Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-8420 SSA-8240 (paper)	Form	New	Available
Addendum - SSA-8240.docx	Supplementary Document	Uploaded 2017-05-25	Available
Supporting Statement - SSA-8240 (revised).docx	Supporting Statement A	Uploaded 2017-08-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226074	Revoking Authorization	Other-Internet Screens	New
226002	Internet (BBA 824)	Other-BBA 824 Internet Screens	New
225980	Title II & Title XVI Electronic (MCS MSSICS, iClaim, and eWork)	Other-Internet screens	New
225979	SSA-8240 (paper)	Form	New

ICR Details

OMB Control No: 0960-0807	ICR Reference No: 201703-0960-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers
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 with change	Conclusion Date: 08/17/2017
	Date Received in OIRA: 05/25/2017
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved
Responses	4,025,127	0	0
Time Burden (Hours)	168,805	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: SSA uses the form SSA-8240 to collect authorization from the public to obtain their wage and employment information from payroll data providers to determine program eligibility and payment amounts. This collection is voluntary, however, failure to provide authorization may prevent SSA from making accurate and timely eligibility determinations and payments. We will request authorization on an as needed basis during contact with the individual including: (a) SSDI and SSI initial claims, (b) SSI redeterminations, and (c) SSDI Work Continuing Disability Reviews. The respondents are individuals who file for or are currently receiving SSDI or SSI payments and any person whose income and resources we count when determining an individual’s SSI eligibility or payment amount.

---

Authorizing Statute(s): PL: Pub.L. 114 - 74 824 Name of Law: Bipartisan Budget 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:
	82 FR 13914	03/15/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 23695	05/23/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
SSA-8240 (paper)	SSA-8420	Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers
Title II & Title XVI Electronic (MCS MSSICS, iClaim, and eWork)
Internet (BBA 824)
Revoking Authorization

---

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	4,025,127	0	0	4,025,127	0	0
Annual Time Burden (Hours)	168,805	0	0	168,805	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new form that increases the public reporting burden. See chart above for updated burden figures.

---

Annual Cost to Federal Government: $8,410,803

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: 05/25/2017

---