Certificate of Coverage Request

ICR 201512-0960-007

OMB: 0960-0554

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2015-12-30
ICR Details
0960-0554 201512-0960-007
Historical Active 201401-0960-006
SSA
Certificate of Coverage Request
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/05/2016
Retrieve Notice of Action (NOA) 12/30/2015
  Inventory as of this Action Requested Previously Approved
10/31/2016 10/31/2016 10/31/2016
81,900 0 81,000
54,833 0 54,233
0 0 0

The United States has agreements with 24 foreign countries to eliminate double Social Security coverage and taxation where, except for the provisions of the agreement, a worker would be subject to coverage and taxes in both countries. The country under whose system the period of work is covered issues a certificate of coverage. This certification serves as proof of exemption under the system of the other country's social security system. The information we collect assists SSA in determining a worker's coverage and in issuing a U.S. Certificate of Coverage as appropriate. Respondents are workers and employers wishing to establish exemption from foreign social security taxes. This is a non-substantive Change Request to add a new Certificate of Coverage due to a new Totalization Agreement. See Justification for the Non-Substantive Change for more details.

US Code: 42 USC 433 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  78 FR 33142 06/03/2013
78 FR 49592 08/14/2013
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 81,900 81,000 0 900 0 0
Annual Time Burden (Hours) 54,833 54,233 0 600 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
We are increasing the burden as a result of adding the new agreement with Hungary. See the Justification for Non-Substantive Changes for information.

$58,400
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.
12/30/2015


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