Application for SSA Employee Testimony

ICR 201507-0960-005

OMB: 0960-0619

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2015-09-18
IC Document Collections
IC ID
Document
Title
Status
43707
Modified
ICR Details
0960-0619 201507-0960-005
Historical Active 201202-0960-002
SSA
Application for SSA Employee Testimony
Extension without change of a currently approved collection   No
Regular
Approved without change 10/21/2015
Retrieve Notice of Action (NOA) 09/18/2015
  Inventory as of this Action Requested Previously Approved
10/31/2018 36 Months From Approved 10/31/2015
100 0 100
100 0 100
0 0 0

SSA regulations at 20 CFR 403.100-.155 establish policies and procedures for an individual, organization, or governmental entity to request official agency information, records, or testimony of an agency employee in a legal proceeding when the agency is not a party. The request, which must be in writing to the Commissioner, must fully set out the nature and relevance of the sought testimony. Respondents are individuals or entities who request testimony from SSA employees in a legal proceeding.

US Code: 5 USC 301 Name of Law: The Plain Writing Act of 2010
   US Code: 31 USC 9701 Name of Law: The Independent Offices Appropriations Act of 1952
   US Code: 42 USC 902 Name of Law: The Social Security Act
   US Code: 42 USC 1306 Name of Law: The Social Security Act
  
None

Not associated with rulemaking

  80 FR 42600 07/17/2015
80 FR 55705 09/16/2015
No

1
IC Title Form No. Form Name
Application for SSA Employee Testimony

  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 100 100 0 0 0 0
Annual Time Burden (Hours) 100 100 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$33,799
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.
09/18/2015


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