Title II of the Social Security Act
(Act) provides for the payment of monthly benefits to children of
an insured retired, disabled, or deceased worker. Section 202(d) of
the Act discloses the conditions and requirements the applicant
must meet when filing an application. SSA uses the information on
Form SSA-4-BK to determine entitlement for children of living and
deceased workers to monthly Social Security payments. Respondents
are guardians completing the form on behalf of the children of
living or deceased workers, or the children of living or deceased
workers.
US Code:
42
USC 404(d) Name of Law: Social Security Act
The decrease in burden hours
stems from a decrease in the number of respondents. Our new burden
reflects current management information data. In addition, since
the last OMB Approval, we reduced our collections to only four. We
removed the stand alone MCS collections, because they are now
included in the MCS/Signature Proxy estimate since we require
attestation (signature proxy) from all interviewees using MCS.
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.
Form SSA-4-BK Application for Child's Insurance Benefits / Death Claim / SSA-4-BK
Addendum - 0010.docx
Application for Child's Insurance Benefits / Death Claim / SSA-4-BK