Child Relationship Statement

ICR 201810-0960-016

OMB: 0960-0116

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2019-02-04
Supplementary Document
2019-01-29
IC Document Collections
IC ID
Document
Title
Status
9088 Modified
ICR Details
0960-0116 201810-0960-016
Active 201511-0960-003
SSA
Child Relationship Statement
Revision of a currently approved collection   No
Regular
Approved without change 06/03/2019
Retrieve Notice of Action (NOA) 02/04/2019
In accordance with 5 CFR 1320, the information collection is approved for three years.
  Inventory as of this Action Requested Previously Approved
06/30/2022 36 Months From Approved 05/31/2019
50,000 0 50,000
12,500 0 12,500
0 0 0

To help determine a child’s entitlement to Social Security benefits, SSA uses criteria under section 216(h)(3) of the Social Security Act, deemed child provision. SSA may deem a child to an insured individual if: (1) the insured individual presents SSA with satisfactory evidence of parenthood, and was living with or contributing to the child’s support at certain specified times; or (2) the insured individual (a) acknowledged the child in writing; (b) was court decreed as the child’s parent; or (c) was court ordered to support the child. To obtain this information, SSA uses Form SSA-2519, Child Relationship Statement. Respondents are people with knowledge of the relationship between certain individuals filing for Social Security benefits and their alleged biological children.

US Code: 42 USC 416 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  83 FR 56133 11/09/2018
84 FR 371 01/25/2019
No

1
IC Title Form No. Form Name
Child Relationship Statement SSA-2519 Child Relationship Statement

  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 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 12,500 12,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$77,000
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.
02/04/2019


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