Agreement to Sell Property

Forms and Documents

Document Name	Status
Form SSA-8060-U3 Agreement to Sell Property (in-person interview) Form	Modified
Addendum - 0127.docx Supplementary Document	2023-11-22
Supporting Statement - 0127.docx Supporting Statement A	2023-11-21

IC Document Collections

IC ID	Document Title	Status
9101	Agreement to Sell Property (in-person interview) Form	Modified
262880	Agreement to Sell Property (telephone interview) Other-SSA-8060-U3 Telephone collection screens	New

ICR Details

OMB Control No: 0960-0127	ICR Reference No: 202308-0960-005
Status: Received in OIRA	Previous ICR Reference No: 202002-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Agreement to Sell Property
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/22/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	02/29/2024
Responses	20,000	20,000
Time Burden (Hours)	23,167	6,667
Cost Burden (Dollars)	0	0

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Abstract: Individuals or couples who are otherwise eligible for Supplemental Security Income (SSI) benefits but whose resources exceed the allowable limit, may receive conditional payments if they agree to dispose of the excess non-liquid resources and make repayment. SSA uses form SSA–8060-U3 to document this agreement and to ensure the individuals understand their obligations. Respondents are applicants for and recipients of SSI payments who will be disposing of excess non-liquid resources.

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Authorizing Statute(s): US Code: 42 USC 1382b Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 62136	09/08/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 78443	11/15/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Agreement to Sell Property (in-person interview)	SSA-8060-U3	Agreement to Sell Property
Agreement to Sell Property (telephone interview)

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ICR Summary of Burden

	Total Request	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	20,000	20,000	0	0	0	0
Annual Time Burden (Hours)	23,167	6,667	0	0	16,500	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: There are no changes to the public reporting burden. *Note: The total burden reflected in ROCIS is 23,167, while the burden cited in #12 of the Supporting Statement is 6,667. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30-minute, one-way, drive burden + learning costs. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

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Annual Cost to Federal Government: $191,825

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? No

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Common Form ICR:  No

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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: 11/22/2023

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