Waiver of Supplemental Security Income Payment Continuation

ICR 201602-0960-017

OMB: 0960-0783

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2016-07-04
Supplementary Document
2016-06-20
IC Document Collections
ICR Details
0960-0783 201602-0960-017
Historical Active 201303-0960-008
SSA
Waiver of Supplemental Security Income Payment Continuation
Revision of a currently approved collection   No
Regular
Approved without change 08/17/2016
Retrieve Notice of Action (NOA) 07/04/2016
  Inventory as of this Action Requested Previously Approved
08/31/2019 36 Months From Approved 08/31/2016
3,000 0 3,000
250 0 250
0 0 0

SSA collects the information on Form SSA-263–U2 to determine whether an individual meets the provisions of the Social Security Act regarding waiver of payment continuation. Recipients must use Form SSA-263-U2 when they are awaiting a determination on their appeal and have decided to stop their payment continuation. SSA needs the information on the form as proof respondents no longer want their payments to continue. Respondents are recipients of SSI payments who wish to discontinue receipt of payment while awaiting a determination on their appeal.

US Code: 42 USC 1383 Name of Law: The Social Security Act
  
None

Not associated with rulemaking

  81 FR 15774 03/24/2016
81 FR 36373 06/06/2016
No

1
IC Title Form No. Form Name
Waiver of Supplemental Security Income Payment Continuation SSA-263-U2 Waiver of Supplemental Security Income Payment Continuation

  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 3,000 3,000 0 0 0 0
Annual Time Burden (Hours) 250 250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$9,240
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.
07/04/2016


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