No
material or nonsubstantive change to a currently approved
collection
No
Regular
10/06/2023
Requested
Previously Approved
02/28/2026
02/28/2026
32,722
32,722
21,975
21,975
0
0
To obtain a certificate of coverage,
SSA requires the worker or employer to write to SSA and provide
personally identifiable information and details of employment. The
information required to issue a certificate differs depending on
the agreement negotiated with a particular country. As a result,
SSA created 30 forms for each agreement corresponding to the 30
countries with which we have agreements. The forms require
respondents to provide personally identifiable information about
the worker; the employer; and residential locations for the worker
and employer. Some of the questions include the applicant’s name,
U.S. Social Security number, date of birth, country of birth,
country of citizenship, country of permanent residence, date of
hire, country of hire, beginning and ending date of work assignment
in the foreign country, the employer, and residential location in
the U.S. and abroad. The respondents are U.S. citizens and
residents who wish to work in a foreign country, and their
employers. We are making non-substantive changes to modify our 30
Totalization informational brochures from a .PDF format to an
online unified website and to modify the display hyperlink for
accessing the Certificate of Coverage collection form is displayed
as a button located at the top of the webpage (for easier
access).
US Code:
42
USC 433 Name of Law: Social Security Act
When we last cleared this IC in
2019, the burden was 56,556 hours. However, we are currently
reporting a burden of 21,975 hours. This change stems a decrease in
the number of responses from 84,473 to 36,722, due to a decrease in
respondents traveling and working in other countries because of the
pandemic. 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. These figures represent current
Management Information data.
$291,867
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.
Justification for Non-Substantive Changes 0960-0554.docx
Certificate of Coverage Request via Letter - Individuals (minus Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay)