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
06/30/2019
16,000,000
0
16,000,000
542,667
0
550,167
0
0
0
SSA collects and verifies financial
account information from individuals requesting a waiver of their
Title II and Title XVI overpayments, as well as those who apply
for, or currently receive (in the case of redetermination)
Supplemental Security Income (SSI) payments. We require financial
information from these individual’s to: (1) determine the
eligibility of the applicant or recipient for SSI benefits; or (2)
determine if a request to waive a Social Security overpayment
defeats the purpose of the Act. If an individual provides
incomplete or seemingly altered records, or if records are
unavailable, SSA contacts his or her financial institutions to
verify the existence; ownership; and value of accounts owned.
Financial institutions need individuals to sign Form SSA-4641-F4,
or contact SSA and use the Internet version, e4641, to authorize
them to disclose the individual’s records to SSA. The respondents
are Title II and Title XVI recipients applying for waivers, or SSI
applicants, recipients, and their deemors to determine SSI
eligibility.
When we last cleared this IC in
2015, the burden was 550,167 hours. However, we are currently
reporting a burden of 542,667 hours. This change stems from a
decrease in the number of responses for the SSA-4641 from 252,500
to 140,000, and an increase in the number of responses for the
e4641 from 15,747,500 to 15,860,000. There is no change to the
burden time per response. Although the number of responses changed,
SSA did not take any actions to cause this change.
$13,800,013
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.