Justification for the Non-Substantive Changes for 0960-0525

Justification for Non-Substantive Changes for Form SSA-7050-F4

Requests for Social Security Earnings Information

20 CFR 404.810, 20 CFR 401.100

OMB No. 0960-0525

Background

The Social Security Administration (SSA) uses the information on Form SSA-7050-F4 to: (1) produce the earnings statement requested; (2) verify the requester’s authorization to receive the earnings information; and (3) collect payment when the requester pays by credit card. In addition, SSA requires proof of death or relationship if the respondent requests earnings information from a deceased person’s record. Such proof must show an existing legal relationship between the requester and the Social Security number holder (e.g., surviving spouse, legal representative) so SSA can access and subsequently disclose the requested information. The respondents are wage earners, or their authorized representatives, who request Social Security earnings information.

Revisions to the Collection Instrument

SSA is making revisions to the SSA-7050-F4 to clarify instructions and increase the commissioner approved standard fees.

SSA published three Federal Register Notices (FRNs) regarding the implementation of the standard fee and an additional FRN, which we will publish in the near future, announcing an increase to the standard fees. The first FRN, issued on August 22, 2012, at 77 FR 50757, announced a schedule of standardized administrative fees SSA charges to recover the full cost of providing information, and related services we provide to the public for non-program purposes including the increase of the OCO Certification Fee from $15 to $32. The supplemental FRN, published on September 18, 2013, at 78 FR 57445, announced the standard fee for the Form SSA-7050-F4 is $102 and advised the public to no longer use the fee schedule. The third FRN which published on November 8, 2013, at 78 FR 67210, revised the effective date of the change from September 18, 2013 to January 1, 2014.

Every two years SSA’s Office of Budget, Finance, Quality, and Management reviews the standard fees to ensure the agency is recouping the cost of processing non-programmatic requests. This year, SSA reviewed Form SSA-7050-F4 and determined we must increase the fee for the earnings statement from $102 to $136. In addition, we will increase the cost to certify earnings records from $32 to $56. SSA will publish the next FRN within the next month announcing the increase to the current standard fees.

Justification for Resubmission of the Collection within One Year of OMB Approval

OMB recently approved a renewal Information Collection Request for this form on 6/16/14. SSA was unable to include these revisions within that request as we needed to finalize the fee increases with our Office of Budget, Finance, Quality, and Management. In addition, we do not want to implement these revisions prior to publishing an FRN to announce them. Therefore, we needed to wait until now to make these revisions to the SSA-7050-F4.

Revisions to Form SSA-7050-F4

• Change #1: On Page 2, we are rearranging the requests for Date of Birth and Date of Death so Date of Birth appears first (currently, we request Date of Death first).

Justification #1: We are making this change because the public continues to place the date of birth in the date of death field causing errors on the form.

• Change #2: Throughout the form, we are revising the Itemized statement of earnings cost from $102 to $136, and the cost for a certified yearly total from $32 to $56. We are also revising the cost to certify the itemized statement of earnings from $134 to $196.

Justification #2: We are making this cost increase due to the commissioner-approved increase in the standard fees (as per the FRN we will publish shortly).

• Change #3: On Page 2, #4, we are replacing the language “Signature of the Individual or legal guardian” with “Signature AND Printed Name of the Individual or Legal Guardian.”

Justification #3: We are making this language change for clarification and processing purposes, as we began receiving requests with signatures we cannot read.

• Change #4: On Page 2, #4, we are shifting and re-spacing the Date section.

Justification #4: We are fixing the spacing issue to increase the space for the signature and printed name field in #4.

• Change #5: We are changing 60 days to 120 days on Page 2, #4 in the date section, and again on Page 3, in the first paragraph under “How do I get my earnings statement.”

Justification #5: We are making this change throughout the form due to the IRS Regulation requiring SSA receive the signed form within 120 days (rather than the 60 days we previously requested).

• Change #6: On Page 3, under the first heading, “How do I get my earnings statement,” we are revising the first sentence as follows:

• From: “You must complete the attached form to tell us the specific years of earnings you want and provide ONE your mailing address.”

• To: “You must complete the attached form. Tell us the specific years of earnings you want, type of earnings record, and provide ONE your mailing address. The itemized statement of earnings will be mailed to only ONE address, therefore, if you want the itemized statement of earnings sent to someone other than yourself, provide their address in section 3.”

Justification #6: We are making this change for clarification purposes.

• Change #7: On Page 3, in #1 under the “Is There A Fee For Earnings Information” heading, we are deleting the word “for” from the sentence “In most instances, individuals request itemized statements of earnings for purposes unrelated to our program such as for a private pension plan or personal injury suit.”

Justification #7: We are making this change for clarification purposes.

• Change #8: On Page 3, in #1 under the “Is There A Fee For Earnings Information” heading, we are changing “Private Pension Plans” to “Bulk submitters.”

Justification #8: We are making this change for clarification purposes.

• Change #9: On Page 3, after #2 under the “Is There A Fee For Earnings Information” heading, we are adding the language “This fee is nonrefundable.”

Justification #9: OCO received clarification from SSA’s Office of Budget, Finance, Quality, and Management that standard fees are non-refundable, so we are making this revision to adhere to agency policy.

• Change #10: On Page 4, under the “Where do I send my complete request?” heading, we are revising the address in the left-hand box.

Justification #10: We are making this change to ensure respondents send the completed form to the correct address, as the Division of Earnings of Earnings Records Operations (DERO) moved from 300 N. Greene Street Baltimore, Maryland 21290-0300 to 6100 Wabash Ave Baltimore, Maryland 21215.

SSA will make these revisions to the SSA-7050-F4 upon OMB’s approval; however, we will not implement the new form until we publish the FRN announcing the standard fee increases.