OMB control number

Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook

OMB 0960-0189 · SSA.

OMB 0960-0189

Section 205(a) of the Social Security Act (Act) authorizes the Commissioner of SSA to conduct the quality review process, which entails collecting information related to the accuracy of payments made under the Old-Age, Survivors, and Disability Insurance Program (OASDI). Sections 228(a)(3), 1614(a)(1)(B), and 1836(2) of the Act require a determination of the citizenship or alien status of the beneficiary; this is only one item that we might question as part of the Annual Quality review. SSA uses Forms SSA-2930, SSA-2931, and SSA-2932 to establish a national payment accuracy rate for all cases in payment status, and to serve as a source of information regarding problem areas in the Retirement Survivors Insurance (RSI) and Disability Insurance (DI) programs. We also use the information to measure the accuracy rate for newly adjudicated RSI or DI cases. SSA uses Form SSA-4659 to evaluate the effectiveness of the annual earnings test, and to use the results in developing ongoing improvements in the process. About twenty-five percent of respondents will have in-person reviews and receive one of the following appointment letters: (1) SSA-L8550-U3 (Appointment Letter – Sample Individual); (2) SSA-L8551-U3 (Appointment Letter – Sample Family); or (3) the SSA-L8552-U3 (Appointment Letter – Rep Payee). Seventy-five percent of respondents will receive a notice for a telephone review using the SSA-L8553-U3 (Beneficiary Telephone Contact) or the SSA-L8554-U3 (Rep Payee Telephone Contact). To help the beneficiary prepare for the interview, we include three forms with each notice: (1) SSA-85 (Information Needed to Review Your Social Security Claim) lists the information the beneficiary will need to gather for the interview; (2) SSA-2935 (Authorization to the Social Security Administration to Obtain Personal Information) verifies the beneficiary’s correct payment amount, if necessary; and (3) SSA-8552 (Interview Confirmation) confirms or reschedules the interview if necessary. The respondents are a statistically valid sample of all OASDI beneficiaries in current pay status or their representative payees.

The latest form for Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook expires 2028-07-31 and is listed under ICR 202502-0960-005.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-2930 RSI/DI Quality Review Case Analysis - Sampled Number HolderForm
Form SSA-2930 SSA-2930Form
Form SSA-8510 Authorization For The Social Security Administration To Obtain Personal InformationForm
Form SSA-8510 SSA-8510Form
Form SSA-2935 Authorization to the Social Security Administration to Obtain Personal InformaitionForm and Instruction
Form SSA-2935 SSA-2935Form and Instruction
Form SSA-85 Information Needed to Review Your Social Security ClaimForm
Form SSA-85 SSA-85Form
Form SSA-8552 Interview ConfirmationForm
Form SSA-8552 SSA-8552Form
Form SSA-4659 Stewardship Annual Earnings Test WorkbookForm
Form SSA-4659 SSA-4659Form
Form SSA-2931 RSI/DI QUALITY REVIEW CASE ANALYSIS – AUXILIARY/SURVIVORForm
Form SSA-2931 SSA-2931Form
PC_202502-0960-005_071725_083841_1.pdf (document unavailable)Public Comments
Addendum - 0189 (Final).docxSupplementary Document
Supporting Statement Part B - 0189 (Final).docxSupporting Statement B
Supporting Statement Part A - 0189 (Final).docxSupporting Statement A
SSA-2930 Form
SSA-2930 Form
SSA-8510 Form
SSA-8510 Form
SSA-2935 Form and Instruction
SSA-2935 Form and Instruction
SSA-2935 Other-Revised Privacy Act and PRA Statements
SSA-85 Form
SSA-85 Form
SSA-85 Other-Revised Privacy Act and PRA Statements
SSA-8552 Form
SSA-8552 Form
SSA-8552 Other-Revised Privacy Act and PRA Statements
SSA-L8554 Other-Notice
SSA-L8553 Other-Notice
SSA-L8552-U3 Other-Notice
SSA-L8551-U3 Other-Notice
SSA-L8550-U3 Other-Notice
SSA-4659 Form
SSA-4659 Form
SSA-4659 Other-Revised Privacy Act and PRA Statements
SSA-2931 Form
SSA-2931 Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202502-0960-005 Revision of a currently approved collection 2025-06-27
202403-0960-002 No material or nonsubstantive change to a currently approved collection 2024-03-14 Approved without change
202401-0960-001 No material or nonsubstantive change to a currently approved collection 2024-01-02 Approved without change
202210-0960-002 No material or nonsubstantive change to a currently approved collection 2022-10-12 Approved without change
202005-0960-010 Revision of a currently approved collection 2020-10-06
201807-0960-008 No material or nonsubstantive change to a currently approved collection 2018-07-20 Approved without change
201703-0960-010 Revision of a currently approved collection 2017-08-18 Approved without change
201312-0960-008 Revision of a currently approved collection 2014-05-14 Approved without change
201201-0960-002 No material or nonsubstantive change to a currently approved collection 2012-01-25 Approved without change
201110-0960-007 No material or nonsubstantive change to a currently approved collection 2011-11-02 Approved without change
201011-0960-005 Revision of a currently approved collection 2011-03-24 Approved without change
201005-0960-004 No material or nonsubstantive change to a currently approved collection 2010-06-16 Approved without change
200908-0960-009 No material or nonsubstantive change to a currently approved collection 2009-08-20 Approved without change
200904-0960-006 No material or nonsubstantive change to a currently approved collection 2009-04-20 Approved without change
200801-0960-002 Revision of a currently approved collection 2008-02-28 Approved with change
200412-0960-012 Extension without change of a currently approved collection 2004-12-29 Approved without change
200108-0960-005 Revision of a currently approved collection 2001-08-14 Approved without change
199808-0960-005 Revision of a currently approved collection 1998-08-24 Approved without change
199707-0960-013 Extension without change of a currently approved collection 1997-07-29 Approved without change
199405-0960-006 Revision of a currently approved collection 1994-05-18 Approved without change
199401-0960-009 No material or nonsubstantive change to a currently approved collection 1994-01-07 Approved with change
199205-0960-003 Revision of a currently approved collection 1992-05-27 Approved without change
198904-0960-003 Revision of a currently approved collection 1989-04-03 Approved without change
198604-0960-007 Revision of a currently approved collection 1986-04-30 Approved without change
198508-0960-055 No material or nonsubstantive change to a currently approved collection 1985-08-15 Approved with change
198309-0960-009 No material or nonsubstantive change to a currently approved collection 1983-09-28 Approved with change
198305-0960-010 Revision of a currently approved collection 1983-05-24 Approved without change
198110-0960-012 Reinstatement with change of a previously approved collection 1981-10-21 Approved without change
198007-0960-005 New collection (Request for a new OMB Control Number) 1980-07-10 Approved without change

OMB Details

SSA-2930

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Information collection instruments
FormNameElectronic accessType
Form SSA-2930RSI/DI Quality Review Case Analysis - Sampled Number HolderFillable FileableForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.