Change Requests

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State-based Marketplace Annual Reporting Tool (SMART) (CMS-10507)

Key Information

Abstract

The Affordable Care Act (ACA). The ACA creates new competitive private health insurance markets - referred to as State-based Marketplaces (SBMs) - that will give millions of Americans and small businesses access to affordable healthcare coverage. HHS provides oversight and monitoring of SBMs to ensure they maintain adequate operational systems. Effective and efficient oversight of Marketplaces will help ensure that affordable and quality health coverage is available to all Americans through monitoring, reporting, and oversight of financial and other Marketplace activities. The SMAR is the primary vehicle to insure comprehensive compliance with all reporting requirements contained in the ACA and applicable Federal Regulations. It is specifically called for in Section 1313(a)(1) of the Act which requires an SBM to keep an accurate accounting of all activities, receipts, and expenditures, and to submit a report annually to the Secretary concerning such accounting. Instructions governing specific facets of the activities covered by the report are contained both in the Act and in various sections of applicable Federal Regulations. CMS has designed the SMAR to reduce the data collection to the maximum extent possible. While it is intended as a comprehensive compliance review to ensure SBM are fulfilling their statutory requirements, very little additional data gathering is required to complete the form. The respondents can answer most questions by attestations and uploading existing documents. Respondents complete the report entirely online.

Federal Register Notices

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30-Day FRN	View Notice

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Complaints

Key Information

Abstract

Under its organizing statutes, the Board has broad authority to hear and act upon complaints. Shippers and other persons may bring claims for damages against railroads or other carriers regulated by the Board by filing a complaint before the Board under the procedures set forth in 49 C.F.R. § 1111 for claims under 49 U.S.C. §§ 10701-10707, 11101-11103, 11701-11707 (rail), 14701-14707 (motor, water & intermediaries), and 15901-15906 (pipelines).

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

49 USC 10707	View Law

49 USC 11701	View Law

49 USC 11702	View Law

49 USC 11703	View Law

49 USC 11704	View Law

49 USC 15906	View Law

49 USC 11101	View Law

49 USC 11102	View Law

49 USC 11103	View Law

49 USC 1321	View Law

49 USC 14707	View Law

49 USC 15901	View Law

49 USC 15902	View Law

49 USC 15903	View Law

49 USC 15904	View Law

49 USC 15905	View Law

49 USC 10701	View Law

49 USC 10702	View Law

49 USC 10703	View Law

49 USC 10704	View Law

49 USC 10705	View Law

49 USC 11705	View Law

49 USC 11706	View Law

49 USC 11707	View Law

49 USC 14701	View Law

49 USC 14702	View Law

49 USC 10706	View Law

49 USC 14703	View Law

49 USC 14704	View Law

49 USC 14705	View Law

49 USC 14706	View Law

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Advanced Notice of Termination of Child's Benefits, and Student's Statement Regarding School Attendance

Key Information

Abstract

SSA collects information on Forms SSA-1372-BK and SSA–-372-BK-FC to determine whether children of an insured worked meet the eligibility requirements for student benefits. The data we collect allows SSA to determine student entitlement and assess whether to terminate benefits. SSA uses the SSA-1372-BK for domestic student claimants and the SSA-1372-BK-FC for student claimants living and attending school outside the United States. The respondents are student claimants for Social Security benefits, their respective schools and, in some cases, their representative payees.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 402	View Law

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Protection and Advocacy for Beneficiaries of Social Security (PABSS)

Key Information

Abstract

The PABSS projects are part of Social Security’s strategy to increase the number of Social Security Disability Insurance (SSDI) or SSI recipients who return to work and achieve financial independence and self-sufficiency as the result of receiving support, representation, advocacy, or other services. PABSS provides: (1) Information and advice about obtaining vocational rehabilitation and employment services; and (2) advocacy or other services a beneficiary with a disability may need to secure, maintain, or regain gainful employment. The PABSS Annual Program Performance Report collects statistical information from each of the PABSS projects in an effort to manage and capture program performance and quantitative data. Social Security uses the information to evaluate the efficiency of the program, and to ensure beneficiaries are receiving quality services. The project data is valuable to Social Security in its analysis of and future planning for the SSDI and SSI programs. The respondents are the 57 PABSS project sites, and recipients of SSDI and SSI programs.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1320b-21	View Law

Pub.L. 106 - 170 122	View Law

Pub.L. 108 - 203 404 & 407	View Law

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Disability Case Development Information Collections

Key Information

Abstract

State Disability Determination Services (DDS) collect the information necessary to administer the Social Security Disability Insurance and SSI programs. They collect medical evidence from consultative examination (CE) sources; credential information from CE source applicants; and medical evidence of record (MER) from claimants’ medical sources. The DDSs collect information from claimants regarding medical appointments, pain, symptoms, and impairments. The respondents are medical providers, other sources of MER, and disability claimants.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 423	View Law

42 USC 421	View Law

42 USC 1382c	View Law

42 USC 405	View Law

42 USC 1383	View Law

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Technical Updates to Applicability of the Supplemental Security Income (SSI) Reduced Benefit Rate for Individuals Residing in Medical Treatment Facilities. 20 CFR 416.708(k)

Key Information

Abstract

SSA uses this information collection to determine SSI eligibility or the benefit amount for SSI recipients who enter or leave institutions. SSA personnel collect this information directly from SSI recipients, or from someone reporting on their behalf. An SSI recipient who enters an institution may be unable to report; therefore, a family member sometimes makes this report on behalf of the recipient. When contacting SSA, the recipient or family member of the recipient provides the name of the institution; the date of admission; and the expected date of discharge. The respondents are SSI recipients who enter or leave an institution.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1382	View Law

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Request for Social Security Statement

Key Information

Abstract

When an individual wants a Statement of earnings or quarters of coverage, as shown in SSA records, they can request it from SSA using Form SSA-7004. The SSA-7004 is available on our website for respondents to print, complete, and mail back to SSA. SSA uses the information from Form SSA-7004 to identify a respondent’s Social Security earnings records; extract posted earnings information; calculate potential benefit estimates; produce the resulting Social Security Statements; and mail them to the requestors. The respondents are Social Security number holders requesting information about their Social Security earnings records and estimates of their potential benefits.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1320b-13	View Law

42 USC 405	View Law

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Student Assistance General Provisions - Subpart J - Approval of Independently Administered Tests

Key Information

Abstract

This request is for an extension without change of the approval for the reporting and recordkeeping requirements that are contained in the information collection 1845-0049 for Student Assistance General Provision in the regulations in Subpart J-Approval of Independently Administered Tests; Specification of Passing Score; Approval of State Process. There are no forms or formats established by the Department for the reporting or recordkeeping requirements. These regulations govern the application for and approval of assessments by the Secretary by a private test publisher or State that are used to measure a student’s skills and abilities. The administration of approved ATB tests may be used to determine a student's eligibility for assistance for the Title IV student financial assistance programs authorized under the Higher Education Act of 1965, as amended (HEA) when, among other conditions, the student does not have a high school diploma or its recognized equivalent.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

20 USC 1091(d)	View Law

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Notification of Substantial Risk of Injury to Health and the Environment under TSCA Section 8(e) (Renewal)

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Abstract

Toxic Substances Control Act (TSCA) section 8(e) states, any person who manufactures, [imports,] processes, or distributes in commerce a chemical substance or mixture and who obtains information which reasonably supports the conclusion that such substance or mixture presents a substantial risk of injury to health or the environment shall immediately inform the [EPA] Administrator of such information unless such person has actual knowledge that the Administrator has been adequately informed of such information. (15 U.S.C. 2607(e); see Ref.1.) EPA receives and screens TSCA section 8(e) submissions including a wide range of chemical toxicity/exposure information on numerous chemical substances and mixtures. Although EPAs receipt of TSCA section 8(e) information does not necessarily trigger immediate regulatory action under TSCA or other authorities administered by EPA, all TSCA section 8(e) submissions receive screening level evaluations by EPAs Office of Pollution Prevention and Toxics (OPPT) to identify priorities for further Agency action and appropriate referrals to other programs. EPA offers an electronic reporting option for those required to submit a notification of substantial risk under TSCA section 8(e) and those who wish to voluntarily submit For Your Information (FYI) notices by registering and submitting information electronically using the Agency's Central Data Exchange (CDX). TSCA section 8(e) data on newly discovered chemical hazards/risks are available via EPAs ChemView website (https://chemview.epa.gov/chemview).

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

15 USC 2607e	View Law

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ICE Mutual Agreement between Government and Employers (IMAGE)

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Abstract

The ICE Mutual Agreement between Government and Employers (IMAGE) program is the outreach and education component of the Homeland Security Investigations (HSI) Worksite Enforcement (WSE) program. IMAGE is designed to build cooperative relationships with the private sector to enhance compliance with the immigration laws and reduce the number of unauthorized aliens within the American workforce. Under this program, ICE will partner with businesses representing a broad cross-section of industries. Businesses must adhere to a series of best practices, enroll in E-Verify, and complete an IMAGE Membership Application form.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

8 USC 1324(a)	View Law

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Request for Contractor Access to TSCA Confidential Business Information (CBI) (Renewal)

Key Information

Abstract

The Environmental Protection Agency (EPA) procures contract support to facilitate the performance of certain duties. EPA may require contractors to handle Toxic Substances Control Act (TSCA) Confidential Business Information (CBI). Each contractor employee who will use TSCA CBI in the performance of his or her duties must be authorized for access to TSCA CBI through a multi-step process. The TSCA CBI Protection Manual (EPA Publication 7700 A2, revised October 2003; see Ref. 2) provides Federal and contractor employees with guidelines and operating procedures for handling TSCA CBI while performing their official duties, as well as the procedures to obtain authorization for access to TSCA CBI. Specifically, for purposes of this information collection, contractor personnel must submit to EPA the EPA form titled TSCA CBI Access Request, Agreement, and Approval (EPA Form 7740-6; Attachment 1). The Office of Pollution Prevention and Toxics (OPPT), uses EPA Form 7740-6 to collect information about contractor personnel so that the Agency can evaluate their suitability for access to TSCA CBI. EPA stores the information on the OPPT Chemical Information System (CIS).

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

15 USC 2613	View Law

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Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons

Key Information

Abstract

The information on all three parts of the form will be used to determine whether applicants meet the eligibility requirements for benefits. This application incorporates information pertinent to eligibility under the Victims of Trafficking and Violence Protection Act (VTVPA), Public Law 106-386, and a request for employment.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 106 - 386 107(e)	View Law

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Permits for Recreation on Public Lands (43 CFR part 2930)

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Abstract

The Bureau of Land Management (BLM) is required to manage commercial, competitive and organized group recreational uses of the public lands, and individual use of special areas. The BLM must assess, evaluate and authorize (permit) activities proposed to be conducted on public land. This OMB Control Number is currently scheduled to expire on June 30, 2026. The BLM request that OMB renew this OMB Control Number for an additional three (3) years.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

16 USC 1241-1251	View Law

16 USC 1271-1287	View Law

16 USC 6801-6814	View Law

16 USC 1131-1136	View Law

16 USC 8401	View Law

43 USC 1701-1787	View Law

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Employer Report of Special Wage Payments

Key Information

Abstract

SSA collects information on the SSA-131 to prevent earnings-related overpayments, and to avoid erroneous withholding of benefits. SSA field offices and program service centers also use Form SSA-131 for awards and post-entitlement events requiring special wage payment verification from employers. While we need this information to ensure the correct payment of benefits, we do not require employers to respond. The respondents are large and small businesses that make special wage payments to retirees.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 403	View Law

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Private Printing and Modification of Prescribed Application and Other Forms

Key Information

Abstract

To obtain SSA's approval, entities must make their requests in writing using their company letterhead, providing the required information set forth in the regulation. SSA uses the information to: (1) ensure requests comply with the law and regulations, and (2) process requests from third-party entities who want to reproduce, duplicate, or privately print any SSA application or other SSA form. SSA employees review the requests and provide approval via email or mail to the third-party entities. The respondents are third-party entities who submit a request to SSA to reproduce, duplicate, or privately print an SSA-owned form.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1320b-10	View Law

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International Direct Deposit

Key Information

Abstract

International Direct Deposit (IDD) Program allows beneficiaries living abroad to receive their payments via direct deposit to an account at a financial institution outside the United States. SSA uses Form SSA–1199-(Country) to enroll Title II beneficiaries residing abroad in IDD, and to obtain the direct deposit information for foreign accounts. Routing account number information varies slightly for each foreign country, so we use a variation of the Treasury Department’s Form SF–1199A for each country. The respondents are Social Security beneficiaries residing abroad who want SSA to deposit their Title II benefit payments directly to a foreign financial institution.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

31 USC 3720	View Law

31 USC 3302	View Law

31 USC 3332	View Law

31 USC 335	View Law

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Medical Report with Allegation of Human Immunodeficiency Virus (HIV) Infection--Adult and Child

Key Information

Abstract

SSA uses Forms SSA-4814 and SSA-4815 to collect the information necessary to determine if an individual with human immunodeficiency virus (HIV) infection, who is applying for SSI disability payments, meets the requirements for PD. SSA mails the appropriate paper form to the claimant's medical source to complete and return to SSA. Respondents can complete this collection via the paper forms or telephone interview. When respondents complete these forms via telephone interview, which per our Management Information data, is most often, FO or DDS personnel enter the information from the respondents directly into the form, and document the medical source’s name, title, and date in the signature block. We then fax the form into the electronic case file. If SSA FO staff is unable to make a PD finding based on the information the applicant’s medical source provides, the DDS agency makes a determination at their discretion. The respondents are the medical sources of the applicants for SSI disability payments. We are updating all the fields where we request date on Form SSA-4814 and SSA-4815. We are adding an arrow on the side where the respondent can pull up a calendar and select the date (the respondent can still type in the date in any format they choose). We are also revising the date format from December 2, 2015 to 12/2/2015.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1383	View Law

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[NCIPC] Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement

Key Information

Abstract

This is a revision request for the previously approved ICR to continue collecting program monitoring and reporting information from jurisdictions (which include states, Washington, D.C., U.S. Territories, cities, and counties) currently funded under the Overdose Data to Action (CDC-RFA-CE19-1904) notice of funding opportunity (OD2A NOFO). Reporting requirements have been carefully designed to align with and support the specific goals and outcomes outlined in the OD2A NOFO. This revision request is to initiate data collection activities for two new Overdose Data to Action NOFOs, the Overdose Data to Action in States (OD2A-S) will collect program monitoring and reporting information from states and Washington, D.C. The Overdose Data to Action-Limiting Overdose through Collaborative Actions in Localities (OD2A-LOCAL) will collect program monitoring and reporting information from U.S. Territories, cities, and counties. This non substantive change request updates questions used in OMB 0920-1283 Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement to be in accordance with E.O. 14168 & E.O. 14151. Revisions are requested to remove previously approved data collection instruments that are no longer active for ongoing data collection purposes and revise burden.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 241	View Law

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Drawback Process Regulations and Entry Collection Documents

Key Information

Abstract

The collections of information related to the drawback process are required as per 19 CFR part 190 (Modernized Drawback), which provides for refunds of duties, taxes, and fees for certain merchandise that is imported into the United States where there is a subsequent related exportation or destruction. All claims for drawback, sometimes referred to as TFTEA-Drawback, must be filed electronically in the Automated Commercial Environment (ACE), in accordance with the Trade Facilitation Trade Enforcement Act of 2015 (TFTEA) (Pub. L. 114–125, 130 Stat. 122), and in compliance with the regulations in part 190, 181 (NAFTA Drawback) and 182 (USMCA Drawback).  Specific information on completing a claim is available in the drawback CBP and Trade Automated Interface Requirement (CATAIR) document at: https://www.cbp.gov/document/guidance/ace-drawback-catair-guidelines. CBP Form 7553, Notice of Intent to Export, Destroy or Return Merchandise for Purposes of Drawback (NOI), documents both the exportation and destruction of merchandise eligible for drawback. The NOI is the official notification to CBP that an exportation or destruction will occur for drawback eligible merchandise. The CBP Form 7553 has been updated to comply with TFTEA-Drawback requirements and is accessible at http://www.cbp.gov/newsroom/publications/forms. Relevant Regulations and Statutes: Title 19, part 190 - https://ecfr.io/Title-19/Part-190 19 USC 1313 - https://www.govinfo.gov/content/pkg/USCODE-2011-title19/pdf/USCODE-2011-title19-chap4-subtitleII-partI-sec1313.pdf 19 USC 1313 authorizes the information collected on the CBP form 7553 as well as in the ACE system for the electronic drawback claim. The New Data Elements in ACE for Drawback include the following: 1. Substituted Value per Unit 2. Entry Summary Line Item Number 3. Bill of Materials/Formula 4. Certificate of Delivery/Drawback Eligibility Indicator 5. Import Tracing Identification Number (ITIN) 6. Manufacture Tracing Identification Number (MTIN) 7. Certification for Valuation of Destroyed Merchandise 8. Substituted Unused Wine Certification 9. Certification of Eligibility for AP and/or WPN Privilege(s) 10. Identification of Accounting Methodology 11. Indicator for Notice of Intent to Export or Destroy 12. Indicator for Waiver of Drawback Claim Rights New data elements added to the CBP Form 7553: 1. Continuation sheet(#15-19) 2. Line item number added (#15) 3. Rejected merchandise box added (#20) 4. Instructions were edited to comply with TFTEA-Drawback requirements This collection of information applies to the individuals and companies in the trade community who are and are not familiar with drawback, importing and exporting procedures, and with the CBP regulations. Please note that CBP Forms 7551 and 7552 are both abolished. From February 24, 2019, onward, TFTEA-Drawback, as provided for in part 190, is the only legal framework for filing drawback claims. No new drawback claims may be filed under the paper-based processes previously provided for in part 191 (Drawback). Sections 190.51, 190.52, and 190.53 provide the requirements to submit a drawback claim electronically. The provisions of part 190 are similar to the provisions in part 191, except where necessary to outline all the data elements for a complete claim (previously contained in CBP form 7551) and modify those requirements to comply with TFTEA-Drawback. CBP form 7552, Certificates of Delivery and Certificates of Manufacturing & Delivery will no longer be requested or accepted to demonstrate the transfer of merchandise. Sections 190.10 and 190.24 require that any transfers of merchandise must be evidenced by business records, as defined in section 190.2.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

19 USC 1313(l)	View Law

Pub.L. 114 - 125 130 Stat. 122	View Law

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Request Type:

Submission of Protocols and Study Reports for Environmental Research Involving Human Subjects (Renewal)

Key Information

Abstract

The EPA is responsible for the regulation of pesticides under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Federal Food, Drug, and Cosmetic Act (FFDCA). Based on this regulation EPA aims to assess the risks of exposure based on studies that may occasionally use humans. Specifically, the EPA regulations at 40 CFR 26 protect subjects of third-party human research (i.e., research that is not conducted or supported by the EPA) that may be submitted to EPA in support of pesticide product registration and/or labeling or conducted to provide data for generic exposure databases. In addition to other protections, the regulations require affected entities to submit information to EPA and an institutional review board (IRB) prior to initiating, and to the EPA upon the completion of, certain studies that involve human research participants. The information collection activity consists of activity-driven reporting and recordkeeping requirements for those who intend to conduct research for submission to EPA under the pesticide laws. If such research involves intentional exposure of human subjects, these individuals (respondents) are required to submit study protocols to the EPA and an IRB before such research is initiated so that the scientific design and ethical standards that will be employed during the proposed study may be reviewed and approved. Also, respondents are required to submit information about the ethical conduct of completed research that involved human subjects when such research is submitted to the EPA. As such, the purpose of this document is to estimate the third-party response burden from complying with the requirements in 40 CFR 26.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

7 USC 136	View Law

21 USC 346a	View Law

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Administrative Procedures for Chronic and Post-Acute Care Quality Programs (CMS-10945)

Key Information

Abstract

This request for a new information collection request covers multiple settings, including home health (HH), hospice, inpatient rehabilitation facility (IRF), long-term acute care hospital (LTCH), and skilled nursing facility (SNF) settings, Any Hospice, HH Agency (HHA), IRF, LTCH, or SNF - collectively referred to as providers - that does not meet the reporting requirements for their respective program may be subject to a payment reduction in its annual payment update. CMS provides HHAs, hospices, IRFs, LTCHs, and SNFs an opportunity to request an exception or extension from their respective program’s reporting requirements in the event they were unable to submit quality data due to extraordinary circumstances beyond their control. This request for a new information collection request includes burden for certain procedural requirements associated with the HH QRP, Hospice QRP (HQRP), IRF QRP, LTCH QRP, SNF QRP and the SNF VBP Program.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 109 - 171 5201C	View Law

Pub.L. 111 - 148 304(a), (b) and (c)`	View Law

Pub.L. 113 - 93 215	View Law

Pub.L. 113 - 185 2(c)(4)	View Law

42 USC 413.560	View Law

42 USC 413.634	View Law

42 USC 413.338	View Law

42 USC 413.360	View Law

42 USC 413.312	View Law

42 USC 413.245	View Law

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Pilot Study Examining Interpersonal Violence Experienced By Young Adults

Key Information

Abstract

The Pilot Study Examining Interpersonal Violence Experienced By Young Adults will recruit a national probability sample of approximately 5,000 young adults with a goal of having a total of 150-300 individuals who respond to the survey. The survey will be administered in the summer of the recruitment year, 2026, and respondents must have either graduated from high school or be no longer in high school. Respondents must be at least 18 years old to be eligible for recruitment. The goals of this study are to pilot test a survey instrument and recruitment methods to examine interpersonal violence (IV) among college-aged persons (ages 18-24) in order to better understand the risks for, experiences with, and consequences of IV among young adults. Of particular interest are the differences between the victimization and perpetration of those who do and do not attend college. The survey will be designed to examine a range of IV committed by partners, family members, acquaintances, and strangers, including nonconsensual sexual contact, intimate partner violence, and stalking. At a stage of the lifespan when we are most vulnerable to interpersonal violence this study could address gaps in knowledge about the experiences of young adults not engaged in post-secondary education and the differences in experiences between groups.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

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Employer Verification of Records for Children Under Age 7

Key Information

Abstract

To ensure we credit the correct person with the reported earnings, SSA verifies wage reports for children under age seven with the children’s employers before posting to the earnings record. SSA uses form SSA-L3231, Request for Employer Information, for this purpose. The respondents are employers who report earnings for children under age seven.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 405	View Law

Presidential Action:

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Representative Payee Evaluation Report

Key Information

Abstract

SSA uses the Representative Payee Evaluation Report, Form SSA-624-F5, as a documentation tool for interviews with, and evaluations of, representative payees. SSA requires our field offices (FO) to conduct a face-to-face interview with the representative payee using Form SSA-624-F5 when: (1) SSA finds the payee’s responses on SSA-required annual accounting reports [Forms SSA-623, SSA 6230, and SSA-6234 (OMB No. 0960 0068)] unacceptable, and we cannot resolve them; (2) the payee fails to complete SSA’s initial and second request for an annual accounting report; or (3) assessing the representative payee’s continued suitability. In addition to the representative payee, we also interview the beneficiary or SSI recipient, and custodian (if other than the payee) to confirm information the payee provides, and to ensure the payee is meeting the beneficiary’s or SSI recipient’s current needs (face to-face interview not required). The respondents are individuals or organizations serving as representative payees for individuals receiving Title II benefits or Title XVI payments who fail to comply with SSA’s statutory annual reporting requirement, SSA beneficiaries or recipients, and third-party custodians.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 405	View Law

42 USC 1383	View Law

Presidential Action:

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Omb Control Number:

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Action:

Request Type:

Certificate of Responsibility for Welfare and Care of Child Not In Applicant's Custody

Key Information

Abstract

SSA uses Form SSA-781 to determine if non-custodial parents who file for spouse, mother’s, father’s, or surviving divorced mother’s or father’s benefits based on having a child in their care, meet the child-in-care requirements. The child-in-care provision requires claimants to have an entitled child under age 16 or disabled in their care. The respondents are applicants for spouse’s; mother’s; father’s; or surviving divorced mother’s or father’s Social Security benefits.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 402	View Law

Presidential Action: