Social Security Benefits Application

ICR 201506-0960-007

OMB: 0960-0618

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
 Unchanged
Form and Instruction
 Modified
Form and Instruction
 Unchanged
Form
 Unchanged
Justification for No Material/Nonsubstantive Change
2015-06-17
IC Document Collections
IC ID
Document
Title
Status
9628 Unchanged
201977 Unchanged
194187 Unchanged
191246 Unchanged
191245 Unchanged
191244 Unchanged
184984 Unchanged
184982 Unchanged
179349 Modified
179348 Unchanged
179344 Unchanged
179343 Unchanged
179340 Unchanged
179338 Unchanged
ICR Details
0960-0618 201506-0960-007
Historical Active 201306-0960-002
SSA
Social Security Benefits Application
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/14/2015
Retrieve Notice of Action (NOA) 06/18/2015
  Inventory as of this Action Requested Previously Approved
12/31/2016 12/31/2016 12/31/2016
7,414,948 0 7,414,948
1,653,231 0 1,653,231
0 0 0
This is a non-substantive change request: SSA is requesting to add the modality of PDF fillable to the collection instrument Form SSA-16. This action does not affect the public burden. Title II of the Social Security Act provides retirement, survivors, and disability benefits to members of the public who meet the required eligibility criteria and file the appropriate application. This collection comprises the various application methods for the retirement, survivors, and disability benefits. These methods include the following modalities: paper forms (Forms SSA–1, SSA–2, and SSA–16), Modernized Claims System (MCS) screens for in-person interview applications, as well as the Internet-based iClaim and iAppointment applications allowing the public to apply electronically. SSA uses the information collected using these modalities to determine: (1) the applicants' eligibility for the above-mentioned Social Security benefits, and (2) the amount of the benefits. The respondents are applicants for retirement, survivors, and disability benefits under title II of the Social Security Act.
US Code: 42 USC 1395o Name of Law: Social Security Act
   US Code: 42 USC 402 Name of Law: Social Security Act
   US Code: 42 USC 423 Name of Law: Social Security Act
   US Code: 42 USC 426 Name of Law: Social Security Act
   US Code: 42 USC 1395j Name of Law: Social Security Act
  
None
Not associated with rulemaking
  78 FR 36291 06/17/2013
78 FR 56264 09/12/2013
No
  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 7,414,948 7,414,948 0 0 0 0
Annual Time Burden (Hours) 1,653,231 1,653,231 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$7,735,300
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 [email protected]
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/18/2015
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