Supporting Statement 0068 (revised)

Supporting Statement for the SSA-623, SSA-6230, SSA-6234,

and iRPA (Internet Representative Payee Accounting)

Representative Payee Report (for Adult and Child Beneficiaries

and for Organizational Representative Payees)

20 CFR 404.635, 404.2035, 404.2065, and 416.665

OMB No. 0960-0068

1. Justification

1. Introduction/Authoring Laws and Regulations

In certain cases, the Social Security Administration (SSA) determines it is not in beneficiaries’ best interest to receive their benefits payments directly. Section 1631(a) of the Social Security Act (the Act) and Sections 20 CFR 404.635, 404.2035, 404.2065, and 416.665 of the Code of Federal Regulations state that, in such cases we can designate a representative payee to act on behalf of the beneficiaries.

2. Description of Collection

When SSA determines it is not in an Old Age Survivors and Disability Insurance (OASDI), or Supplemental Security Income (SSI) recipient’s best interest to receive Social Security payments directly, the agency will designate a representative payee for the recipient. The representative payee can be: (1) A family member; (2) a non-family member who is a private citizen and is acquainted with the beneficiary; (3) an organization; (4) a state or local government agency; (5) a business. In the capacity of representative payee, the person or organization receives the SSA recipient’s payment directly and manages these payments.

As part of its stewardship mandate, SSA must ensure the representative payees are properly using the payments they receive for the recipients they represent. The agency annually collects the information necessary to make this assessment using the SSA-623, Representative Payee Report-Adult, SSA-6230 Representative Payee Report-Child, SSA-6234, Representative Payee Report-Organizational Representative Payees, and through the electronic Internet application Internet Representative Payee Accounting (iRPA). The respondents are representative payees of OASDI and SSI recipients.

3. Use of Information Technology to Collect the Information

In accordance with the agency’s Government Paperwork Elimination Act plan, SSA created an Internet version of Forms SSA-623, SSA-6230, and SSA-6234. Based on our data, we estimate approximately 10% 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 significantly affect small businesses or other small entities.

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

If we did not collect use Forms SSA-623, SSA-6230 and SSA-623, we would not be able to ensure the representative payees uses the money they receive from us for the beneficiary’s benefit. Since we only collect the information annually to reflect the past year’s use of SSA payments, we cannot collect it less frequently.

There are no technical or legal obstacles to 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 28, 2014, at

79 FR 17632, and we received no public comments. The 30-day FRN published on June 18, 2014 at 79 FR 34824. 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 maintenance of these forms.

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.

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 (minutes)	Estimated Total Annual Burden (hours)
SSA-623	2,811,819	1	15	702,955
SSA-6230	2,968,096	1	15	742,024
SSA-6234	719,469	1	15	179,867
iRPA*	650,000	1	15	162,500
*Totals	7,149,384			1,787,346

*One Internet platform encompasses all three paper forms

The total burden for this ICR is 1,787,346 hours. This figure represents burden hours, and we did not calculate a separate cost burden.

13. Annual Cost to the Respondents (Other)

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

14. Annual Cost To Federal Government

For paper forms, the annual cost to the Federal Government is approximately $32,800,000. This estimate is a projection of the costs for printing, distributing the collection instrument, and for collecting the information.

For iRPA, the estimated cost to the Federal Government to collect the information is negligible. Because the cost of maintaining the system which collects this information is accounted for within the cost of maintaining all of SSA’s automated systems, it is not possible to calculate the cost associated with just one Internet application.

15. Program Changes or Adjustments to the Information Collection Request

There has been an increase in burden hours. The increase stems from an increase in the number of respondents completing the three paper forms.

16. Plans for Publication Information Collection Results

SSA will not publish the results of this information collection.

17. Displaying the OMB Approval Expiration Date

For the paper forms, SSA-623, SSA-6230, and SSA-6234, we will not publish 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.

For the Internet version, iRPA, SSA is not requesting an exception to the requirement to display the OMB approval expiration date .

18. 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.

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