Electronic Records Express Third-Party Registration Form

Forms and Documents

Document Name	Status
Electronic Records Express Third-Party Registration Form Form and Instruction	New
ERE 3rd-Party Registration Supporting Statement (0960-NEW).doc Supporting Statement A	2008-01-17

IC Document Collections

IC ID	Document Title	Status
181427	Electronic Records Express Third-Party Registration Form Form and Instruction	New

ICR Details

OMB Control No: 0960-0767	ICR Reference No: 200708-0960-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Electronic Records Express Third-Party Registration Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/22/2008
	Date Received in OIRA: 01/20/2008
Terms of Clearance: This ICR is approved; however, pursuant to the GPEA, SSA shall develop an electronic version of this form upon next submission if more than 50,000 responses are expected. The current estimate for this submission is almost 80,000 responses annually. An electronic version of such a high-demand form would minimize burden to the public, particularly since users of this form are registering to use a fully-electronic platform (the ERE).

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2011	36 Months From Approved
Responses	78,344	0	0
Time Burden (Hours)	3,917	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Electronic Records Express (ERE) is a new online system third parties such as beneficiary representatives and medical or vocational experts to electronically submit information to SSA which will be used in the disability appeals process. The respondents for this form are representatives, medical experts, or vocational experts who are applying for access to ERE so they can upload and/or view documents for their clients.

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Authorizing Statute(s): PL: Pub.L. 107 - 347 all sections Name of Law: E-Government Act of 2002
   PL: Pub.L. 105 - 277 3501-3520 Name of Law: Government Paperwork Elimination Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 24651	05/03/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 52594	09/14/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Electronic Records Express Third-Party Registration Form	None	Electronic Records Express Third-Party Registration Form

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	78,344	0	0	78,344	0	0
Annual Time Burden (Hours)	3,917	0	0	3,917	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden is changing due to the implementation of ERE, a new electronic initiative which third party representatives need to register to access.

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Annual Cost to Federal Government: $116,707

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/20/2008

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