Centenarian Project Development Worksheets: Face-to-Face Interview; Telephone Interview

ICR 201212-0960-004

OMB: 0960-0780

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2013-03-21
Supporting Statement A
2013-03-21
ICR Details
0960-0780 201212-0960-004
Historical Active 201001-0960-006
SSA
Centenarian Project Development Worksheets: Face-to-Face Interview; Telephone Interview
Revision of a currently approved collection   No
Regular
Approved without change 06/05/2013
Retrieve Notice of Action (NOA) 03/22/2013
  Inventory as of this Action Requested Previously Approved
06/30/2016 36 Months From Approved 06/30/2013
22,000 0 14,000
5,500 0 3,500
0 0 0

SSA conducts interviews with centenary title II beneficiaries and title XVI recipients age 100 and older to: (1) assess if the beneficiaries are still living; (2) to prevent fraud, through either identity misrepresentation or representative payee misuse of funds; and (3) to evaluate the well being of the beneficiaries. SSA field office personnel obtain the information through one-time interviews with the centenarians. If the centenarians have representatives or caregivers, SSA personnel invite them to the interviews. During the interview, SSA employees make overall observations of the centenarian and their representative payee (if applicable). The interviewer uses the appropriate Centenarian Development Worksheet as a guide for the interview, in addition to documenting findings during the interview. Non-completion of the Worksheets, or refusal of the interview, does not result in the suspension of the centenarian's payments. SSA conducts the interview either over the telephone or through a face-to-face discussion with the centenarian. This is a national project for our title II beneficiaries and title XVI recipients. Respondents are SSI recipients or Social Security beneficiaries 100 years old or older, their representative payees, or their caregivers.

US Code: 42 USC 405 Name of Law: The Social Security Act
   US Code: 42 USC 1383 Name of Law: The Social Security Act
  
None

Not associated with rulemaking

  77 FR 76591 12/28/2012
78 FR 17276 03/20/2013
No

1
IC Title Form No. Form Name
Centenarian Project Development Worksheets: Face-to-Face Interview and Telephone Interview

  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 22,000 14,000 0 8,000 0 0
Annual Time Burden (Hours) 5,500 3,500 0 2,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
We increased the public reporting burden as we lowered the age criterion for this program to 100 years or older. This programmatic change increases the respondent pool.

$185,573
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@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.
03/22/2013


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