Per a phone
conversation with Fred Brickencamp, SSA will change the estimate of
time required to complete Form SSA-4184 specified on the PRA
Statement from 10 minutes to 20 minutes, which is consistent with
the overall burden estimate.
Inventory as of this Action
Requested
Previously Approved
08/31/2002
08/31/2002
08/31/1999
50,000
0
50,000
16,667
0
16,667
0
0
0
Form SSA-4184 is used by SSA to
develop earnings and to corroborate the claimant's allegations of
retirement when the claimant is self-employed or a corporate
officer. The respondents are self-employed individuals and
corporate officers.
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.