Supporting Statement 0101(revised)

Supporting Statement for Form SSA-1724

Claim for Amounts Due In The Case of a Deceased Social Security Recipient

20 CFR 404.503(b)

OMB No. 0960-0101

1. Justification

1. Introduction/Authorizing Laws and Regulations

Section 204(d) of the Social Security Act (the Act) provides that, if an individual dies before payment under Title II is complete, the amount due (including the amount of any check that is not negotiated) will be paid to persons meeting specified qualifications. Per section 20 CFR 404.503(b) of the Code of Federal Regulations, the Social Security Administration (SSA) outlines the order of priority for distribution of underpayments. The agency uses the SSA-1724 Claim for Amounts Due in the Case of a Deceased Social Security Recipient to request the Social Security Numbers (SSN) of the person(s) claiming the underpayment. The SSN will facilitate computerized processing of the claim and use of reporting payment information and identification of the payee to the Internal Revenue Service, if needed.

2. Description of Collection

SSA requests applicants complete Form SSA-1724 when there is insufficient information in the file to identify the person(s) entitled to the underpayment, or the person’s address. SSA collects the information when a surviving widow(er) is not already entitled to a monthly benefit on the same earnings records, or is not filing for a lump-sum death payment as a former spouse. SSA uses the information Form SSA-1724 provides to ensure proper payment of an underpayment due a deceased beneficiary. The respondents are applicants for underpayments owed to deceased beneficiaries.

2. Use of Information Technology to Collect the Information

Form SSA-1724 is available on the internet for the public to print, fill-out, and send in to SSA for processing. Applicant’s can complete Form SSA-1724 while in the field office. SSA did not create an electronic version of form SSA-1724 under the agency’s Government Paperwork Elimination Act (GPEA) plan due to higher volume forms taking precedence.

2. Why We Cannot Use Duplicate Information

The nature of the information we are collecting and the manner in which we are collecting it precludes duplication. SSA does not use another collection instrument to obtain similar data.

2. Minimizing Burden on Small Respondents

This collection does not affect small businesses or other small entities.

2. Consequence of Not Collecting Information or Collecting it Less Frequently

If we did not use Form SSA-1724, we would not be sure that the proper recipients are paid underpayments as required by federal law. Because we collect the information on an as needed basis, we cannot collect it less frequently.

There are no technical or legal obstacles to burden reduction.

2. 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.

2. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on May 09, 2012, at 77 FR 27264, and we received no public comments. The 30-day FRN published on July 16, 2012 at

77 FR 41874. If we receive any comments in response to this Notice, we will forward them to OMB. We did not consult with the public in the revision of this form.

2. Payment or Gifts to Respondents

SSA does not provide payment or gifts to the respondents.

2. Assurances of Confidentiality

SSA protects and holds confidential the information it collects 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.

2. Justification for Sensitive Questions

The information collection does not contain any questions of a sensitive nature.

2. Estimates of Public Reporting Burden

Collection Instrument	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Total Annual Burden (hours)
SSA-1724	250,000	1	10	41,667

The total burden for this ICR is 41,667 hours. This figure represents burden hours, and we did not calculate a separate cost burden.

2. Annual Cost to the Respondents (Other)

This collection does not impose a known cost burden to respondents.

2. Annual Cost To Federal Government

The annual cost to the Federal Government is approximately $800,000. This estimate is a projection of printing and distributing the collection instrument and for collecting the information.

15. Program Changes or Adjustments to the Information Collection Request

There are no changes to the public reporting burden.

16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

16. 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.

16. 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.