Supporting Statement - 0466 (revised)

Supporting Statement for SSA-7004

Request for Social Security Statement

20 CFR 404.810

OMB No. 0960-0466

A. Justification

1. Introduction/Authoring Laws and Regulations

Section 205(c)(2)(A) of the Social Security Act (the Act) requires that the Commissioner of the Social Security Administration (SSA) establish and maintain records of wages paid to, and amounts of self-employment income derived by, each individual as well as the periods in which such wages were paid and such income derived. In addition, upon request, the Commissioner must inform any individual or his survivor of the periods during which employers paid those wages or an individual derived such income. Section 1143(a)(2) of the Act requires the Commissioner provide upon the request of an eligible individual a Social Security account Statement (hereinafter referred to as “Statement”). 20 CFR 404.810 of the Code of Federal Regulations provides that an individual may obtain a Statement of earnings or quarters of coverage, as shown in the Social Security Administration (SSA) records, by making a written request. SSA established Form SSA‑7004 to fulfill the “written request” requirement.

SSA suspended mailing Social Security Statements in October 2012, therefore; we are placing the paper and internet version of Form SSA-7004 on hold, until further notice.

2. Description of Collection

SSA uses the information Form SSA-7004 collects to identify a respondent’s Social Security earnings information, calculate potential benefit estimates, produce the resulting Social Security statements, and mail them to the requestors. The respondents are Social Security number holders requesting information about their Social Security earnings records and estimates of their potential benefits.

3. Use of Information Technology to Collect the Information

An individual may complete and mail Form SSA-7004 to SSA to obtain a Statement of Earnings or Quarters of Coverage. Individuals who authenticate through the online system are able to access their Social Security Statement information electronically.

In accordance with the agency’s Government Paperwork Elimination Act plan, SSA created an Internet version of form SSA-7004. Based on our data, we estimate approximately 99% of respondents under this OMB number use the electronic version.

4. Why We Cannot Use Duplicate Information

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

5. Minimizing Burden on Small Respondents

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

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

If we did not use Form SSA-7004, individuals would be unable to exercise their statutory right to submit a request for copies of their earnings or credits (also known as quarters of coverage) as shown on SSA records. Because we only collect the information on an as need basis, we cannot collect it less frequently.

There are no technical or legal obstacles to prevent burden reduction.

7. 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.

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

The 60-day advance Federal Register Notice published on March 20, 2013, at

78 FR 17276 and we received no public comments. The 30-day FRN published on June

28, 2013 at FR 39056. If we receive any comments in response to this Notice, we will forward them to OMB.

9. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents.

10. 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.

SSA’s system encrypts requests transmitted electronically using the Secure Socket Layer Security Protocol, an industry standard protocol used by banks and other financial institutions for Internet transactions.

11. Justification for Sensitive Questions

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

12. Estimates of Public Reporting Burden

Modality of collection	Number of Respondents	Frequency of Response	Average Burden per Response (min)	Estimated total annual burden (hours)
SSA-7004 (paper)	17,219	1	5	1,435
SSA-7004 (internet)	3,198,361	1	5	266,530
Total	3,215,580	-	-	267,965

13. Annual Cost Burden to the Respondents (Other)

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

14. Annual Cost To Federal Government

The annual cost to the Federal Government is approximately $19,115.00. This estimate is a projection of the costs for printing, distributing the forms, and collecting the information.

15. Program Changes or Adjustments to the Information Collection Request

There has been a decrease in the burden hours due to taking the paper form out of circulation when we suspended mailing the statements. There has been an increase in burden hours for the Internet version, due to the increase amount of people attempting to access their statements online.

16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

17. 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 usable forms with expired OMB approval dates, avoiding Government waste.

18. Exception 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).

B. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.