Employer Report of Special Wage Payments

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-131 Employer Report of Special Wage Payments	Form	Modified	Available
Form SSA-131 Employer Report of Special Wage Payments	Form	Modified	Available
Addendum - 0565.docx	Supplementary Document	Uploaded 2016-12-26	Available
Supporting Statement - 0565.docx	Supporting Statement A	Uploaded 2016-12-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9507	Employer Report of Special Wage Payments--No Response to Question #6	Form	Modified	Employer Report of Special Wage Payments
9507	Employer Report of Special Wage Payments--No Response to Question #6	Other-Revised PA and PRA Statements	Modified
195194	BSO Special Wage Payments Submission - Electronic Version	Other-Internet Screens	Modified
183800	Employer Report of Special Wage Payments - #6 Only	Form	Modified	Employer Report of Special Wage Payments
183800	Employer Report of Special Wage Payments - #6 Only	Other-Revised PA and PRA Statements	Modified

ICR Details

OMB Control No: 0960-0565	ICR Reference No: 201609-0960-012
Status: Historical Active	Previous ICR Reference No: 201309-0960-004
Agency/Subagency: SSA	Agency Tracking No:
Title: Employer Report of Special Wage Payments
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/09/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/26/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	05/31/2017
Responses	106,076	0	106,076
Time Burden (Hours)	35,037	0	35,037
Cost Burden (Dollars)	0	0	0

---

Abstract: SSA gathers the information on Form SSA-131 to prevent earnings-related overpayments to Social Security beneficiaries, and to avoid erroneous withholding of benefits. The respondents are employers who provide special wage payment verification. We are making non-substantive changes to update the phone number for the Division of Business Services alert, and adding language to alert the employer to complete the field.

---

Authorizing Statute(s): US Code: 42 USC 403 Name of Law: The Social Security Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 63837	09/16/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 81224	11/17/2016
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
BSO Special Wage Payments Submission - Electronic Version
Employer Report of Special Wage Payments - #6 Only	SSA-131	Employer Report of Special Wage Payments
Employer Report of Special Wage Payments--No Response to Question #6	SSA-131	Employer Report of Special Wage Payments

---

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	106,076	106,076	0	0	0	0
Annual Time Burden (Hours)	35,037	35,037	0	0	0	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:

---

Annual Cost to Federal Government: $573,911

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

---

Common Form ICR:  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:

(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: 12/26/2016

---