The Department of the Treasury’s Pay.gov Collection Application for Benefit Overpayments

Forms and Documents

Document	Type	Status	Availability
Supporting Statement - 0960-NEW (Pay.gov).docx	Supporting Statement A	Uploaded 2019-01-11	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
234709	Internet Application for Pay.gov	Other-Internet Screens	New

ICR Details

OMB Control No: 0960-0811	ICR Reference No: 201810-0960-015
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: The Department of the Treasury’s Pay.gov Collection Application for Benefit Overpayments
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 without change	Conclusion Date: 03/04/2019
	Date Received in OIRA: 01/22/2019
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	36 Months From Approved
Responses	5,089,512	0	0
Time Burden (Hours)	848,252	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Social Security Administration will use the new Internet Pay.gov Application for Overpayments to offer a new repayment option to beneficiaries and recipients to recover overpayments they incurred. Pay.gov is an online collection portal developed and maintained by the Department of the Treasury (Treasury). The Internet remittance portal will offer beneficiaries and recipients another option to repay overpayments via credit card, debit card, and automated clearing house (ACH). The SSA application located on SocialSecurity.gov will request the overpaid individual’s Social Security Number (SSN) and dollar amount they wish to repay on his or her overpayment prior to sending them to Treasury’s Pay.gov application which will request and process the payment information on SSA’s behalf. The information SSA will collect is used to reconcile the Pay.gov transactions, and update the overpaid individual’s balance on his or her record. The respondents are individuals who have Title II or XVI overpayments, and who wish to voluntarily repay the overpayment online through SocialSecurity.gov.

---

Authorizing Statute(s): US Code: 42 USC 404 Name of Law: Social Security Act
   US Code: 42 USC 1383 Name of Law: Social Security Act
   PL: Pub.L. 104 - 134 Vol. II Name of Law: Social Security Act, the Debt Collection Improvement Act of 1996
   US Code: 31 USC 3711(f), 3716, 3717, and 3718 Name of Law: Money and Finance
   US Code: 5 USC 5514 Name of Law: Installment deduction for indebtedness to the United States
  

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:
	83 FR 53352	10/22/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 66330	12/26/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Internet Application for Pay.gov

---

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	5,089,512	0	0	5,089,512	0	0
Annual Time Burden (Hours)	848,252	0	0	848,252	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 application that increases the public reporting burden. We will update our figures once our management information is available. See the chart above for the burden figures.

---

Annual Cost to Federal Government: $343,577

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

---

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: 01/22/2019

---