# Agency Information Collection Activities: Proposed Request and Comment Request
The Social Security Administration (SSA) publishes a list of information collection packages requiring clearance by the Office of Management and Budget (OMB) in compliance with Public Law 104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes revisions of OMB approved information collections.
SSA is soliciting comments on the accuracy of the agency's burden estimate; the need for the information; its practical utility; ways to enhance its quality, utility, and clarity; and ways to minimize burden on respondents, including the use of automated collection techniques or other forms of information technology. Mail, email, or fax your comments and recommendations on the information collection(s) to the OMB Desk Officer and SSA Reports Clearance Officer at the following addresses or fax numbers.
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA
(SSA) Social Security Administration, OLCA, Attn: Reports Clearance Director, Mail Stop 3253 Altmeyer, 6401 Security Blvd., Baltimore, MD 21235, Fax: 833-410-1631, Email address: *[email protected]*
Or you may submit your comments online through *https://www.reginfo.gov/public/do/PRAmain* by clicking on Currently under Review—Open for Public Comments and choosing to click on one of SSA's published items. Please reference Docket ID Number [SSA-2026-0133] in your submitted response.
I. The information collections below are pending at SSA. SSA will submit them to OMB within 60 days from the date of this notice. To be sure we consider your comments, we must receive them no later than May 22, 2026. Individuals can obtain copies of the collection instruments by writing to the above email address.
1. *Request for Corrections of Earnings Record—20 CFR 404.820 and 20 CFR 422.125—0960-0029.* Individuals alleging inaccurate earnings records in SSA's files use paper Form SSA-7008, or a personal interview during which SSA employees key their answers into our electronic Earnings Modernization Item Correction system, to provide the information SSA needs to check earnings posted, and as necessary, initiate development to resolve any inaccuracies. The respondents are individuals who request correction of earnings posted to their Social Security earnings record.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of | Number of | Frequency of response | Average | Estimated total annual burden | Average | Average wait time in field | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| SSA-7008 | 9,766 | 1 | 30 | 4,883 | * $32.66 | | *** $159,479 |
| In-person or telephone interview | 112,312 | 1 | 30 | 56,156 | * 32.66 | ** 38 | *** 4,157,193 |
| mySSA Earnings Correction Screen | 14,194 | 1 | 30 | 7,097 | *32.66 | | *** 231,788 |
| Totals | 136,272 | | | 68,136 | | | *** 4,548,460. |
2. *Application for Supplemental Security Income (Deferred or Abbreviated)—20 CFR 416.305-416.335, Subpart C—0960-0444.* SSA provides Supplemental Security Income (SSI) payments to members of the public who meet the required eligibility criteria and file an application. SSA uses Form SSA8001BK, Application for SSI (Deferred or Abbreviated), to collect information from respondents to either: (1) provide a formal determination of ineligibility based on non-medical reasons only, or (2) document allegations of potential eligibility prior to requesting a medical determination from the state disability determination services (DDS) while deferring the collection of additional information until after the DDS approves a medical determination. Respondents apply for SSI using the deferred application through one of three modalities: (1) a paper application for both adult and child claims (Form SSA-8001), which the public can access as a fillable PDF from our website and submit through SSA's Upload Documents Portal (OMB Control No. 0960-0830); (2) a field office interview (in person or over the phone), during which an SSA employee enters applicant data directly into the Consolidated Claim Experience (CCE) and Intranet SSI Claims System screens; or (3) using the internet Claims (iClaim) System to complete the iSSI internet application to complete the basic eligibility questions. In December 2024, SSA implemented a new simplified SSI online application. SSA developed a hybrid approach to streamline and simplify the online application form and the modalities we offer across other service channels ( *i.e.,* phone and in-person interviews). SSA's hybrid approach consists of two separate steps: (1) capturing the claimant's basic eligibility with a simplified application, and (2) a technician supported experience to develop additional information necessary to make an initial determination. This second step only happens after we provide medical approval and identify what other information we need. This approach strikes a balance between improving the applicant's filing experience and collecting all necessary information to make eligibility determinations. SSA uses the information we gather on the SSA-8001, deferred SSI Application, to: (1) formally deny SSI for nonmedical reasons when information the applicant provides results in ineligibility; or (2) establish a disability claim but defer the evidence development of non-medical issues until SSA approves the disability. The respondents are individuals who are applying for SSI and are either clearly ineligible or, disabled or blind, or are the third parties who aid these individuals in applying for SSI.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality | Number | Frequency | Average | Estimated total annual burden | Average | Average wait time in | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Intranet CCE or SSI Claims System | 596,633 | 1 | 28 | 278,429 | * $23.47 | ** 38 | *** $15,403,291 |
| Internet Claim System (iSSI) | 167,331 | 1 | 6 | 16,733 | * 23.47 | | *** 392,724 |
| SSA-8001 (Paper Version) | 371,585 | 1 | 15 | 92,896 | * 23.47 | ** 38 | *** 7,703,629 |
| Total | 1,135,579 | | | 388,058 | | | *** 23,499,644 |
3. *Authorization to Obtain Earnings Data From the Social Security Administration—0960-0602.* On occasion, public and private organizations and agencies need to obtain detailed earnings information about specific Social Security number (SSN) holding wage earners for business purposes ( *e.g.* pension funds and State agencies, etc.). Respondents use Form SSA-581 to identify the SSN holder whose information they are requesting, and provide authorization from the SSN holder, when applicable. SSA uses the information provided on Form SSA-581 to: (1) identify the wage earner; (2) establish the period of earnings information requested; (3) verify the wage earner authorized SSA to release this information to the requesting party; and (4) produce the Itemized Statement of Earnings (SSA-1826). The respondents are private businesses, state or local agencies, and other federal agencies.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of completion | Number of | Frequency of response | Average | Estimated total annual burden | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| SSA-581 | 24,000 | 1 | 10 | 4,000 | * $39.86 | ** $159,440 |
4. *Medicare Subsidy Quality Review Forms—20 CFR 418(b)(5)—0960-0707* The Medicare Modernization Act of 2003 mandated the creation of the Medicare Part D prescription drug coverage program and provides certain subsidies for eligible Medicare beneficiaries to help pay for the cost of prescription drugs. As part of its stewardship duties of the Medicare Part D subsidy program, SSA conducts periodic quality review checks of the information Medicare beneficiaries report on their subsidy applications (Form SSA-1020). SSA uses the Medicare Quality Review program to conduct these checks. The respondents are applicants for the Medicare Part D subsidy whom SSA chose to undergo a quality review.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of completion | Number of | Frequency of response | Average | Estimated total annual burden | Average | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| SSA-9301 (Medicare Subsidy Quality Review Case Analysis Form | 3,500 | 1 | 30 | 1,750 | * $32.66 | ** 52 | *** $156,212 |
| SSA-9302 (Notice of Quality Review Acknowledgment Form for those with Phones) | 3,500 | 1 | 15 | 875 | * 32.66 | | *** 28,578 |
| SSA-9303 (Notice of Quality Review Acknowledgment Form for those without Phones) | 350 | 1 | 15 | 88 | * 32.66 | | *** 2,874 |
| SSA-9308 (Request for Information) | 7,000 | 1 | 15 | 1,750 | * 32.66 | | *** 57,155 |
| SSA-9310 (Request for Documents) | 3,500 | 1 | 5 | 292 | * 32.66 | | *** 9,537 |
| SSA-9311 (Notice of Appointment- Denial -Reviewer Will Call) | 450 | 1 | 15 | 113 | * 32.66 | | *** 3,691 |
| SSA-9312 (Notice of Appointment-Denial-Please Call Reviewer) | 50 | 1 | 15 | 13 | * 32.66 | | *** 425 |
| SSA-9313 (Notice of Quality Review acknowledgment Form for those with Phones) | 2,500 | 1 | 15 | 625 | * 32.66 | | *** 20,413 |
| SSA-9314 (Notice of Quality Review acknowledgement Form for those without Phones) | 500 | 1 | 15 | 125 | * 32.66 | | *** 4,083 |
| Total | 21,350 | | | 5,631 | | 53 | ** 282,968 |
5. *Electronic SSDI and SSI Wage Reporting: myWageReport, SSA Mobile Wage Reporting, and Supplemental Security Income Telephone Wage Reporting—20 CFR 404.1520(b), 404.1571-1576, 404.1584-1593, & 416.701-416.732—0960-0715.* SSA requires Social Security Disability Insurance (SSDI) beneficiaries or their representative payees to report changes when beneficiaries return to work, when their amount of work increases, or when their earnings increase. Similarly, SSA requires recipients of SSI, their deemors, and representative payees to report changes in work and monthly wages. SSA allows SSDI beneficiaries, SSI recipients, deemors, and representative payees to report earnings via electronic means, though the methods available depend on the type of benefits received. SSDI users may report wages using an internet reporting system called myWageReport. myWageReport is a secure internet reporting tool within the mySSA portal that enables SSDI beneficiaries to submit pay stub information to SSA. In addition to myWageReport, SSI users have two other electronic options, the SSA Mobile Wage Reporting application (SSAMWR) and the SSI Telephone Wage Reporting System (SSITWR). The SSITWR allows callers to report their wages by speaking their responses through voice recognition technology, or by keying in responses using a telephone key pad. The SSAMWR allows recipients to report their wages through the mobile wage reporting application on their smartphone. SSITWR and SSAMWR systems collect the same information and send it to SSA over secure channels. To ensure the security of the information provided, SSITWR and SSAMWR ask respondents to provide information SSA can compare against our records for authentication purposes. Once the system authenticates the identity of the respondents, they can report their wage data. The respondents are SSDI beneficiaries, SSI recipients, SSI deemors, or representative payees.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of | Number of | Frequency of response | Number of | Average | Estimated total annual burden | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Training/Instruction | 129,032 | 1 | 129,032 | 35 | 75,269 | * $23.47 | ** $1,766,563 |
| myWageReport | 37,425 | 12 | 449,100 | 22 | 164,670 | * 23.47 | ** 3,864,805 |
| SSITWR | 8,678 | 12 | 104,136 | 20 | 34,712 | * 23.47 | ** 814,691 |
| SSAMWR | 82,929 | 12 | 995,148 | 20 | 331,716 | * 23.47 | ** 7,758,375 |
| Totals | 258,064 | | 1,667,416 | | 606,367 | | ** 14,204,434 |
6. *Request for Evidence from Doctor and Request for Evidence from Hospital—20 CFR 404 Subpart P and 20 CFR 416 Subpart I—0960-0722.* Sections 223(d)(5) and 1614(a)(3)(H)(i) of the Act require claimants to furnish medical evidence of their disability when filing a disability claim. SSA uses Forms HA-66 and HA-67 to request evidence from medical sources, which claimants identify as having information relative to their impairments, or ability to do work-related activities. In addition to accepting manual paper responses, SSA sends a barcode with the HA-66 and HA-67, allowing respondents to fax the information directly into the electronic claims folder rather than submitting it manually. SSA uses the information to determine eligibility for benefits, and to pay medical sources for furnishing the information. The respondents are medical sources, doctors, and hospitals that evaluate the claimants.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of | Number of | Frequency of response | Number of | Average | Estimated total annual burden | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| HA-66—Paper Version | 6,843 | 22 | 150,546 | 15 | 37,637 | * $103 | ** $3,876.611 |
| HA-66—Electronic Version (ERE or barcode) | 12,708 | 22 | 279,576 | 15 | 69,894 | * 103 | ** 7,199,082 |
| HA-67—Paper Version | 2,752 | 22 | 60,544 | 15 | 15,136 | * 103 | ** 1,559,008 |
| HA-67—Electronic Version (ERE or barcode) | 5,111 | 22 | 112,442 | 15 | 28,111 | * 103 | ** 2,895,433 |
| Totals | 27,414 | | | | 150,778 | | ** 15,530,134 |
7. *Government-to-Government Services Online website Registration Form; Government-to-Government Services Online website Account Modification/Deletion Form—20 CFR 401.45—0960-0757.* The Government-to-Government Services Online (GSO) website allows various external organizations to submit files to a variety of SSA systems and, in some cases, receive files in return. The SSA systems that process data transferred via GSO include, but are not limited to, systems responsible for disability processing and benefit determination or termination. SSA uses the information on Form SSA-159, Government-to-Government Online website Registration Form, to register the requestor to use the GSO website. Once we receive the SSA-159, SSA provides the user with account information and conducts a walkthrough of the GSO website as necessary. Established organizations may submit Form SSA-159 to register additional users as well. The established requesting organizations can also complete Form SSA-160, Government-to-Government Online website Account Modification/Deletion Form, to modify their online accounts ( *e.g.,* address change). Respondents are State and local government agencies, and some private sector business entities.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of completion | Number of | Frequency of response | Average | Estimated total annual burden | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| SSA-159 | 1,973 | 1 | 15 | 493 | * $21.44 | ** $10,570 |
| SSA-160 | 366 | 1 | 15 | 92 | * 21.44 | ** 1,972 |
| Totals | 2,339 | | | 585 | | ** 12,542 |
8. *Request to Show Cause for Failure to Appear—20 CFR 404.938, 416.1438, and 404.957(b)(i) and (ii)—0960-0794.* When claimants who requested a hearing before an administrative law judge (ALJ) fail to appear at their scheduled hearing, the ALJ may reschedule the hearing if the claimants establish good cause for missing the hearings. To establish good cause, respondents must show proof of one of the following: (1) SSA did not properly notify the claimant of the hearing; or (2) an unexpected event occurred without sufficient time for the claimant to request a postponement. The claimants can use paper Form HA-L90 or HA-L90-OP1 to provide their reason for not appearing at their scheduled hearings; or the claimants' representatives can use Electronic Records Express (ERE), OMB Control No. 0960-0753, to submit the HA-L90 online. SSA uses the HA-L90 for new cases, and the HA-L90-OP1 for redeterminations cases. We need two versions of the paper form, as the ALJ follows different procedures when determining the good cause on redetermination cases (cases that have a prior decision and evidence on file), than they do for new cases (where we have no evidence on file). The ERE modality automatically adjusts for redetermination cases, so we only need one version of the internet screens. If the ALJ determines the claimant established good cause for failure to appear at the hearing, the ALJ will schedule a supplemental hearing; if not, the ALJ will make a claims eligibility determination based on the claimants' evidence of record. Respondents are claimants, or their representatives, seeking to establish good cause for failure to appear at a scheduled hearing before an ALJ.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of completion | Number of | Frequency of response | Average | Estimated total annual burden | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| HA-L90 | 37,265 | 1 | 10 | 6,211 | * $23.47 | ** $145,772.17 |
| HA-L90-OP1 | 500 | 1 | 10 | 83 | * 23.47 | ** 1948.01 |
| Totals | 37,765 | | | 6,294 | | ** 147,720.18 |
9. *Vocational Resource Facilitator Demonstration—0960-0829* . SSA administers the Vocational Resource Facilitator Demonstration (VRFD) under the Interventional Cooperative Agreement Program (ICAP). ICAP allows SSA to partner with various non-federal groups and organizations to advance interventional research connected to the SSI and SSDI programs. VRFD tests the Vocational Resource Facilitator (VRF) intervention, which helps newly injured spinal cord injury or disease (SCI) or brain injury (BI) patients in pursuing their employment goals. The VRFD provides empirical evidence on the impact of the intervention on patients in several critical areas: (1) employment and earnings; (2) SSI and SSDI benefit receipt; and (3) satisfaction and well-being. A rigorous evaluation of VRFD is critical to help SSA and other interested parties assess promising options to improve employment-related outcomes and decrease benefit receipt. The VRFD evaluation uses a randomized control experimental design that includes one treatment group and one control group. Control group members receive a referral for services to the Division of Vocational Rehabilitation Services (DVRS), New Jersey's state Vocational Rehabilitation agency. The treatment group receives a referral to DVRS and employment services from a resource facilitator (RF). RFs are fully integrated members of clinical teams who engage with injured workers during inpatient rehabilitation about return to work. The central research questions include:
• Was the intervention implemented as planned?
• What are key considerations for scaling up or adopting the VRF model at other facilities?
• What were the impacts of VRF on outcomes of interest?
• Did treatment group members earn or work more than control group members?
• Were treatment group members relatively less likely to apply to or receive SSI or SSDI benefits?
• Did treatment group members experience greater satisfaction and well-being than control group members?
• What were the benefits and costs of the demonstration across key groups?
The proposed public survey data collections supports three components of the planned implementation, impact, and benefit-cost analyses. The data collection efforts provides information that is not available in SSA program records about the characteristics and outcomes of VRFD participants in the treatment and control groups. Respondents are newly injured SCI and BI patients, who will provide written consent before agreeing to participate in the study and are randomly assigned to one of the study groups.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of | Number of | Frequency of | Average | Estimated total | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| 12-month Follow-up Survey | 90 | 1 | 25 | 38 | * $14.27 | ** $542 |
| Staff Interviews with Site Staff | 12 | 1 | 66 | 13 | * 32.66 | ** 425 |
| Onsite Audit of sample of case files | 1 | 1 | 30 | 1 | * 32.66 | ** 32.66 |
| Totals | 103 | | | 51 | | ** 1,000 |
II. SSA submitted the information collections below to OMB for clearance. Your comments regarding these information collections would be most useful if OMB and SSA receive them 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than April 22, 2026. Individuals can obtain copies of these OMB clearance packages by writing to the *[email protected].*
1. *Application for Child's Insurance Benefits—20 CFR 404.350-404.368, 404.603, & 416.350—0960-0010.* Title II of the Social Security Act (Act) provides for the payment of monthly benefits to children of an insured worker who is retired, disabled, or deceased. Section 202(d) of the Act discloses the conditions and requirements SSA requires the applicant to meet when filing an application. SSA uses the information on Form SSA-4-BK to determine entitlement for children of living and deceased workers to monthly Social Security payments. Respondents are guardians completing the form on behalf of the children of living or deceased workers, or the children of living or deceased workers.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality | Number | Frequency of | Average | Estimated total | Average | Average wait time in field | Total |
| --- | --- | --- | --- | --- | --- | --- | --- |
| SSA-4-BK (Death Claim): Paper | 1,702 | 1 | 12 | 340 | * $32.66 | | *** $11,104 |
| SSA-4-BK (Death Claim): MCS Interview | 235,166 | 1 | 11 | 43,114 | * 32.66 | ** 38 | *** 6,272,418 |
| SSA-4-BK (Life Claim): Paper | 2,912 | 1 | 12 | 582 | * 32.66 | | *** 19,008 |
| SSA-4-BK (Life Claim): MCS Interview | 332,333 | 1 | 11 | 60,928 | * 32.66 | ** 38 | *** 8,864,120 |
| Totals | 572,113 | | | 104,964 | | | *** 15,166,650 |
2. *Statement Regarding Marriage—20 CFR 404.726—0960-0017.* Section 216(h)(1)(A) of the Act directs SSA to apply State law to determine an individual's marital relationship. Some state laws recognize marriages without a ceremony ( *i.e.,* common-law marriages). In such cases, SSA provides the same spouse or widow(er) benefits to the common-law spouses as it does to ceremonially married spouses. To determine common-law spouses, SSA must elicit information from blood relatives or other persons who are knowledgeable about the alleged common-law relationship. SSA uses Form SSA-753, Statement Regarding Marriage, to collect information from third parties to verify the applicant's statements about intent; cohabitation; and holding out to the public as married, which are the basic tenets of a common-law marriage. SSA uses the information to determine if a valid marital relationship exists, and if the common-law spouse is entitled to Social Security spouse, or widow(er) benefits. The respondents are blood relatives of the worker or claimant for spouse's or widow(er)'s benefits, or other third parties who can confirm or deny an alleged common-law marriage.
*This is a correction notice:* SSA published the incorrect burden information for this collection at 90 FR 42294, on 8/29/25. We are correcting this error here.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of completion | Number of | Frequency of | Average | Estimated total | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| SSA-753 (paper) | 179,804 | 1 | 9 | 26,971 | * $32.66 | *** $880,873 |
| SSA-753 Submittable PDF Version via Upload Documents (0960-0830) | 165 | 1 | 9 | 25 | * 32.66 | ** 817 |
| Totals | 179,969 | | | 56,990 | | ** 881,690 |
3. *Claimant's Work Background—20 CFR 404.1512(a); 404.1520(a)(4); 404.1565(b); 416.912(a); 416.920(a)(4); 416.965(b)—0960-0300* . Sections 205(a) and 1631(e) of the Act provide the Commissioner of Social Security with the authority to establish procedures for determining if a claimant is entitled to disability benefits. The administrative law judge (ALJ) may ask individuals to provide background information on Form HA-4633 about work they performed in the past 15 years. When a claimant requests a hearing before an ALJ to establish an entitlement to disability benefits, the ALJ may request that the claimant provide a work history to assist the ALJ in fully inquiring into issues related to the disability. The ALJ uses the information collected from the claimants on Form HA-4633 to: (1) identify the claimant's relevant work history; (2) decide if SSA requires expert vocational testimony and, if so, have a vocational expert available to testify during the hearing; and (3) provide a reference for the ALJ to discuss the claimant's work history. The ALJ makes the completed Form HA-4633 part of the documentary evidence of record. The respondents are claimants for disability benefits under Title II or Title XVI who requested a hearing before an ALJ after SSA denied their application for disability payments.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of completion | Number of | Frequency of | Average | Estimated total | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| HA-4633 (paper) | 48,450 | 1 | 20 | 16,150 | * $14.27 | ** $230,461 |
| Electronic Records Express Submissions | 236,550 | 1 | 20 | 78,850 | * 32.66 | ** 275,241 |
| Totals | 285,000 | | | 142,500 | | *** 505,702 |
4. *Disability Update Report—20 CFR 404.1589-404.1595 and 416.988-416.996—09600511.* As part of our statutory requirements, SSA periodically uses Form SSA-455, the Disability Update Report, to evaluate current Title II disability beneficiaries' and Title XVI disability payment recipients' continued eligibility for Social Security disability payments. Specifically, SSA uses the form to determine if: (1) there is enough evidence to warrant referring the respondent for a full medical Continuing Disability Review (CDR); (2) the respondent's impairments are still present and indicative of no medical improvement, precluding the need for a CDR; or (3) the respondent has unresolved work related issues. SSA mails Form SSA-455 to specific disability recipients, whom we select as possibly qualifying for the CDR process. SSA pre-fills the form with data specific to the disability recipient, except for the sections we ask the recipients to complete. When SSA receives the completed form, we scan it into SSA's system. This allows us to gather information electronically and enables SSA to process the returned forms through automated decision logic to decide the proper course of action to take. The respondents are recipients of Title II and Title XVI Social Security disability payments.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of | Number of | Frequency of | Average | Estimated total | Average | Average wait time in | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| SSA-455 (mail-in) | 1,049,176 | 1 | 15 | 262,294 | * $14.27 | | *** $3,684,818 |
| SSA-455 (electronic online process) | 89,104 | 1 | 15 | 22,276 | * 14.27 | | *** 317,879 |
| Telephone Interview Process | 100 | 1 | 15 | 25 | * 14.27 | ** 52 | *** 1,598 |
| Totals | 1,138,380 | | | 284,595 | | | *** 4,004,295 |
5. *Incorporation by Reference of Oral Findings of Fact and Rationale in Wholly Favorable Written Decisions (Bench Decision Regulation)—20 CFR 404.953 and 416.1453—0960-0694.* If an administrative law judge (ALJ) makes a wholly favorable oral decision, including all the findings and rationale for the decision for a claimant of Title II or Title XVI payments, at an administrative appeals hearing, the ALJ sends a Notice of Decision (Form HA-82), as the records from the oral hearing preclude the need for a written decision. We call this the incorporation-by-reference process. In addition, the regulations for this process state that if the involved parties want a record of the oral decision, they may submit a written request for these records. SSA collects identifying information under Sections 20 CFR 404.953 and 416.1453 of the Code of Federal Regulations to determine how to send interested individuals written records of a favorable incorporation-by-reference oral decision made at an administrative review hearing. Since there is no prescribed form to request a written record of the decision, the involved parties send SSA their contact information and reference the hearing for which they would like a record. The respondents are applicants for Disability Insurance Benefits and SSI payments, or their representatives, to whom SSA gave a wholly favorable oral decision under the regulations cited above.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of completion | Number of | Frequency of | Average | Estimated total | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| HA-82 | 622 | 1 | 5 | 52 | * $14.27 | ** $742 |
6. *Help America Vote Act—0960-0706.* Public Law 107-252, the Help America Vote Act of 2002, mandates that States verify the identities of newly registered voters. When newly registered voters do not have driver's licenses or State-issued ID cards, they must supply the last four digits of their Social Security number to their local State election agencies for verification. The election agencies forward this information to their State Motor Vehicle Administration (MVA), and the State MVA inputs the data into the American Association of MVAs (AAMVA), a central consolidation system that routes the voter data to SSA's Help America Vote Verification (HAVV) system. SSA's HAVV system returns the result (a “match” or “no match” of name, DOB, and last four digits of an SSN) to the AAMVA hub, which then routes the information back to the state MVA. The respondents are State MVAs seeking to confirm voter identities.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of | Number of | Frequency of | Number of | Average | Estimated total | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| HAVV | 45 | 121,01345 | 5,445,585 | 2 | 181,520 | * $24.14 | ** $4,381,893 |
*Cost Burden:* Per our current management information data, the 45 state MVAs participating in HAVA each pay an annual maintenance cost of $1,344.88. Additionally, states pay .30 per verification request. Therefore, the total annual cost to respondents is $60,520.
7. *Advance Designation of Representative Payee—0960-0814.* On April 13, 2018, the President signed into law The Strengthening Protections for Social Security Beneficiaries Act of 2018, also known as Public Law (Pub. L.) 115-165. Section 201 of the law allows SSA beneficiaries and applicants under Title II, Title VIII and Title XVI, of the Act to designate individuals to serve as a representative payee should the need arise in the future. Section 201(j)(2) of Public Law 115-165 provides the requirements for selecting a qualified representative payee. SSA only offers the option to advance designate to capable adults and emancipated minors. Beneficiaries who have an assigned representative payee, or have a representative application in process, cannot advance designate. SSA uses Form SSA-4547, Advance Designation of Representative Payee, or the electronic modalities for this form [the internet i4547 (available through both iClaim and an individual's mySocial Security account), and Intranet SSI Claim System, Modernized Claim System (MCS), and iMain System screens] to allow beneficiaries or applicants the option to designate individuals in order of priority, to serve as a representative. Beneficiaries or applicants can update or change the advance designee order of priority at any time. SSA uses the information on Form SSA-4547 or its equivalent modalities to select a qualified representative payee in order of priority. If the selected representative payee is unable or unwilling to serve, or does not meet SSA requirements, SSA selects another representative payee to serve in the beneficiaries and applicant's best interest. SSA notifies beneficiaries annually of the individuals they chose in advance to be their representative payee. The respondents are SSA beneficiaries and claimants who want to designate individuals to serve as a representative payee should the need arise in the future.
*Type of Request:* Revision of an OMB-approved information collection.
| Modality of | Number of | Frequency of response | Average | Estimated total annual burden | Average | Average wait time for a field office or | Total annual |
| --- | --- | --- | --- | --- | --- | --- | --- |
| | | | | | | | |
| Intranet version (Paper Form SSA-4547, SSI Claims System, MCS, iMain) | 693,339 | 1 | 6 | 69,334 | * $23.47 | ** 38 | *** $11,933,298 |
| Internet version (mySocial Security) | 304,471 | 1 | 6 | 30,447 | * 23.47 | | *** 714,591 |
| Internet version (iClaim) | 898,233 | 1 | 6 | 89,823 | * 23.47 | | *** 2,108,146 |
| Totals | 1,896,043 | | | 189,604 | | | *** 14,756,035 |
| | | | | | | | |
| Intranet version (Paper Form SSA-4547, SSI Claims System, MCS, iMain) | 1,507,403 | 1 | 2 | 50,247 | * 23.47 | ** 38 | *** 23,585,848 |
| Internet version (mySSA) | 1,442 | 1 | 2 | 48 | * 23.47 | | *** 1,127 |
| Internet version (iClaim) | 1,498,363 | 1 | 2 | 49,945 | * 23.47 | | *** 1,172,209 |
| Totals | 3,007,208 | | | 100,240 | | | *** 24,759,184 |
| | | | | | | | |
| Totals | 4,903,251 | | | 289,844 | | | *** 39,515,219 |
8. *Electronic Consent Based Social Security Number Verification—20 CFR 400.100—0960-0817.* The electronic Consent Based Social Security Number Verification (eCBSV) is a fee-based Social Security Number (SSN) verification service that allows permitted entities (a financial institution as defined by Section 509 of the Gramm-Leach-Bliley Act. 42 U.S.C. 405b(b)(4), Public Law 115-174, Title II, 215(b)(4), or service provider, subsidiary, affiliate, agent, subcontractor, or assignee of a financial institution), to verify that an individual's name, date of birth (DOB), and SSN match our records based on the SSN holder's signed—including electronic—consent in connection with a credit transaction or any circumstance described in section 604 of the Fair Credit Reporting Act (15 U.S.C. 1681b).
**Background**
We created this service due to section 215 of the Economic Growth, Regulatory Relief, and Consumer Protection Act of 2018 (Banking Bill), Public Law 115-174. Permitted entities are able to submit an SSN, name, and DOB of the number holder in connection with a credit transaction or any circumstances described in Section 604 of the Fair Credit Reporting Act to SSA for verification via an application programming interface. The purpose of the information collection is for SSA to verify for the permitted entity (PE) that the submitted SSN, name and DOB matches, or does not match, the data contained in our records. After obtaining number holders' consents, a PE submits the names, DOBs, and SSNs of number holders to the eCBSV service. SSA matches the information against our Master File, using SSN, name, and DOB. The eCBSV service responds in real time with an indication as to whether there is a match with a “yes” or “no” response, along with details specifying which data element(s) do not align with SSA records. Additionally, if applicable, the SSN verification result indicates the status of the individual's death based on data in SSA's records. The verification does not authenticate the identity of the number holders or conclusively prove the number holders we verify are who they claim to be. Respondents can find up-to-date information on the service, eligibility, fees, enrollment, technical specifications, and guides to written consent on the eCBSV website.
**Consent Requirements**
Under the eCBSV process, the PE does not submit the number holder's consent forms to SSA. SSA requires each PE to retain a valid consent for each SSN verification request submitted for a period of 5 years. The agency permits the PE to retain the consent in an electronic format.
SSA requires a wet or electronic signature on the consent. A PE may request verification of a number holder's SSN on behalf of a financial institution pursuant to the terms of the Banking Bill, the user agreement between SSA and the PE, and the SSN Holder's consent. In this case, the PE ensures that the financial institution agrees to the terms in the user agreement, which require the PE use the SSN verification only for the purpose stated in the consent, and to mark their own records as “verified” or “unverified,” and prohibits entities from further using or disclosing the SSN verification. This relationship is subject to the terms in the user agreement between SSA and the PE.
**Compliance Review**
SSA requires each PE to undergo compliance reviews. An SSA approved certified public accountant (CPA) conducts the compliance reviews. SSA designed the compliance reviews to ensure that the permitted entities meet all terms and conditions of the user agreement, including that the permitted entities obtain valid consent from number holders. The PE pays all compliance review costs through the eCBSV fees. In general, every permitted entity is subject to an initial audit then once within five (5) years based on compliance. The CPA follows review standards established by the American Institute of Certified Public Accountants and contained in the Generally Accepted Government Auditing Standards (GAGAS). eCBSV is available to all interested permitted entities, as defined in section 215 of the Banking Bill with an estimated annual 58,000,000 requests. The respondents to the eCBSV information collection are the permitted entities; members of the public who consent to SSN verifications; and CPAs who provide compliance review services.
*Note:* Per OMB's Terms of Clearance, SSA is allowing for public comment on several minor changes to the User Agreement which OMB approved via Change Request. These minor changes enhance the match/no match data we provide to include which elements do not align with our records; minor language changes to update language which discusses the match/no match data process; revisions to the agreement period and tier levels to allow for greater flexibility in costs and utilization; and to update language for clarity purposes.
*Type of Request:* Revision of an OMB-approved information collection.
| Requirement | Number of | Frequency | Average | Estimated | Average | Total annual |
| --- | --- | --- | --- | --- | --- | --- |
| a) People whose SSNs SSA will verify—Reading and Signing | 58,000,000 | 1 | 3 | 2,900,000 | * $14.27 | ** $41,383,000 |
| a) Sending in the verification request, calling our system, getting a response | 58,000,000 | 1 | 1 | 966,667 | * 45.04 | ** 43,538,682 |
| c) CPA Compliance Review and Report *** | 21 | 1 | 4,800 | 1,680 | * 44.96 | ** 75,533 |
| Totals | 116,000,021 | | | 3,868,347 | | ** 84,997,215 |
**Cost Burden**
The public cost burden depends on the number of PEs using the service and the annual transaction volume. We based the current tier fee schedule below on 21 participating PEs in fiscal year (FY) 2024 submitting an anticipated annual volume of 58 million transactions. For FY 2026, we are maintaining the current tier structure, based on our analysis, which estimated 21 participating PEs with an anticipated annual volume of 68 million. The total cost for developing and operating the service is $66.3 million through FY 2024. Of this amount, $25.5 million remains unrecovered/unreimbursed. The current subscription tier structure and associated fees are intended to recover these costs over a three-year period, assuming projected enrollments and transaction volumes meet these projections. SSA uses the fee to allocate forecasted systems and operational expenses; agency oversight; and overhead necessary to sustain the service.
| Tier | Annual transaction threshold | Annual fee |
| --- | --- | --- |
| 1 | Up to 10,000 (1-10,000) | $5,100 |
| 2 | Up to 75,000 (10,001-75,000) | 37,125 |
| 3 | Up to 200,000 (75,001-200,000) | 98,000 |
| 4 | Up to 500,000 (200,001-500,000) | 240,000 |
| 5 | Up to 1 million (500,001-1 million) | 470,000 |
| 6 | Up to 2.5 million (1,000,001-2.5 million) | 907,500 |
| 7 | Up to 5 million (2,500,001-5 million) | 1,765,500 |
| 8 | Up to 10 million (5,000,001-10 million) | 3,206,250 |
| 9 | Up to 15 million (10,000,001-15 million) | 3,562,500 |
| 10 | Up to 20 million (15,000,001-20 million) | 4,453,125 |
| 11 | Up to 25 million (20,000,001-25 million) | 5,165,625 |
| 12 | Up to 200 million (25,000,001-200 million) | 5,878,125 |
SSA calculates fees based on forecasted systems and operational expenses, agency oversight, overhead, and Certified Public Accountant audit contract costs. Section 215(h)(1)(B) of the Banking Bill requires that the Commissioner shall “periodically adjust” the price paid by users to ensure that amounts collected are sufficient to fully offset the costs of administering the eCBSV system. On at least an annual basis, SSA monitors costs incurred to provide eCBSV services and revises the tier fee schedule accordingly. SSA notifies permitted entities of the tier fee schedule in effect at the renewal of eCBSV user agreements, when a permitted entity begins a new 365-day agreement period, and via notice in the *Federal Register* . Permitted entity renewals are governed by the tier in effect at the time of renewal.
Mark Steffensen,
General Counsel, Chief of Law and Policy, Social Security Administration.