Statement of Income and Resources

ICR 202011-0960-002

OMB: 0960-0124

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2020-11-06
Supplementary Document
2020-11-06
IC Document Collections
IC ID
Document
Title
Status
9097 Modified
ICR Details
0960-0124 202011-0960-002
Received in OIRA 201702-0960-003
SSA
Statement of Income and Resources
Revision of a currently approved collection   No
Regular 11/06/2020
  Requested Previously Approved
36 Months From Approved 01/31/2021
1,916,720 341,000
638,907 147,767
0 0

SSA uses Form SSA-8010-BK to collect income and resources information in Supplemental Security Income (SSI) claims and redeterminations. SSA uses the information to make initial or continuing eligibility determinations for SSI claimants/recipients who are subject to deeming. The respondents are persons whose income and resources SSA considers deemed to applicants or recipients of SSI payments.

US Code: 42 USC 1382a-1382c Name of Law: Social Security Act
   US Code: 42 USC 1382 Name of Law: Social Security Act
   US Code: 42 USC 1382j Name of Law: Social Security Act
   US Code: 42 USC 1383 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  85 FR 53428 09/28/2020
85 FR 70216 11/04/2020
No

1
IC Title Form No. Form Name
Statement of Income and Resources SSA-8010, SSA-8010-BK Statement of Income and Resources (Screens) ,   Statement of Income and Resources

  Total Request 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 1,916,720 341,000 0 0 1,575,720 0
Annual Time Burden (Hours) 638,907 147,767 0 0 491,140 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
When we last cleared this IC in 2017, the burden was 147,767 hours. However, we are currently reporting a burden of 638,907 hours. This change stems an increase in the number of responses from 341,000 to 1,916,700. This change also stems from a decrease in the completion time from 26 minutes to 20 minutes. These figures represent current Management Information data.

$19,123,852
No
    Yes
    Yes
No
No
No
No
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.
11/06/2020


© 2024 OMB.report | Privacy Policy