Supporting Statement 0663 (Revised)

Supporting Statement For

Private Printing and Modification of Prescribed Applications and Other Forms

20 CFR 422.527

OMB No. 0960-0663

1. Justification

1. Introduction/Authoring Laws and Regulation

The current regulation at 20 CFR 422.527 of the Code of Federal Regulations requires a person, institution, or organization (third party requesting entities) to obtain approval from the Social Security Administration (SSA) prior to reproducing, duplicating, or privately printing any application or other form prescribed by the agency. We require such approval whether or not the requesting entity intended to charge a fee for SSA’s application(s) or other form(s). Section 1140(a)(2)(A) of the Social Security Act (the Act) prohibits requesting entities from charging a fee to reproduce, reprint, or distribute any SSA application, form, or publication unless they obtain the authorization of the Commissioner of Social Security in accordance with such regulations as the Commissioner may prescribe. (42 USC 1320b-10(a)(2)(A) of the United States Code).

This rule implements Section 1140(a)(2)(A) of the Act by adding SSA’s publications to the pre-authorization requirement identified in 20 CFR 422.527 and by establishing that requesting entities only require SSA’s authorization when they intend to charge a fee. The rule also prescribes the procedures requesting entities who intend to charge a fee must follow to obtain SSA’s written authorization prior to reproducing, reprinting, and/or distributing SSA’s applications, forms, or publications.

2. Description of Collection

SSA uses the information to ensure requests comply with the law and regulations. SSA uses the information to process requests from third-party entities who want to reproduce, duplicate, or privately print any SSA application or other SSA form. To obtain SSA’s approval, entities must make their requests in writing, usin their company letterhead, providing the required information set forth in the regulation. SSA employees review the requests and provide approval via email or mail to the third-party entities. The respondents are third-party entities who submit a request to SSA to reproduce, duplicate, or privately print an SSA-owned form.

To receive approval, a third party organization submits the following information to SSA on company letterhead:

1. The title and form number to be reproduced,

2. A summary of how they will use the reproduced form,

3. The services that they offer the customer, if they charge a fee,

4. The requesting organization's name and corporate address,

5. The requesting individual's name and address,

6. The requesting individual's area code and telephone number,

7. A reproduction of the form for SSA to review,

8. A description of how the organization intends to provide only the most up-to- date edition of SSA forms.

3. Use of Information Technology to Collect the Information

SSA accepts submissions via email, and many third party companies submit their request via email rather than mail.

4. 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.

5. Minimizing Burden on Small Respondents

This collection does not significantly affect small businesses or other small entities.

6. Consequence of Not Collecting Information or Collectiong it Less Frequently

Since obtaining SSA approval for reproducing, duplicating, or privately printing any application or other form prescribed by the agency is mandated by law, we need to collect this information to allow respondents to reproduce SSA forms. If we did not collect the information, the respondent would not legally be able to reproduce SSA forms or charge a fee. Because we only collect the information on an as needed basis, we cannot collect it less frequently.

There are no technical or legal obstacles that prevent burden reduction.

7. 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.

8. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on October 22, 2013, at

78 FR 62932, and we received no public comments. The 30-day FRN published on December 31, 2013 at 78 FR 79723. If we receive any comments in response to this Notice, we will forward them to OMB. We did not consult with the public in the maintenance of this regulation.

9. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents.

10. 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.

11. Justification for Sensitive Questions

The information collection does not contain any questions of a sensitive nature.

12. Estimates of Public Reporting Burden

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden per Response (minutes)	Estimated Total Annual Burden (hours)
20 CFR 422.527	15	15	8	30

The total burden for this ICR is 30 hours. This figure represents burden hours, and we did not calculate a separate cost burden.

13. Annual Cost to the Respondents (Other)

This collection does not impose a known cost burden to the respondents.

14. Annual Cost To Federal Government

The annual cost to the Federal Government is approximately $928. This estimate is a projection of the costs for printing and distributing the forms, and reviewing the information the third parties provide.

15. Program Changes or Adjustments to the Information Collection Request

There has been a decrease in burden hours. The decrease stems from receiving fewer requests within the last three years.

16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

17. Displaying the OMB Approval Expiration Date

SSA is not requesting an exception to the requirements to display an expiration date.

18. 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 Employinq Statistical Methods

SSA does not use statistical methods for this information collection