Partnership Questionnaire

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-7104 Partnership Questionnaire (mailed)	Form	Modified	Repair queued
Form SSA-7104 Partnership Questionnaire (completed in or brought to a field office)	Form	New	Repair queued
0960-0025 Addendum.docx	Supplementary Document	Uploaded 2024-07-03	Repair queued
Supporting Statement - 0025 (Final).docx	Supporting Statement A	Uploaded 2024-07-10	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8923	Partnership Questionnaire (mailed)	Form	Modified
269180	Partnership Questionnaire (completed in or brought to a field office)	Form	New

ICR Details

OMB Control No: 0960-0025	ICR Reference No: 202404-0960-012
Status: Received in OIRA	Previous ICR Reference No: 202012-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Partnership Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/10/2024

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2024
Responses	6,462	12,350
Time Burden (Hours)	5,385	12,350
Cost Burden (Dollars)	0	0

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Abstract: SSA considers partnership income in determining entitlement to Social Security benefits. SSA uses information from Form SSA-7104 to determine several aspects of eligibility for benefits, including the accuracy of reported partnership earnings; the veracity of a retirement; and lag earnings where SSA needs this information to determine the status of the insured. The respondents are applicants for, and recipients of, Title II Social Security benefits who are reporting partnership earnings.

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Authorizing Statute(s): US Code: 40 USC 402 Name of Law: Social Security Act
   US Code: 40 USC 405 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:
	89 FR 30428	04/23/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 55666	07/05/2024
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Partnership Questionnaire (completed in or brought to a field office)	SSA-7104	Partnership Questionnaire
Partnership Questionnaire (mailed)	SSA-7104	Partnership Questionnaire

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ICR Summary of Burden

table that charts list 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	6,462	12,350	0	0	-5,888	0
Annual Time Burden (Hours)	5,385	12,350	0	0	-6,965	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 2021, the burden was 12,350 hours. However, we are currently reporting a burden of 2,154 hours. This change stems from both a decrease in the number of respondents using Form SSA-7104, as well as a change in the source of our management information (MI) data to a more accurate source, which shows that our old data showed overestimated numbers for this form. We are correcting for this issue now. These figures represent current MI data. 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. * Note: The total burden reflected in ROCIS is 5,385, while the burden cited in #12 of the Supporting Statement is 2,154. 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: $16,372

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: 07/10/2024

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