Report of New Information in Disability Cases

ICR 200810-0960-011

OMB: 0960-0071

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2009-03-04
Supporting Statement A
2009-03-11
IC Document Collections
IC ID
Document
Title
Status
9013 Modified
ICR Details
0960-0071 200810-0960-011
Historical Active 200601-0960-002
SSA
Report of New Information in Disability Cases
Revision of a currently approved collection   No
Regular
Approved without change 04/22/2009
Retrieve Notice of Action (NOA) 03/11/2009
  Inventory as of this Action Requested Previously Approved
04/30/2012 36 Months From Approved 04/30/2009
27,000 0 27,000
2,250 0 2,250
0 0 0

SSA uses the information it collects on Form SSA–612 to ensure federal Old Age, Survivors, and Disability Insurance (OASDI) payments are correct. It is essential beneficiaries notify SSA of any information that may affect their continuing entitlement to disability benefits. To facilitate and encourage timely reporting of such events, SSA furnishes beneficiaries a Form SSA–612. The beneficiary completes and returns the form to SSA when there is a change in his/her circumstances. When a beneficiary reports a change, SSA investigates any reported work activity or improvement in the beneficiary’s condition, updates its records, and makes necessary payment changes. The respondents are recipients of federal OASDI benefits.

US Code: 42 USC 402 Name of Law: Social Security Act
   US Code: 42 USC 405 Name of Law: Social Security Act
   US Code: 42 USC 424a Name of Law: Social Security Act
   US Code: 42 USC 425 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  73 FR 73377 12/02/2008
74 FR 7506 02/17/2009
No

1
IC Title Form No. Form Name
Report of New Information in Disability Cases SSA-612 Report of New Information in isability Cases

  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 27,000 27,000 0 0 0 0
Annual Time Burden (Hours) 2,250 2,250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$41,580
No
No
Uncollected
Uncollected
No
Uncollected
John Biles 410 965-3758 John.Biles@ssa.gov

  No

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.
03/11/2009


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