Coverage of Employees of State and Local Governments

Forms and Documents

Document Name	Status
Supporting Statement 0960-0723 (8-23-11).doc Supporting Statement A	2011-12-19
11efw2c.pdf Supplementary Document	2011-10-13
Filing_Electronic_and_Instructions_for_W2C.doc[1].pdf Supplementary Document	2011-10-13
Addendum.doc Supplementary Document	2011-10-13

IC Document Collections

IC ID	Document Title	Status
9277	20 CFR 404.1203 Evidence	Removed
188194	20 CFR 404.1239 Wage Reports for Employees Performing Services in More than One Coverage Group - for Wages Paid Prior to 1987.	Removed
187841	20 CFR 404.1292 How to Request Review for Wages Paid Prior to 1987	Removed
187840	20 CFR 404.1272 Refund or Recomputation of Overpayments which are Not Adjustable	Removed
187839	20 CFR 404.1271 Adjustment of Overpayment of Contributions	Removed
187838	20 CFR 404.1265 Addition of Interest to Contributions	Removed
187837	20 CFR 404.1249 When and Where to Make Deposits of Contributions and to File Contribution Returns and Wage Reports - for Wages Paid Prior to 1987	Removed
187836	20 CFR 404.1247 When to Report Wages - for Wages Paid Prior to 1987	Removed
187835	20 CFR 404.1237, Wage Reports.	Removed
187834	20 CFR 404.1225 Records - for Wages Paid Prior to 1987	Removed
187832	20 CFR 404.1216 Modification of Agreement to Correct an Error	Unchanged
187831	20 CFR 404.1215 Modification of Agreement	Unchanged
187830	20 CFR 404.1214 Agreement for Coverage	Removed
187829	20 CFR 404.1204 Designating Officials to Act on Behalf of the State	Unchanged

ICR Details

OMB Control No: 0960-0425	ICR Reference No: 201109-0960-005
Status: Historical Active	Previous ICR Reference No: 200809-0960-004
Agency/Subagency: SSA	Agency Tracking No:
Title: Coverage of Employees of State and Local Governments
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/25/2012
	Date Received in OIRA: 12/22/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	36 Months From Approved	04/30/2012
Responses	156	0	173
Time Burden (Hours)	130	0	159
Cost Burden (Dollars)	0	0	0

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Abstract: The Code of Federal Regulations at 20 CFR 404 prescribe the rules for States submitting reports of deposits and related record keeping to SSA. States are required to provide wage information and deposit- related contribution information for pre-1987 periods. The respondents are State and local governments.

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Authorizing Statute(s): US Code: 42 USC 410 Name of Law: Social Security Act
   US Code: 42 USC 418 Name of Law: Social Security Act
   US Code: 42 USC 405 Name of Law: Social Security Act
   US Code: 42 USC 902 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:
	76 FR 59180	09/23/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 78068	12/15/2011
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
20 CFR 404.1216 Modification of Agreement to Correct an Error
20 CFR 404.1204 Designating Officials to Act on Behalf of the State
20 CFR 404.1249 When and Where to Make Deposits of Contributions and to File Contribution Returns and Wage Reports - for Wages Paid Prior to 1987
20 CFR 404.1215 Modification of Agreement
20 CFR 404.1265 Addition of Interest to Contributions
20 CFR 404.1271 Adjustment of Overpayment of Contributions
20 CFR 404.1239 Wage Reports for Employees Performing Services in More than One Coverage Group - for Wages Paid Prior to 1987.
20 CFR 404.1203 Evidence
20 CFR 404.1292 How to Request Review for Wages Paid Prior to 1987
20 CFR 404.1237, Wage Reports.
20 CFR 404.1247 When to Report Wages - for Wages Paid Prior to 1987
20 CFR 404.1225 Records - for Wages Paid Prior to 1987
20 CFR 404.1272 Refund or Recomputation of Overpayments which are Not Adjustable
20 CFR 404.1214 Agreement for Coverage

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ICR Summary 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	156	173	0	-17	0	0
Annual Time Burden (Hours)	130	159	0	-29	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: We have removed the regulation sections for which there were less than 10 respondents. We have also removed the regulation sections cleared by Internal Revenue Service (IRS) forms where formerly we had placed a 1-hour place holder burden on those sections, and have removed regulation sections cleared under OMB numbers 0960-0030 and 0960-0036 (see Addendum). We have adjusted the burden to reflect these actions.

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Annual Cost to Federal Government: $10,000

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]? 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

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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: 12/22/2011

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