SSA-L3365, Request for Employee Information
SSA-L4002 Request for Employer Information
20 CFR 422.120
Justification
Introduction/Authoring Laws and Regulations
Sections 205(a) and 205(c)(2)(A) of the Social Security Act (Act) authorize the Social Security Administration (SSA) to request an employer, employee, or self-employed individual to furnish additional evidence of earnings, such as the name and Social Security number (SSN) shown on the Social Security card of the individual for whom they reported earnings. 20 CFR 422.120 of the Code of Federal Regulation implements this authority.
Description of Collection
When SSA cannot identify Form W-2 wage data for an individual, we place the data in an earnings suspense file and contact the individual (and in certain instances the employer) to obtain the correct information. If the respondent furnishes the name and Social Security number (SSN) information which agrees with SSA’s records, or provides information that resolves the discrepancy, SSA adds the reported earnings to the respondent’s Social Security record. We use Forms SSA-L2765, SSA-L3365, and
SSA-L4002 for this purpose. The respondents are self-employed individuals and employees whose name and SSN information do not agree with their employer’s and SSA records.
Use of Information Technology to Collect the Information
SSA did not create an electronic version of Forms SSA-L2765, SSA-L3365, and SSA‑L4002 under the agency’s Government Paperwork Elimination Act plan because
they are agency-initiated forms with pre-filled information.
Why We Cannot Use Duplicate Information
The nature of the information we collect and the manner in which we collect it preclude duplication. SSA does not use another collection instrument to obtain similar data.
Minimizing Burden on Small Respondents
This collection does not significantly affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not use Forms SSA-L2765, SSA-L3365, and SSA-L4002, we would have no way to report credit earnings to the proper earnings record, which could result in a potential loss of future benefits. Because we collect the information on an as needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.
7. Special Circumstances
There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on October 24, 2016, at
81 FR73189, and we received no public comments. The 30-day FRN published on January 12, 2017 at 82 FR 3838. 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 respondents |
Frequency of response |
Average burden per response (minutes) |
Estimated total annual burden (hours) |
SSA-L2765 |
12,321 |
1 |
10 |
2,054 |
SSA-L3365 |
179,749 |
1 |
10 |
29,958 |
SSA-L4002 |
121,679 |
1 |
10 |
20,280 |
Totals |
313,749 |
|
|
52,292 |
The total burden for this ICR is 52,292 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 $3,724,824. This estimate is a projection of the costs for printing and inputting data.
Program Changes or Adjustments to the Information Collection Request
There are no changes to the public reporting burden.
16. Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
17. 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.
Exceptions 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).
Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Supporting Statement |
| Subject | OMB 0960-0508 |
| Author | LAMartin |
| File Modified | 0000-00-00 |
| File Created | 2021-01-23 |