Student Reporting Form

ICR 201701-0960-007

OMB: 0960-0088

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2017-04-18
Supporting Statement A
2017-05-01
IC Document Collections
ICR Details
0960-0088 201701-0960-007
Historical Active 201505-0960-014
SSA
Student Reporting Form
Revision of a currently approved collection   No
Regular
Approved without change 09/29/2017
Retrieve Notice of Action (NOA) 05/01/2017
In accordance with 5 CFR 1320, the information collection is approved for three years.
  Inventory as of this Action Requested Previously Approved
09/30/2020 36 Months From Approved 09/30/2017
76,134 0 75,000
7,614 0 7,500
0 0 0

To qualify for Social Security Title II student benefits, student beneficiaries must be in full-time attendance status at an educational institution. In addition, SSA requires these beneficiaries to report events that may cause a reduction, termination, or suspension of their benefits. SSA collects such information on Forms SSA-1383 and SSA-1383-FC to determine if the changes or events the student beneficiaries report will affect their continuing entitlement to SSA benefits. SSA also uses the SSA-1383 and SSA-1383-FC to calculate the correct benefit amounts for student beneficiaries. The respondents are Social Security Title II student beneficiaries.

US Code: 42 USC 402 Name of Law: Social Security Act
   US Code: 42 USC 403 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  82 FR 10623 02/14/2017
82 FR 18335 04/18/2017
No

2
IC Title Form No. Form Name
Student Reporting Form (FC) SSA-1383-FC Report to Social Security Administration by Student Outside the United States
Student Reporting Form SSA-1383 Student Reporting Form

  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 76,134 75,000 0 1,134 0 0
Annual Time Burden (Hours) 7,614 7,500 0 114 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Due to an increase in students outside the United States, there is an increase in usage of Form SSA-1383-FC.

$115,500
No
    Yes
    Yes
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.
05/01/2017


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