a signed authorization and other documents if needed.

We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.

SSA-9310

Change 4: We are changing the language in the over letter from Beneficiary Name: to Applicant Name:

Justification 4:

With the implementation of the SSN Application Process (SSNAP), it has become necessary for OQP to expand the Enumeration Quality Review to include applicant contact via mail to obtain a signed authorization and other documents if needed.

Change 5: We are deleting the first sentence.

• Old Language: On (fill-in 1), I spoke with you regarding the review of (fill-in 2). In order to proceed with the review, the following is needed:

• New Language: In order to proceed with the review, the following is needed:

Justification 5:

OQP has expanded the Enumeration Quality Review to include applicant contact via mail to obtain a signed authorization and other documents if needed.

We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.

SS-5 and SS-5-FS:

Change 6:  We are removing I-688B under on page two under Evidence of Immigration Status

• Old Language:  You must provide a current unexpired document issued to you by the Department of Homeland Security (DHS) showing your immigration status, such as Form I-551, I-94, I-688B, or I-766.

• New Language:  You must provide a current unexpired document issued to you by the Department of Homeland Security (DHS) showing your immigration status, such as Form I-551, I-94, or I-766.

Justification 6: 

DHS is no longer using form I-688B and all forms issued are now expired.  Therefore, it is no longer acceptable evidence.

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