Application for Survivor's Benefits

ICR 200806-0960-002

OMB: 0960-0062

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2008-06-05
IC Document Collections
IC ID
Document
Title
Status
8991 Modified
ICR Details
0960-0062 200806-0960-002
Historical Active 200503-0960-005
SSA
Application for Survivor's Benefits
Extension without change of a currently approved collection   No
Regular
Approved without change 08/15/2008
Retrieve Notice of Action (NOA) 06/24/2008
  Inventory as of this Action Requested Previously Approved
08/31/2011 36 Months From Approved 08/31/2008
3,200 0 3,200
800 0 800
0 0 0

Surviving family members of armed services personnel can file for benefits at SSA or the Veterans Administration (VA) to be considered for benefits at either agency. If applicants go to the VA first, they complete form SSA-24, the Application for Survivor’s Benefits. The VA then forwards form SSA-24 to SSA for processing. If applicants previously filed for benefits at SSA, the Agency disregards this form. The respondents are survivors of deceased armed services personnel who are applying for benefits at the VA.

US Code: 38 USC 5105 Name of Law: null
   US Code: 42 USC 402 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  73 FR 16734 03/28/2008
73 FR 30656 05/28/2008
No

1
IC Title Form No. Form Name
Application for Survivor's Benefits SSA-24 Application for Survivor's Benefits

  Total Approved 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 3,200 3,200 0 0 0 0
Annual Time Burden (Hours) 800 800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$4,298
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 liz.davidson@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.
06/24/2008


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