Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-2032-BK Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate	Form	Modified	Available
Supporting Statement - 0698 (Final).docx	Supporting Statement A	Uploaded 2020-04-15	Available
Addendum - 0698.docx	Supplementary Document	Uploaded 2019-12-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9752	Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate	Form	Modified

ICR Details

OMB Control No: 0960-0698	ICR Reference No: 201908-0960-004
Status: Active	Previous ICR Reference No: 201609-0960-013
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/15/2020
	Date Received in OIRA: 12/16/2019
Terms of Clearance: 14 months following the approval of this ICR, the agency will provide OMB a briefing regarding maintaining consistent, burden-minimizing question-framing among all forms related to overpayment waivers and changes in repayment rate. Additionally, prior to re-submission of this ICR, the agency will discuss with OMB the anticipated timeline for this information collection becoming obsolete.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2023	36 Months From Approved	04/30/2020
Responses	134	0	450
Time Burden (Hours)	268	0	900
Cost Burden (Dollars)	0	0	0

---

Abstract: Title VIII of the Act requires SSA to pay a monthly benefit to qualified World War II veterans who reside outside the United States. When an SVB overpayment occurs, the beneficiary can request a waiver of recovery of the overpayment, or a change in the repayment rate, using Form SSA-2032-BK. Respondents are beneficiaries who have overpayments on their Title VIII record and wish to file a claim for waiver of recovery or change in repayment rate.

---

Authorizing Statute(s): US Code: 42 USC 1008 Name of Law: The Social Security Act
   PL: Pub.L. 108 - 203 210 Name of Law: The Social Security Protection Act of 2004
  

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:
	84 FR 48694	09/16/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 66262	12/03/2019
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate	SSA-2032-BK	Request for Waiver of special veterans Benefit (SVB) Overpayment Recovery or Change in Repayment

---

ICR Summary of Burden

table that charts list 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	134	450	0	0	-316	0
Annual Time Burden (Hours)	268	900	0	0	-632	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: When we last cleared this IC in 2016, the burden was 900 hours. However, we are currently reporting a burden of 268 hours. This change stems from a decrease in the number of responses from 450 to 134. We will continue to see a decrease in the number of responses, due to the decrease in the SVB eligible population. 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.

---

Annual Cost to Federal Government: $8,040

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: 12/16/2019

---