Supporting Statement - 0116

Supporting Statement for Form SSA-2519
Child Relationship Statement

20 CFR 404.355 & 404.731
OMB No. 0960-0116

A. Justification

1. Introduction/Authoring Laws and Regulations

Section 216(h)(3) of the Social Security Act (the Act) provides the criteria necessary to entitle certain children to Social Security child's benefits. This section provides that we may deem an insured individual's son or daughter as his/her child if: (1) the Social Security Administration (SSA) determines the evidence demonstrates the insured individual is the child’s parent, and was living with or contributing to the child's support at certain specified times; or (2) the insured individual acknowledged the child in writing or was decreed by a court to be the child's parent or was ordered to support the child. 20 CFR 404.355 and 404.731 of the Code of Federal Regulations gives us the authority to collect this information.

2. Description of Collection

SSA employees use the information collected on Form SSA‑2519 to determine whether children meet the entitlement requirements for Social Security benefits under the deemed child provisions of section 216(h)(3) of the Act. SSA employees make benefit determinations based in part upon the information collected. Since the respondent may not be the individual filing for benefits, his/her response is voluntary. The possible modalities are paper, telephone or in-person interview. The respondents are individuals with knowledge of the relationship between the number holder and the biological child filing for benefits.

3. Use of Information Technology to Collect the Information

SSA did not create an electronic version of Form SSA-2519 under the agency’s Government Paperwork Elimination Act (GPEA) plan because the number of respondents for this collection is at the 50,000 threshold for electronic implementation.

4. Why We Cannot Use Duplicate Information

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

5. Minimizing Burden on Small Respondents

This collection does not affect small businesses or other entities.

6. Consequence of Not Collecting Information or Collecting it Less Frequently

SSA conducts this information collection in order to obtain data relevant to entitlement of a child under the deemed child provisions in section 216(h)(3) of the Act. If we did not collect this information, the consequence would mean possible preclusion of entitlement. We cannot collect this information less frequently. There are no technical or legal obstacles that prevent 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 October 26, 2009, at 74 FR 55080, and SSA has received no public comments. The second Notice published on December 28, 2009, at 74 FR 68655. If SSA receives any comments in response to the 30-day Notice, we will forward them to OMB. There have been no outside consultations with members of the public.

9. Payment or Gifts to Respondents

SSA provides no payment or gifts to the respondents.

10. Assurances of Confidentiality

The information requested is protected and held confidential 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

Approximately 50,000 respondents will use Form SSA-2519 annually. We estimate an average response time of 15 minutes, for a total of 12,500 burden hours. The total burden represents burden hours, and SSA calculated no separate cost burden.

13. Annual Cost to the Respondents (Other)

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

14. Annual Cost To Federal Government

The annual cost to the Federal Government is approximately $77,000. This estimate is a projection of printing and distribution costs for the information collection.

15. Program Changes or Adjustments to the Information Collection Request

There have been no program changes or adjustments in this form, and there is no change in 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

OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.

18. Exceptions to Certification Statement

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.

SSA does not use statistical methods for this information collection.

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