Supporting Statement - 0734

Supporting Statement for Forms SSA-1712,

Notice of Reclamation, and

SSA-1713, Statement of Reclamation Action

31 CFR 210

OMB No. 0960-0734

1. Justification

1. Introduction/Authoring Laws and Regulations

31 CFR 210 of the Code of Federal Regulations authorizes the Social Security Administration (SSA) to send benefit payments to beneficiaries, at their request, to foreign financial institutions (FIs). The regulation also provides authority to SSA to reclaim any benefits from a foreign FI erroneously paid after the death of the beneficiary.

2. Description of Collection

There are instances when our agency erroneously sends payments to beneficiaries after death. SSA uses Forms SSA-1712, SSA-1712-CN, and SSA-1713 to collect information needed to reclaim erroneously paid benefits. Collection via this method is mandatory per agency policy, and takes place throughout the year. SSA is responsible for reclaiming funds from certain countries when:

• the total outstanding amount is at least $30 but less than $100;

• The Department of the Treasury already made two unsuccessful attempts to reclaim incorrect payments through the FI; or

• The Department of the Treasury already reclaimed part of the incorrectly issued payments, but part of the money is still outstanding.

Specifically, SSA uses Form SSA-1713 (Statement of Reclamation Action) to reclaim incorrect payments sent to a foreign FI, after death of the beneficiary. SSA uses the SSA‑1712-CN (Notice of Reclamation – Canada Pmt Made in CAD) to reclaim incorrect Canadian dollar (CAD) payments sent to Canadian FIs. Additionally, SSA uses the SSA-1712 (Notice of Reclamation) to reclaim incorrect U.S. dollar (USD) payments sent to Canadian FIs. The information we collect from the forms tells SSA if the foreign FI can return the erroneous payments. The FI fills out the paper forms with information at hand concerning the deceased beneficiary’s account, and mails the form back to our agency. SSA then collects the information from the forms. The respondents are FIs who receive the erroneous Social Security payments.

3. Use of Information Technology to Collect the Information

These forms are available as print-only, fillable PDF’s on SSA’s InForm website. SSA did not create an electronic version of Forms SSA-1712, SSA-1712-CN, and SSA-1713 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 15 respondents complete the forms annually. This is less than the GPEA cut-off of 50,000.

4. 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.

5. Minimizing Burden on Small Respondents

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

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

If we did not collect this information, SSA would not be able to track erroneous payments sent to FIs internationally. Because we collect this information on an as needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.

7. 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.

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

The 60-day advance Federal Register Notice published on April 3, 2018, at

83 FR 14306, and we received no public comments. The 30-day FRN published on June 8, 2018 at 83 FR 26732. If we receive any comments in response to this Notice, we will forward them to OMB.

9. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents.

10. Assurances of Confidentiality

SSA protects and holds confidential the information it collects 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.

11. Justification for Sensitive Questions

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

12. 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-1712	8	1	5	1
SSA-1713	7	1	5	1
Totals	15			2

The total burden for this ICR is 2 hours. We based these figures on current management data. This figure represents burden hours, and we did not calculate a separate cost burden.

13. Annual Cost to the Respondents (Other)

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

14. Annual Cost To Federal Government

The annual cost to the Federal Government is approximately $27. This estimate accounts for costs from the following areas: (1) designing, printing, and distributing the form; and (2) SSA employee (e.g., field office, 800 number, DDS staff) 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.

17. 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.

18. 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).

B. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.