Supporting Statement for Form SSA-6233
Representative Payee Report of Benefits and Dedicated Account
20 CFR 416.546, 416.635, 416.640, 416.665
OMB No. 0960-0576
A. Justification
Introduction/Authoring Laws and Regulations
Section 1631(a) of the Social Security Act (the Act) and Sections 20 CFR 416.546, 416.640, 416.635 and 416.665 of the Code of Federal Regulations require representative payees to establish and maintain a separate (i.e., “dedicated”) account in a financial institute when a blind or disabled child under age 18 is eligible for certain past-due Supplemental Security Income (SSI) monthly payments on or after August 23, 1996. The payee has the option to deposit certain subsequent past-due benefits and underpayments into the dedicated account. SSA restricts the funds from the account to specific purchases. SSA requires representative payees (RP) with dedicated accounts to annually report the activity of funds in the account to ensure deposits and expenditures comply with the law. This reporting requirement remains in effect until the account is depleted, or until eligibility for benefits terminates.
Description of Collection
SSA requires RPs to submit a written report accounting for the use of money paid to Social Security or SSI recipients, and to establish and maintain a dedicated account for these payments. SSA uses Form SSA-6233 to ensure the RPs are using the benefits for the recipient’s current maintenance and personal needs, and the expenditures of funds from the dedicated account in compliance with the law. Respondents are RPs for SSI and Social Security recipients.
Use of Information Technology to Collect the Information
SSA did not create an electronic version of Form SSA-6233 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 30,000 respondents complete the form. This is less than the GPEA cut-off of 50,000.
Why We Cannot Use Duplicate Information
The nature of the information we are collecting and the manner in which we are collecting it preclude duplication. SSA does not use another collection instrument to obtain similar data.
Minimizing Burden on Small Respondents
This collection does affect small businesses or other small entities. However, if we did not impose the burden we would be unable to obtain annual representative payee reporting from those small businesses or entities, which serve as payees for Social Security recipients. The collection of information could have an impact on small businesses serving as representative payees. We have minimized the burden by incorporating YES and NO responses where feasible.
Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not use Form SSA-6233 we would have no way of knowing if there were any unauthorized expenditures made knowingly by the payee constitutes “misapplication” of funds and if they are recoverable from the payee on a dollar-for-dollar basis. Because we collect this information annually, we cannot collect it less frequently.
There are no technical or legal obstacles that prevent burden reduction.
Special Circumstances
There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on September 17, 2012, at
77 FR 57178, and we received no public comments. The 30-day FRN published on November 29, 2012 at 77 FR 71204. If we receive any comments in response to this Notice, we will forward them to OMB.
We did not consult members of the public in the development of this form.
Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
Assurances of Confidentiality
SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.
Justification for Sensitive Questions
The information collection does not contain any questions of a sensitive nature.
Estimates of Public Reporting Burden
Modality of Completion |
Number of Respondents |
Frequency of Response |
Average Burden Per Response (minutes) |
Estimated Total Annual Burden (hours) |
SSA-6233 |
30,000 |
1 |
20 |
10,000 |
The total burden for this ICR is 10,000 hours. This figure represents burden hours, and we did not calculate a separate cost burden.
Annual Cost to the Respondents (Other)
This collection does not impose a known cost burden on the respondents.
Annual Cost to Federal Government
The annual cost to the Federal Government is approximately $231,000. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
Program Changes or Adjustments to the Information Collection Request
There are no changes to the public reporting burden.
Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
Displaying the OMB Approval Expiration Date
OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.
Exceptions to Certification Statement
SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
B. Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Supporting Statement for Form SSA-6233 |
| Author | 071528 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |