National Beneficiary Survey - NBS General Waves and Semi-Structured Interviews

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement 0960-NEW (NBS) - Part A.docx	Supporting Statement A	Uploaded 2014-07-02	Available
Supporting Statement 0960-NEW (NBS) - Part B.docx	Supporting Statement B	Uploaded 2014-05-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
211720	NBS General Waves - Round 3 Successful Workers Longitudinal Samples	Other-survey instrument	New
211719	NBS General Waves - Round 3 Successful Workers	Other-survey instrument	New
211718	NBS General Waves Round 3 Representative Sample	Other-survey instrument	New
211717	NBS General Waves Round 2 Successful Workers	Other-survey instrument	New
211715	NBS General Waves Round 2 Reprsentative Sample	Other-survey instrument	New
211714	NBS Qualitive, Semi-Structured Interviews	Other-Survey Instrument	New
211713	NBS-General Waves Instrument Round 1 - Administration Year	Other-Survey Instrument	New

ICR Details

OMB Control No: 0960-0800	ICR Reference No: 201405-0960-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: National Beneficiary Survey - NBS General Waves and Semi-Structured Interviews
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/23/2014
	Date Received in OIRA: 07/07/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved
Responses	21,840	0	0
Time Burden (Hours)	17,678	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: SSA proposes to conduct a survey intended to gather data from Supplemental Security Income (SSI) recipients and Social Security Disability Insurance (SSDI) beneficiaries about their characteristics, their well-being, and other factors that promote or hinder employment. The survey seeks to uncover information on factors that promote self-sufficiency and, conversely, factors that impede efforts to maintain employment. We will use this data to improve the administration and effectiveness of the SSDI and SSI programs. These results will be valuable as SSA and other policymakers continue efforts to improve programs and services that help SSDI beneficiaries and SSI recipients become more self-sufficient.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 21499	04/16/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 37828	07/02/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
NBS General Waves Round 2 Reprsentative Sample
NBS General Waves Round 2 Successful Workers
NBS General Waves Round 3 Representative Sample
NBS General Waves - Round 3 Successful Workers
NBS General Waves - Round 3 Successful Workers Longitudinal Samples
NBS-General Waves Instrument Round 1 - Administration Year
NBS Qualitive, Semi-Structured Interviews

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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	21,840	0	0	0	21,840	0
Annual Time Burden (Hours)	17,678	0	0	0	17,678	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: This is a new information collection that increases the burden on the public.

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Annual Cost to Federal Government: $1,822,705

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

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Common Form ICR:  No

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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: 07/07/2014

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