The approval for
this information collection is extended for 6 months to allow
additional time for SSA to comply with the terms of clearance
associated with their last approval. These terms are that SSA will
use a copy of the first page of VA form 21-534 (OMB 2900-0004) for
initiating determinations of survivors eligibility for SSA benefits
as soon as the revised VA form incorporating the SSA 24 is placed
in use. SSA will submit a change request to adjust the burden hours
to reflect joint SSA and VA use of part of the VA application.
Inventory as of this Action
Requested
Previously Approved
06/30/1987
06/30/1987
12/31/1986
160,000
0
160,000
40,000
0
40,000
0
0
0
TH INFORMATION COLLECTED BY THE USE OF
FORM SSA-24 IS NEEDED TO SATISFY T THE "JOINTLY PRESCRIBED
APPLICATION" PROVISION THAT SURVIVORS OF VETERANS WHO FILE WITH
EITHER THE VA OR SSA SHALL ALSO BE DEEMED TO HA FILED WITH BOTH
AGENCIES AND THAT EACH AGENCY'S FORMS MUST REQUEST SUFFICIENT
INFORMATION TO CONSTITUTE AN APPLICATION FOR THE OTHER
AGENCY.
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.