Supporting Statement - 0525

Supporting Statement - 0525.docx

Request for Social Security Earnings Information

OMB: 0960-0525

Document [docx]
Download: docx | pdf

Supporting Statement for Form SSA-7050-F4

Request for Social Security Earnings Information

20 CFR 401.100 and 404.810

OMB No. 0960-0525


  1. Justification


  1. Introduction/Authoring Laws and Regulations

The Social Security Administration (SSA) uses the Request for Social Security Earnings Information, Form SSA-7050-F4, for Social Security number (SSN) holders or their legal representatives to request an Itemized Statement of Earnings (Form SSA-1826) for various non-program related reasons. Section 205(c)(2)(A) of the Social Security Act (Act) mandates the disclosure of earnings. Section 20 CFR 404.810 of the Code of Federal Regulations describes the information individuals must provide to obtain a statement of earnings and a benefit estimate statement. Section 20 CFR 401.100 describes the rules for disclosure of official records and information.


  1. Description of Collection

SSA uses the information the respondent provides on Form SSA-7050-F4 to verify the wage earner has: (1) earnings; (2) the right to access the correct Social Security Record; and (3) the right to request the earnings statement. If we verify all three items, SSA produces an Itemized Statement of Earnings (Form SSA‑1826) and sends it to the requester. Respondents are wage earners and their authorized representatives who are requesting Itemized Statement of Earnings records.


  1. Use of Information Technology to Collect the Information

We currently make Form SSA-7050-F4 available on the Internet in a fillable PDF format which can completed, printed, and sent to SSA for processing. Once we receive the form showing identifying information and the authorizing signature, we review it manually. Following review, we key the data into an electronic program developed to control requests and to obtain the necessary information. The MySSA.gov website allows the public access to printout the SSA-7050-F4 for mailing to the administration.


  1. Why We Cannot Use Duplicate Information

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


  1. Minimizing Burden on Small Respondents

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


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

If we did not collect this information, we would deny the requester’s right to obtain information about their earnings record, thus violating the mandate in Section 205(c)(2)(A) of the Act which requires SSA to disclose earnings. Because we only collect the information on an as needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction


  1. 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.


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

The 60-day advance Federal Register Notice published on March 7, 2017, at

82 FR 12878, and we received no public comments. The 30-day FRN published on May 12, 2017, at 81 FR 22173. If we receive any comments in response to this Notice, we will forward them to OMB. We did not consult with the public in the revision of this form.


  1. Payment or Gifts to Respondents

SSA does not provide payment or gifts to the respondents.


  1. Assurances of Confidentiality

SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401.100 and 404.810, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A‑130.


  1. Justification for Sensitive Questions

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


  1. Estimates of Public Reporting Burden

Approximately 66,800 respondents use the form annually. The estimated average response time is eleven minutes, for 12,247 burden hours. This figure represents burden hours, and we did not calculate a separate cost burden.


  1. Annual Cost to the Respondents (Other)

Participating requesters must compensate SSA for non-program-related work so the Social Security Trust Funds do not bear the costs of such activities. Page 2 of the form provides the requester with a cost explanation and fee charge per request. The cost per non-certified respondent is $2,211,105.00. The cost per certified respondent is $1,601,656 ($3,812,761 per year total).


  1. Annual Cost To Federal Government

The annual cost to the Federal Government is $245,773. This estimate is a projection of the costs for printing and distributing the form, and collecting the information.



  1. Program Changes or Adjustments to the Information Collection Request

There are no changes to the public reporting burden.


  1. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.


  1. 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.


  1. 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).


  1. Collections of Information Employing Statistical Methods


SSA does not use statistical methods for this information collection.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleTitle of Information Collection and Form Number(s)
AuthorNaomi
File Modified0000-00-00
File Created2021-01-13

© 2024 OMB.report | Privacy Policy