0960-0101 Supporting Statement

Supporting Statement for Form SSA-1724

Claim for Amounts Due In The Case of a Deceased Social Security Recipient

20 CFR 404.503(b)

OMB No. 0960-0101

1. Justification

1. Introduction/Authorizing Laws and Regulations

Section 204(d) of the Social Security Act (Act) provides that if an individual dies before payment under Title II is complete, the Social Security Administration (SSA) will pay the amount due (including the amount of any check not negotiated) to persons meeting specified qualifications. Section 20 CFR 404.503(b) of the Code of Federal Regulations outlines the order of priority for distribution of underpayments due a deceased beneficiary.

Section 1870(g) of the Act provides that the Centers for Medicare and Medicaid Services refund any excess Medicare premiums paid or withheld from Social Security, Railroad Retirement Board, or Office of Personnel Management benefit payments. As per the Act we refund these payments only to people meeting specified qualifications following the death of a Title XVIII beneficiary. This section of the Act also outlines the order of priority for distribution of excess premium refunds due a deceased beneficiary.

2. Description of Collection

SSA requests applicants complete Form SSA-1724 when there is insufficient information in the file to identify the people entitled to the underpayment, or their addresses. SSA

collects the information when a surviving widow(er) is not already entitled to a monthly benefit on the same earnings records, or is not filing for a lump-sum death payment as a former spouse. SSA uses the information Form SSA-1724 provides to ensure proper payment of an underpayment due a deceased beneficiary. The agency also uses

Form SSA-1724, Claim for Amounts Due in the Case of a Deceased Social Security Recipient, to request the Social Security numbers (SSN) of the people claiming the underpayment. The SSN facilitates computerized processing of the claim; use of reporting payment information; and identification of the payee to the Internal Revenue Service, if needed. The respondents are applicants for underpayments owed to deceased beneficiaries.

2. Use of Information Technology to Collect the Information

Form SSA-1724 is available on the internet for the public to print, fill-out, and send to SSA for processing. Applicants can complete Form SSA-1724 while in an SSA field office. SSA did not create an electronic version of form SSA-1724 under the agency’s Government Paperwork Elimination Act (GPEA) plan due to higher volume forms taking precedence.

2. Why We Cannot Use Duplicate Information

The nature of the information we collect and the manner in which we collect it precludes duplication. SSA does not use another collection instrument to obtain similar data.

2. Minimizing Burden on Small Respondents

This collection does not affect small businesses or other small entities.

2. Consequence of Not Collecting Information or Collecting it Less Frequently

If we did not use the SSA-1724, we would not be sure that the proper recipients are paid death underpayments or Medicare premium refunds as required by Federal law. Because we collect the information on an as needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.

2. Special Circumstances

There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.

2. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on January 12, 2018, at

83 FR 1651, and we received no public comments. The 30-day FRN published on

April 3, 2018 at 83 FR 14306. If we receive any comments in response to this Notice, we will forward them to OMB.

2. Payment or Gifts to Respondents

SSA does not provide payment or gifts to the respondents.

2. Assurances of Confidentiality

SSA protects and holds confidential the information we collect in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.

2. Justification for Sensitive Questions

The information collection does not contain any questions of a sensitive nature.

2. Estimates of Public Reporting Burden

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Total Annual Burden (hours)
SSA-1724	250,000	1	10	41,667

The total burden for this information collection is 41,667 hours. We based this estimate on current management information data. This figure represents burden hours, and we did not calculate a separate cost burden.

2. Annual Cost to the Respondents (Other)

This collection does not impose a known cost burden on the respondents.

2. Annual Cost To Federal Government

The annual cost to the Federal government is approximately $860,000. This estimate accounts for the cost of the following areas: (1) designing, printing and distributing the form; and (2) SSA employee information collection and processing time.

15. Program Changes or Adjustments to the Information Collection Request

There are no changes to the public reporting burden.

16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

16. Displaying the OMB Approval Expiration Date

OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its

public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.

16. Exceptions to Certification Statement

SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).

2. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.

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