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

Forms and Documents

Document Name	Status
Form SSA-8420 SSA-8240 (paper) Form	Modified
Justification for the Non-Substantive Changes - Including Fillable Version - 0807.docx Justification for No Material/Nonsubstantive Change	2017-09-08

IC Document Collections

IC ID	Document Title	Status
226074	Revoking Authorization Other-Internet Screens	Unchanged
226002	Internet (BBA 824) Other-Payroll Data Release Form Screen	Unchanged
225980	Title II & Title XVI Electronic (MCS MSSICS, iClaim, and eWork) Other-Internet screens	Unchanged
225979	SSA-8240 (paper) Form	Modified

ICR Details

OMB Control No: 0960-0807	ICR Reference No: 201709-0960-002
Status: Historical Active	Previous ICR Reference No: 201703-0960-002
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: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/25/2018
	Date Received in OIRA: 09/08/2017
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved.

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

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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. We are making the Form SSA-8240 fillable.

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Authorizing Statute(s): PL: Pub.L. 114 - 74 824 Name of Law: Bipartisan Budget Act
  

Citations for New Statutory Requirements: None

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

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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

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

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

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ICR Summary 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	4,025,127	0	0	0	0
Annual Time Burden (Hours)	168,805	168,805	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:

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

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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

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Common Form ICR:  No

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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: 09/08/2017

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