20 CFR 404.335-404.338, and 404.603
OMB No. 0960-0004
Justification
Introduction/Authoring Laws and Regulations
Sections 202(e) and 202(f) of the Social Security Act (Act) set forth the requirements for entitlement to widow(er)’s benefits, including the requirement to file an application. In addition, 20 CFR 404.335-404.338 of the Code of Federal Regulations (Code) state the policies for implementing the requirements from sections 202(e) and 202(f) of the Act, including the requirement to apply for benefits. To become entitled to benefits, 20 CFR 404.603 of the Code requires a claimant to file an application. Therefore, the Social Security Administration (SSA) designated Form SSA-10-BK to meet the application requirement.
Description of Collection
SSA needs information to make a formal determination for entitlement to widow(er)’s benefits. We use Form SSA-10-BK to determine whether an applicant meets the statutory and regulatory conditions for entitlement to widow(er)’s Title II benefits. SSA employees interview individuals applying for benefits either face-to-face or via telephone, and enter the information on the paper form, or into the Modernized Claims System (MCS) and the Preliminary Claims System (PCS). The respondents are applicants for Widow(er)’s Insurance Benefits.
Use of Information Technology to Collect the Information
In accordance with the agency’s Government Paperwork Elimination Act plan,
SSA created and uses MCS and the PCS screens to document information we obtain from individuals. In addition, we made the form available on our website as a print‑only PDF. Based on our data, we estimate that over 99% of respondents under this OMB number use the electronic version.
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.
Minimizing Burden on Small Respondents
This collection does not affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not use Form SSA-10-BK, the public would have no way to apply for Widow(er)’s Insurance Benefits, causing a violation of regulations at 20 CFR 404.335-404.338, and 404.603. Because we only collect the information once, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.
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.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on December 6, 2018, at
83 FR 62943, and we received no public comments. The 30-day FRN published on February 15, 2019 at 84 FR 4597. If we receive any comments in response to this Notice, we will forward them to OMB.
Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
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.
Justification for Sensitive Questions
The information collection does not contain any questions of a sensitive nature.
Estimates of Public Reporting Burden
Modality of Completion |
Number of Responses |
Frequency of Response |
Average Burden Per Response (minutes) |
Estimated Total Annual Burden (hours) |
SSA-10-BK MCS and PCS versions |
518,784 |
1 |
14 |
121,050 |
SSA-10-BK Paper version |
2,255 |
1 |
15 |
564 |
Totals |
521,039 |
|
|
121,614 |
The total burden for this ICR is 121,614 hours. We based these figures on current management information data. This figure represents burden hours, and we did not calculate a separate cost burden.
Annual Cost to the Respondents (Other)
This collection does not impose a known cost burden on the respondents.
Annual Cost To Federal Government
The annual cost to the Federal Government is approximately $4,669,332. This estimate accounts for costs from the following areas: (1) designing, printing, and distributing the form; (2) SSA employee (e.g., field office, 800 number, DDS staff) information collection and processing time; and (3) systems development, updating, and maintenance costs.
Program Changes or Adjustments to the Information Collection Request
When we last cleared this IC in 2016, the burden was 106,330 hours. However, we are currently reporting a burden of 121,614 hours. This change stems from an increase in responses for the MCS version from 453,509 to 518,784, and an increase in responses for the paper version from 2,045 to 2,255. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change.
Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
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.
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).
Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | 889123 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |