Supporting Statement 0025 (revised)

Supporting Statement for Form SSA‑7104

Partnership Questionnaire

20 CFR, Subpart K, 404.1080-404.1082(e)

OMB No. 0960-0025

A. Justification

1. Introduction/Authoring Laws and Regulations

Section 202(b) (1) of the Social Security Act (Act) directs the Commissioner of the Social Security Administration (SSA) to make findings and decisions as to the rights of individuals applying for payments under the Act. Section 205(c) (2) (A) of the Act requires the Commissioner to establish and maintain records of such individuals. 20 CFR 404.1080-404.1082(e) of the Code of Federal Regulations (CFR) defines a partnership as two or more persons joined to carry on a trade or business. Each partner contributes in one or more ways with money, property, labor or skill, and shares in the profits and risks of loss in accordance with the partnership agreement or understanding.

2. Description of Collection

SSA considers partnership income in determining Social Security Benefits. SSA uses information from Form SSA‑7104 to determine several aspects of eligibility for benefits, including accuracy of reported partnership earnings; the veracity of a retirement; and lag earnings where SSA needs this information to determine the status of the insured. The respondents are applicants for, and recipients of, Title II Social Security Old Age, Survivors, and Disability Insurance.

3. Use of Information Technology to Collect Information

Form SSA-7104 is available for public use as an on-line PDF that can be printed, filled out, and sent to SSA for processing. SSA did not create an electronic version of Form SSA-7104 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 12,350 respondents complete the form. This is less than the GPEA cut-off of 50,000.

4. Why We Cannot Use Duplicate Information

The nature of the information we collect and the manner in which we collect it precludes duplication. SSA does not use another collection instrument to obtain similar data.

5. Minimizing Burden to Small Respondents

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

6. Consequences of Not Collecting Information or Collecting It Less Frequently If we did not use Form SSA-7104, we may not be able to make proper eligibility determinations, and incorrect payments to beneficiaries may occur. 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.

6. Special Circumstances

There are no special circumstances that would cause SSA to collect this information in a manner inconsistent with 5 CFR.1320.5.

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

The 60-day advance Federal Register Notice published on August 28, 2014, at

79 FR 51387, and we received no public comments. The 30-day FRN published on October 31, 2014 at 79 FR 64872. If we receive any comments in response to this Notice, we will forward them to OMB.

6. Payment or Gifts to Respondents

SSA provides no payment or gifts to the respondents.

6. Assurances of Confidentiality

SSA protects and holds confidential the information we collect 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.

6. Justification for Sensitive Questions

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

6. Estimates of Public Burden

Modality of Completion	Number of Responses	Frequency of Response	Average Burden per Response (minutes)	Total Estimated Annual Burden (hours)
SSA-7104	12,350	1	30	6,175

The total burden for this ICR is 6,175 hours. This figure represents burden hours, and SSA did not calculate a separate cost burden.

6. Annual Cost to the Respondents (Other)

This collection does not impose a known burden on the respondents.

6. Annual Cost to the Federal Government

The annual cost to the Federal Government is approximately $223,000. This estimate is a projection of the costs for collecting and processing the information.

6. Program Changes or Adjustments to the Information Collection Request

There are no changes in the public reporting burden.

6. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

6. 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.

6. Exception 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.

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