Supporting Statement for Form SSA-783
Statement Regarding Contributions
20 CFR 404.360 - 404.366 and 404.736
OMB No. 0960-0020
A. Justification
1. Introduction/Authoring Laws and Regulations
Per Sections 202(d), (h), and 216(e) of the Social Security Act (Act) as well as
20 CFR 404.360-404.366 and 404.736 of the Code of Federal Regulations, the Social Security Administration (SSA) must collect information about a child’s support and other regular or substantial contributions when determining if child applicants for Social Security benefits are entitled to payments.
2. Description of Collection
SSA uses the SSA-783 to collect information regarding a child's current sources of support when determining the child's entitlement to Social Security benefits. We request this information from adults acting on behalf of the child claimants who can provide SSA with any sources of support or substantial contributions for the child. These adults inform the claims representative of these sources as part of the initial benefits process. If the individual capable of providing the information does not accompany the child claimant, we mail the SSA-783 to the individual for completion, or if the person has access to a computer, we refer them to SSA’s website. The respondents are individuals providing information about a child's sources of support.
3. Use of Information Technology to Collect the Information
A PDF version of Form SSA-783 is available on SSA’s website for respondents to download, complete, and send to SSA for processing. SSA did not create an electronic version of Form SSA-783 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 30,000 respondents complete the form. 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 precludes 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.
6. Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not use Form SSA-783, we would have no way of confirming sources of support for child applicants who must meet certain requirements for entitlement to Social Security benefits. Because we only collect the information once, we cannot collect it less frequently. There are no technical or legal obstacles to prevent 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.
8. Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on April 18, 2017, at
82 FR 18335, and we received no public comments. The 30-day FRN published on June 19, 2017 at 82 FR 27939. If we receive any comments in response to this Notice, we will forward them to OMB.
9. Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
10. 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.
11. Justification for Sensitive Questions
The information collection does not contain any questions of a sensitive nature
12. 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-783 |
30,000 |
1 |
17 |
8,500 |
The total burden for this ICR is 8,500 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
14. Annual Cost To Federal Government
The annual cost to the Federal Government is approximately $38,000. This estimate is a projection of the cost for collecting the information.
15. 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.
18. 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
SSA does not use statistical methods for this information collection.
| File Type | application/msword |
| File Title | March 2002 |
| Author | OPB |
| Last Modified By | Mandley, Tasha |
| File Modified | 2017-06-27 |
| File Created | 2017-04-05 |