Supporting Statement 0960-0105

Supporting Statement 0960-0105.doc

Advanced Notice of Termination of Child's Benefits, and Student's Statement Regarding School Attendance

OMB: 0960-0105

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Supporting Statement for Form SSA-1372-BK and SSA-1372-BK-FC

Advance Notice of Termination of Child’s Benefits and

Student’s Statement Regarding School Attendance

20 CFR 404.350-404.352, 404.367-404.368


OMB No. 0960-0105



A. Justification


  1. Introduction/Authoring Laws and Regulation

Section 202(d) of the Social Security Act provides, under certain conditions, for payment of monthly benefits to students who are children of entitled workers. The Social Security Administration (SSA) collects the following on Forms SSA-1372-BK and SSA‑1372‑BK-FC: (1) information from students regarding their attendance at an educational institution and (2) verification of students’ allegations about school attendance from a school official. 20 CFR 404.350, 404.351, 404.352, 404.367 and 404.368 of the Code of Federal Regulations describe the information necessary to determine student eligibility.


  1. Description of Collection

SSA collects information on Forms SSA-1372-BK and SSA-1372-BK-FC to determine if the children of an insured worker are eligible for student benefits. The collected data allow SSA to determine whether student entitlement exists and when it will end. SSA uses the SSA-1372-BK for domestic student claimants and the SSA‑1372‑BK-FC for student claimants living and attending school outside the United States. Since there are differences in schooling outside of the United States, SSA created the SSA-1372-BK-FC, which asks questions applicable to schooling outside the United States and removes questions that do not apply to schools in foreign countries. The two versions of the form ask the same essential information. SSA collects this information usually once per student, but a student who changes schools or who does not graduate on schedule must complete another form and a school official must certify it. Child beneficiaries receive the SSA-1372 approximately three months before they turn age 18 so they can complete the form, take it to a school official for certification, and return the completed form to SSA for review and processing. The respondents are applicants for student benefits. School officials are also respondents, and they must complete their portion of the form for a student to obtain benefits.


  1. Use of Information Technology to Collect the Information

SSA did not create an electronic version of the SSA-1372 under the agency’s Government Paperwork Elimination Act (GPEA) due to a lack of resources to do so. However, in accordance with the agency’s GPEA plan, the form is available on the SSA website as a print-only PDF. The respondent must still mail or return it in person to SSA.


  1. 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.




  1. Minimizing Burden on Small Respondents

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


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

Collection of this information takes place when a child, who can only be entitled as a student, files a claim, or when a child, currently entitled to benefits, reaches age 18. If SSA did not collect this information, the agency would be unable to determine entitlement to student benefits. Since we only collect this information when the above-mentioned situations apply, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.


  1. 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.


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

SSA published the 60-day advance Federal Register Notice on December 17, 2013 at 78 FR 76378, and we received no public comments. We published the 30-day Notice on March 3, 2014 at 79 FR 11852. If we receive any comments in response to the 30-day Notice, we will forward them to OMB. SSA did not consult members of the public in the development or maintenance of this form.


  1. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents.


  1. 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.


  1. Justification for Sensitive Questions

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


  1. Estimates of Public Reporting Burden

Approximately 200,000 respondents, both within and outside the United States, will use Forms SSA-1372-BK and SSA-1372-BK-FC annually. The estimated total average response time is 11 minutes, for 18,334 burden hours. The charts below show the breakdown of the respondents (domestic and foreign, student and school official):


SSA-1372-BK:

Type of Respondent

Number of Respondents

Frequency of Response

Average Burden Per Response

(minutes)

Estimated Total Annual Burden

(hours)

Individuals/Households

99,850

1

8

13,313

State/Local/

Tribal Government

99,850

1

3

4,993

Totals

199,700



18,306


SSA-1372-BK-FC:

Type of Respondent

Number of Respondents

Frequency of Response

Average Burden Per Response

(minutes)

Estimated Total Annual Burden

(hours)

Individuals/Households

150

1

8

20

State/Local/

Tribal Government

150

1

3

8

Totals

300



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The total burden for this information collection request is 18,334 hours. This figure represents burden hours, and we did not calculate a separate cost burden.


  1. Annual Cost to the Respondents (Other)

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


  1. Annual Cost To Federal Government

The annual cost to the Federal Government for this collection is approximately $1,232,000. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.


  1. Program Changes or Adjustments to the Information Collection Request

There are no changes to the public reporting burden.


  1. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.


  1. 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.



  1. 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).


B. Collections of Information Employing Statistical Methods


SSA does not use statistical methods for this information collection.

File Typeapplication/msword
File TitleSupporting Statement for Form SSA-1372-BK and SSA-1372-BK-FC,
AuthorLinda Mitchell, OISP, 51327
Last Modified By889123
File Modified2014-03-07
File Created2014-01-02

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