Supporting Statement for Form SSA-1414
Credit Card Payment Form
OMB No. 0960-0648
A. Justification
Introduction/Authoring Laws and Regulations
Section 702(a)(4) of the Social Security Act(Act) gives the Commissioner the responsibility and power to discharge all duties of the Social Security Administration (SSA), and full authority and control over all personnel and activities. For many years, the Federal government has been accepting credit card payments for debts owed by individuals and businesses. The Department of the Treasury, which creates the Federal government's general debt collection policy and procedures, has long encouraged the use of electronic funds transfer, including credit cards, for repaying debts. It is a long-standing business practice used by other Federal agencies as well as the Social Security Administration (SSA). Form SSA-1414, Credit Card Payment Form, ensures that we collect all of the necessary information from a debtor to collect and process payment.
Description of Collection
SSA uses the information collected on form SSA-1414 to process: (1) Credit card payments from former employees and vendors who have outstanding debts owed to the agency; (2) advance payments for reimbursable agreements, and (3) credit card payment for all Freedom of Information Act (FOIA) requests requiring payment. The respondents are former employees, and vendors who have outstanding debts to the agency; entities who have reimbursable agreements with SSA; and individuals who request information through FOIA.
Use of Information Technology to Collect the Information
SSA did not create an electronic version of form SSA-1414 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 10,000 respondents complete the form. This is less than the GPEA cut-off of 50,000.
Why We Cannot Use Duplicate Information
There are other credit card forms that collect similar information to that of the SSA-1414. However, each form is case or program specific, often involving different operating components and authorized by varying statutes and regulations. Therefore, there is no duplication of the information.
Minimizing Burden on Small Respondents
This collection does not affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not collect the information on Form SSA-1414, the agency would not be able to process credit card payments from former employees and vendors who still owe debts to the agency, or from individuals requesting certain information through FOIA. Because we collect this information on an as needed basis, 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 that is not consistent with 5 CFR 1320.5. However, in some situations SSA may collect this information more often than quarterly if a debtor is using the form to make monthly payments.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on May 22, 2015, at
80 FR 29787, and we received no public comments. The 30-day FRN published on July 23, 2015 at 80 FR 43828. If we receive any comments in response to this Notice, we will forward them to OMB.
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 Responses |
Frequency of Response |
Average Burden Per Response (minutes) |
Estimated Total Annual Burden (hours) |
SSA-1414 |
6,000 |
1 |
2 |
200 |
The total burden for this ICR is 200 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 $23,435. This estimate is a projection of printing and distribution expenditures for the form and the cost of 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 form 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 requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8 (b)(3).
B. Collections of Information Employing Statistical Methods
SSA is not use statistical methods for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Davis, Paul A. |
| File Modified | 0000-00-00 |
| File Created | 2021-01-25 |