Epidemiological Research Request

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Addendum - 0701.doc	Supplementary Document	Uploaded 2014-01-08	Available
Supporting Statement - 0701.doc	Supporting Statement A	Uploaded 2014-01-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9755	Epidemiological Research Request -- State and Local Government	Other-Internet Screens	Modified
183743	Epidemiological Research Request -- Private Entities	Other-Internet Screens	Modified

ICR Details

OMB Control No: 0960-0701	ICR Reference No: 201308-0960-013
Status: Historical Active	Previous ICR Reference No: 201010-0960-004
Agency/Subagency: SSA	Agency Tracking No:
Title: Epidemiological Research Request
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: 04/28/2014
	Date Received in OIRA: 01/09/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2017	36 Months From Approved	04/30/2014
Responses	25	0	28
Time Burden (Hours)	50	0	56
Cost Burden (Dollars)	87,500	0	102,620

---

Abstract: Section 311 of the Social Security Independence and Program Improvements Act of 1994 directs SSA to provide support to health researchers involved in epidemiological research. Specifically, when we determine a study contributes to a national health interest, SSA furnishes information to determine whether a study subject appears in SSA administrative records as alive or deceased (vital status). SSA charges a small fee per request for providing this information. Web-posted questions solicit the information SSA needs to provide the data and to collect the fees. The respondents are qualified health and scientific researchers who are applying to receive vital status information about individuals from Social Security administrative data records.

---

Authorizing Statute(s): US Code: 5 USC 552a Name of Law: Social Security Act
   US Code: 42 USC 1306 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:
	78 FR 56265	09/12/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 79723	12/31/2013
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
Epidemiological Research Request -- State and Local Government
Epidemiological Research Request -- Private Entities

---

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	25	28	0	0	-3	0
Annual Time Burden (Hours)	50	56	0	0	-6	0
Annual Cost Burden (Dollars)	87,500	102,620	0	0	-15,120	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: The burden change is due to a slight decrease in the number of annual vital status requests SSA receives. Since we are receiving fewer requests, the annual burden decreased.

---

Annual Cost to Federal Government: $115,000

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

---

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: 01/09/2014

---