Supporting Statement - 0471 (Final)

Supporting Statement for Form SSA-L2794

Real Property Current Market Value Estimate

OMB No. 0960-0471

A. Justification

1. Introduction/Authoring Laws and Regulations

Resources are defined in 20 CFR 416.1201 of the Code of Federal Regulations as “cash or other liquid assets or any real or personal property that an individual (or spouse, if any) owns and could convert to cash to be used for his or her support and maintenance.” Section 1611(a)(1)(B) of the Social Security Act states individuals may be eligible for SSI payments if their resources do not exceed a specified amount. Therefore, when determining eligibility for Supplemental Security Income (SSI), the Social Security Administration (SSA), must determine ownership and value of an applicant or recipient’s resources, which may include real property.

2. Description of the Collection

SSA develops current market value of real property when determining resource eligibility for SSI. Most commonly, this development occurs prior to adjudicating initial claims, or during periodic redeterminations. SSA may also develop resource eligibility when we receive a report of change from the individual. SSA fills out the Form SSA-L2794, and mails it to the respondent along with a cover letter explaining why we need the information and what information we are requesting, and a prepaid envelope to send the SSA-L2794 back to SSA. SSA mails the SSA-L2794 to a knowledgeable source only when: 1) we cannot use the claimant’s allegation of property value; 2) we have no other evidence of current market value is available; and 3) the claimant needs assistance in obtaining an estimate. SSA contacts a third party using this form when we cannot use the individual’s allegation to establish the current market value and the individual is unable to furnish evidence of the property value. The respondent may complete the SSA-L2794 with information readily available, or we can accept a best estimate.

SSA uses Form SSA-L2794 to collect information about the value of real property owned by SSI recipients and applicants. SSA contacts independent and collateral sources to obtain an estimate on the value of such resources. SSA uses the information obtained on Form SSA-L2794 to determine whether individuals meet the resource requirements for SSI program eligibility. SSA has a list of acceptable sources a technician selects from, the selection is based on whichever source is most appropriate based on individual case circumstances, and local variation preferences. SSA requests this information from a list of an outside source, as needed, only if the SSI applicant or recipient cannot provide a valid third-party knowledgeable source estimate. SSA maintains a list of potential sources who have historically been able to provide up to date, reliable information. SSA does not have an order of preference established for the list of acceptable sources; SSA’s technicians select the source most appropriate based on individual case circumstances. When SSA receives the completed SSA-L2794, an SSA technician evaluates the information, and enters the market value information into the SSI claim system on the property page. SSA electronically files the completed SSA-L2794 into the evidence portal. The respondents are small business operators in real estate; State and local employees; and other individuals who are knowledgeable about local real estate values.

3. Use of Information Technology to Collect the Information

SSA downloads from SSA’s internal system, and mails the prefilled Form

SSA-L2794 to the respondents.

This collection does not currently have a fully public-facing Internet version, nor do we have a fully submittable PDF. SSA is unable to create an electronic version of this information collection at this time, as we send this agency-initiated form to respondents with pre-filled property information based on the specific individual case circumstances, and local variations (as mentioned in #2 above). We may also include a bar code which allows us to scan the completed form into the electronic folder once we receive it from the respondent. In addition, we cannot send these via email, as the pre-filled information contains personal identifying information (PII) of the respondents, and email is a non-secured means of transferring PII. We will reassess our ability to create an electronic version of this collection in the future, as we are not able to schedule it at this time.

4. Why We Cannot Use Duplicate Information

The nature of the information we collect and the manner in which we collect it preclude duplication. SSA does not use another collection instrument to obtain similar data.

5. 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 use Form SSA-L2794, we would be unable to make accurate determinations of eligibility as required by the statute, and we would risk incorrect SSI eligibility determinations and incorrect SSI payment amounts. Because we collect this information only on an as-needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to 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 June 24, 2022, at

87 FR 37899, and we received no public comments. The 30-day FRN published on August 26, 2022, at 87 FR 52605. If we receive any comments in response to this Notice, we will forward them to OMB. We did not consult with the public in the development

9. Payment of Gifts to Respondents

SSA does not provide payments or gifts to the respondents.

10. Assurances of Confidentiality

SSA protects and holds confidential the information we collect 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)	Average Theoretical Hourly Cost Amount (dollars)*	Total Annual Opportunity Cost (dollars)**
SSA-L2794	300	1	20	100	$23.45*	$2,345**

* We based this figure on the median hourly salary of Real Estate Brokers and Sales Agents as of May 2022, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).

** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application.

We base our burden estimates on current management information data, which includes data from actual interviews, as well as from years of conducting this information collection. Per our management information data, we believe that

20 minutes accurately shows the average burden per response for reading the instructions, gathering the facts, and answering the questions. Based on our current management information data, the current burden information we provided is accurate. The total burden for this ICR is 100 burden hours (reflecting SSA management information data), which results in an associated theoretical (not actual) opportunity cost financial burden of $2,345. SSA does not charge respondents to complete our applications.

13. Annual Cost to the Respondents

This collection does not impose a known cost burden to the respondents.

14. Annual Cost to the Federal Government

The annual cost to the Federal Government is approximately $4,506. This estimate accounts for costs from the following areas:

Description of Cost Factor	Methodology for Estimating Cost	Cost in Dollars*
Designing and Printing the Form	Design Cost + Printing Cost	$246
Distributing, Shipping, and Material Costs for the Form	Distribution + Shipping + Material Cost	$156
SSA Employee (e.g., field office, 800 number, DDS staff) Information Collection and Processing Time	GS 9 employee average pay x # of responses x processing time	$684
Full-Time Equivalent Costs	Out of pocket costs + Other expenses for providing this service	$0*
Systems Development, Updating, and Maintenance	GS-9 employee x man hours for development, updating, maintenance	$3,420
Quantifiable IT Costs	Any additional IT costs	$0*
Total		$4,506

* We have inserted a $0 amount for cost factors that do not apply to this collection.

SSA is unable to break down the costs to the Federal government further than we already have. First, since we work with almost every US citizen, we often do bulk mailings, and cannot track the cost for a single mailing. In addition, it is difficult for us to break down the cost for processing a single form, as field office and State Disability Determination Services staff often help respondents fill out several forms at once, and the time it takes to do so can vary greatly per respondent. As well, because so many employees have a hand in each aspect of our forms, we use an estimated average hourly wage, based on the wage of our average field office employee (GS-9) for these calculations. However, we have calculated these costs as accurately as possible based on the information we collect for creating, updating, and maintaining these information collections.

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

SSA is not requesting an exception to the requirement to display the OMB approval expiration date.

18. Exemption to Certification Statement

SSA is not requesting an exception to the certification requirements at

5 CFR 1320.9 and related provisions at CFR 1320.8(b)(3).

B. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.

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