Supporting Statement for Form SSA-24
Application for Survivor’s Benefits
20 CFR 404.611(a) and (c)
OMB No. 0960-0062
A. Justification
Introduction/Authoring Law/Regulations
Section 202(o) of the Social Security Act (Act) authorizes the Social Security Administration (SSA) to collect information for armed services personnel survivors for benefits determination purposes. Sections 20 CFR 404.611(a) and 404.611(c) of the Code of Federal Regulations discuss general Social Security benefits application rules. Section 38 U.S.C. 5105 of the United States Code provides for a joint SSA-VA application for survivors of deceased armed services personnel.
Description of Collection
Surviving family members of armed services personnel can file for Social Security and veterans’ benefits with SSA or at the Veterans Administration (VA). If applicants file for Title II survivor benefits at the VA, SSA receives a copy of the completed Form SSA-24 for processing. SSA uses the information to determine eligibility for benefits. The respondents are survivors of deceased armed services personnel who are applying for benefits at the VA.
Use of Information Technology to Collect the Information
SSA did not create an electronic version of Form SSA-24 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 3,200 respondents complete the form annually. This is less than the GPEA cut-off of 50,000.
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 affect small businesses or other small entities.
Consequence of Not Collecting
Information or Collecting it Less Frequently If
SSA did not use Form SSA-24, we would not have an instrument for a
joint VA-SSA application, and would not be able to determine
eligibility for benefits. Because we only collect the information
once, we cannot collect it less frequently. There are no technical
or legal obstacles to burden reduction.
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 December 29, 2016, at 81 FR 96160, and we received no public comments. The 30-day FRN published on March 10, 2017 at 82 FR 13372. If we receive any comments in response to this Notice, we will forward them to OMB. We did not consult with the public in the revision of this form.
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-24 |
3,200 |
1 |
15 |
800 |
The total burden for this ICR is 800 hours. This figure represents burden hours, and we did not calculate a separate cost burden.
Annual Cost to the Respondents
This collection does not impose a known cost burden on the respondents.
Annual Cost to the Federal Government
The annual cost to the Federal Government for this collection is approximately $4,298. This estimate is a projection of the costs for printing and distributing the collection instrument, and for processing the information once the VA sends it to us.
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 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).
B. Collections of Information Employing Statistical Methods
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Title of Information Collection and Form Number(s) |
| Author | Naomi |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |