SUPPORTING STATEMENT FOR FORM SSA-723
STATEMENT REGARDING THE INFERRED DEATH OF AN INDIVIDUAL BY REASON OF CONTINUED AND UNEXPLAINED ABSENSE
20 CFR 404.720-.721
OMB No. 0960-0002
A. Justification
Section 202(d)-(i) of the Social Security Act mandates that when insured workers pass away, their surviving family members are entitled to a lump-sum death payment and monthly survivor benefits from the Social Security Administration (SSA). In cases where insured wage earners have been absent from their homes for at least seven years, and there is no evidence these individuals are alive, SSA can presume the individuals are dead and will pay their survivors the appropriate benefits (as per section 20 CFR 404.720-.721 of the Code of Federal Regulations).
Before SSA can declare a missing individual deceased, it must ensure there is no evidence indicating the individual is still alive. SSA uses form SSA-723, the Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexpected Absence, to collect the information needed to make that determination.
The respondents for this form are relatives, friends, neighbors, or acquaintances of the presumed-dead wage earner or the person who is filing for survivors’ benefits. SSA will ask these people to complete the form and provide any information they might have about the missing and presumed-dead wage earner. SSA will then use this information to 1) determine if it can make a presumption of death about a missing wage earner and 2) possibly establish a presumed date of death.
SSA has not created an electronic version of this form under its Government Paperwork Elimination Act plan due to the form’s low volume of usage.
The nature of the information SSA is requesting and the manner in which we are collecting it preclude duplication. The Agency does not use any other form to collect similar information.
This collection does not affect small businesses or other small entities.
If SSA did not collect this information, it would have no means of presuming death for missing and presumed-dead wage earners, which would deprive their survivors of rightful Social Security benefits. Since we only collect this information once, we cannot collect it less frequently.
There are no technical or legal obstacles to burden reduction.
There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.
SSA published the advance 60-day Federal Register Notice for this information collection on March 26, 2008, at 73 FR 16087, and we did not receive any public comments. We published the 30-day Federal Register Notice on May 28, 2008, at 73 FR 30656. If we receive any public comments in response to this Notice, we will forward them to OMB.
We did not consult with members of the public in the development or maintenance of this form.
SSA provides no payment or gifts to the respondents.
SSA protects and maintains the confidentiality of the information it collects on this form 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.
The information collection does not ask any questions of a sensitive nature.
Approximately 3,000 respondents take 30 minutes each to complete form SSA-723 annually, for a total burden of 1,500 hours. The total is reflected as burden hours, and we did not calculate a separate cost burden.
There is no known cost burden to the respondents.
The annual cost of this collection to the Federal Government is approximately $5,000. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
There are no changes to the public reporting burden.
SSA will not publish the results of the information collection.
OMB has granted SSA an exemption from the requirement that the expiration date for OMB approval be printed on its program forms. SSA produces millions of public-use forms, many of which have a life cycle longer than that of an OMB approval. SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis). This exemption was granted so that otherwise useable editions of forms would not be taken out of circulation because the expiration date had been reached. In addition, Government waste has been avoided because stocks of forms will not have to be destroyed and reprinted.
SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
B. Collections of Information Employing Statistical Methods
Statistical methods are not used for this information collection.
0960-0002 (Form SSA-723)
| File Type | application/msword |
| Author | Elizabeth A. Davidson |
| Last Modified By | 666429 |
| File Modified | 2008-06-17 |
| File Created | 2008-06-17 |