Information about Joint Checking/Savings Account

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SA-2574 Information about Joint Checking/Savings Account--Paper Version	Form and Instruction	Modified	Available
Form SSA-2574 (MSSICS S Information About Joint Checking/Savings Account--MSSICS Version	Form	Modified	Available
Supporting Statement_0960-0461.doc	Supporting Statement A	Uploaded 2013-03-20	Available
Addendum.doc	Supplementary Document	Uploaded 2010-04-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9346	Information about Joint Checking/Savings Account--Paper Version	Form and Instruction	Modified
180315	Information About Joint Checking/Savings Account--MSSICS Version	Form	Modified

ICR Details

OMB Control No: 0960-0461	ICR Reference No: 201212-0960-007
Status: Historical Active	Previous ICR Reference No: 201002-0960-020
Agency/Subagency: SSA	Agency Tracking No:
Title: Information about Joint Checking/Savings Account
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: 06/05/2013
	Date Received in OIRA: 04/03/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2016	36 Months From Approved	07/31/2013
Responses	200,000	0	200,000
Time Burden (Hours)	23,333	0	23,333
Cost Burden (Dollars)	0	0	0

---

Abstract: SSA considers a person's resources when evaluating eligibility for SSI payments and generally we consider funds in checking and savings accounts to be resources owned by the individuals whose names appear on the account. SSA uses Form SSA-2574 to collect information from SSI applicants/recipients who object to our assumption they own all or part of the funds in accounts bearing their names. We collect information about the account from both the SSI applicant/recipient and any other account holder(s) listed on the account. SSA requires these statements regarding ownership to determine whether the account is a resource of the SSI claimant. Respondents are applicants and recipients of SSI and individuals who are joint owners of financial accounts with SSI applicants/recipients.

---

Authorizing Statute(s): US Code: 42 USC 1382 Name of Law: Social Security Act
  

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:
	77 FR 76591	12/28/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 17276	03/20/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Information About Joint Checking/Savings Account--MSSICS Version	SSA-2574 (MSSICS Screens)	Information About Joine Checking/Savings Accounts
Information about Joint Checking/Savings Account--Paper Version	SA-2574	Information About Joint Checking/Savings Accounts

---

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)	23,333	23,333	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: $848,050

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: 04/03/2013

---