THE INFORMATION COLLECTED BY THIS FORM
PROVIDES CLARIFICATION OF MISSI OR INCOMPLETE DATA PREVIOUSLY
SUBMITTED BY AN EMPLOYER ON THE FORM SS- THE INFORMATION IS
TRANSLATED INTO VARIOUS CODES FOR USE IN MAINTAININ THE CONTINUOUS
WORK HISTORY SAMPLE. THIS DATA, COMBINED WITH RETURN DATA, IS
USEFUL IN PROGRAM PLANNING, REVENUE ESTIMATES, AND EMPLOYER
STUDIES. THE RESPONDENTS ARE NEW EMPLOYERS HAVING 11 OR MORE
EMPLOYEE
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:
(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;
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.