Modified Benefit Formula Questionnaire-Foreign Pension

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-308 Modified Benefit Formula Questionnaire-Foreign Pension	Form and Instruction	Modified	Available
Form SSA-308 Modified Benefit Formula Questionnaire-Foreign Pension	Form	Modified	Available
Form SSA-308 Modified Benefit Formula Questionnaire - Foreign Pension	Form	Modified	Missing upstream
Justification for Non-Substantive Changes for 0960-0561.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-10-24	Available
Justification for Non-Substantive Changes for 0960-0561.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-10-24	Repair queued
Supporting Statement - 0561.docx	Supporting Statement A	Uploaded 2021-04-12	Available
Supporting Statement - 0561.docx	Supporting Statement A	Uploaded 2021-04-12	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9495	Modified Benefit Formula Questionnaire - Foreign Pension	Form and Instruction	Modified	Modified Benefit Formula Questionnaire-Foreign Pension
9495	Modified Benefit Formula Questionnaire - Foreign Pension	Form	Modified	Modified Benefit Formula Questionnaire-Foreign Pension
9495	Modified Benefit Formula Questionnaire - Foreign Pension	Form	Modified

ICR Details

OMB Control No: 0960-0561	ICR Reference No: 202410-0960-014
Status: Historical Active	Previous ICR Reference No: 202409-0960-010
Agency/Subagency: SSA	Agency Tracking No:
Title: Modified Benefit Formula Questionnaire-Foreign Pension
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/13/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/24/2024
Terms of Clearance: Approved consistent with the agency's commitments under Sec. 4 (k)(iii) and (iv) of E.O. 14058.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2025	07/31/2025	07/31/2025
Responses	2,465	0	2,465
Time Burden (Hours)	1,643	0	1,643
Cost Burden (Dollars)	0	0	0

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Abstract: SSA uses the information Form SSA-308 collects to determine exactly how much (if any) of a foreign pension may be used to reduce the amount of title II Social Security retirement or disability benefits under the modified benefit formula. The respondents are applicants for Title II Social Security or disability benefits who have foreign pensions. We are submitting this non-substantive change request to remove the signature requirement from this form. We are submitting this non-substantive change request to include the Consolidated Claims Experience (CCE) System.

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Authorizing Statute(s): US Code: 42 USC 415 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:
	86 FR 7446	01/28/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 18583	04/09/2021
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Modified Benefit Formula Questionnaire - Foreign Pension	SSA-308, SSA-308	Modified Benefit Formula Questionnaire-Foreign Pension ,   Modified Benefit Formula Questionnaire-Foreign Pension

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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	2,465	2,465	0	0	0	0
Annual Time Burden (Hours)	1,643	1,643	0	0	0	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:

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Annual Cost to Federal Government: $1,391,069

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: 10/24/2024

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