Addendum to Supporting Statement for 0960-0686

Addendum to the Supporting Statement for Form SSA-1199-(Country)

International Direct Deposit

31 CFR 210

OMB No. 0960-0686

Revisions to the Collection Instrument

Change 1: We updated the form to a fillable PDF format.

Justification 1: We made this change to adhere with the 508-compliance standardization.

Change 2: We removed the gridlines and indications for Name, Street, Address, City, and Country in the top left box on the first page. We replaced the previously mentioned with a blank space and the heading “Name and Complete Mailing Address.”

Justification 2: Removing the gridlines gives the respondent more space to fill in the needed address information required. It also makes the form easier to read.

Change 3: We moved the “Social Security Number” field from bottom left corner of Section 1, to the top right corner of Section 1 on the first page. And we separated the 11 boxes within the Social Security Number field. The change displays 9 boxes with a heading for the SSN, a black line, and 2 boxes with a heading for the Beneficiary Identification Code (BIC).

Justification 3: We made this change to make the SSN field more visible. We wanted to indicate that the last two boxes on this line are for the BIC code.

Change 4: On the first page mid right, we added a field for the respondent to indicate allotment of payment.

Justification 4: We added this field to give the respondent an option to indicate the payment allotment if applicable.

Change 5: We removed the “Your Daytime Telephone Number” field.

Justification 5: We are leaving it up to the discretion of the responder to indicate which telephone number is best to reach them. In addition, with the rise of cell phones and other electronic devices, many people only have one phone number.

Change 6: We added a “Beneficiary Date of Birth” field on the first page directly above section two.

Justification 6: Sometimes claimants file for International Direct Deposit (IDD) with a Canadian SSN. When this happens, the technician is unable to process the form. If the claimant provides a date of birth, the technician can use that information to do further research to find the correct SSN and process the IDD request.

Change 7: We removed the word “Payee” from the heading in the box directly below the “Telephone Number” field in section 1 on the first page.

Justification 7: Sometimes the word “Payee” confuses people. It gives the impression that only a representative payee should sign on this section of the form. This box contains payment certification information relevant to claimants who manages their own benefits or a representative payee handling a claimant’s benefits. Either have the authority to certify the payment. Therefore, a claimant or a representative payee can sign on this portion of the form depending on the scenario.

Change 8: We changed the certification language in the box directly below the “Telephone Number” field in section one on the first page.

The old language reads:

“I certify that I have read and understand the back of this form. In signing this form, I authorize the Social Security Administration to send my payment to my bank and deposit it in the designated account. I understand that personal information in these payments will be treated confidentially, but I consent to disclosure of payment information that is compelled by law or necessary to protect against fraud or crime.”

The new language reads:

“I (beneficiary or representative payee) certify that I have read and understand the back of this form. In signing this form, I authorize the Social Security Administration to send this payment to the financial institution indicated in Section 3 and deposit it in the designated account. I understand that personal information in these payments is confidential, but I consent to disclosure of payment information compelled by law or necessary to protect against fraud or crime.”

Justification 8: The new language displays a general tone, eliminates passive voice, and indicates the beneficiary or representative payee can certify payment. This creates less confusion (see justification for change 7).

Change 9: Directly under the certification signature in section one on the first page, we added the question, “Are you the representative payee? Yes/No.”

Justification 9: This box gives the technician a clearer indication that the person signing is the representative payee. It alleviates confusion in the field when processing the form. This also helps the technician to identify a potential discrepancy if the payee on the form is not the payee listed within the SSA system.

Change 10: We changed the wording in the signature block in section one on the first page under the Joint Account Holder’s Certification information. The language now states “Joint Account Holder’s Signature.”

Justification 10: Previously we noted some confusion surrounding who signs in this block. This clarifies the person signing under the Joint Account Holder’s Certification must be the joint account holder.

Change 11: The heading at the top of section three in parenthesis now reads: “(Completed By Your Financial Institution)” instead of “(To Be Completed By Your Financial Institution).”

Justification 11: We adjusted this language to eliminate passive voice in the interest of clear writing standards for the agency.

Change 12: We updated the language at the top of second page, first paragraph.

The old language reads:

“The Information you give on this form is confidential. We need the information to send your U.S. Social Security payments electronically to the financial institution in your country.”

The new language reads:

“The information you give on this form is confidential. We need the information to send your U.S. Social Security payments electronically to your _____ bank account.”

Justification 12: The new language will include a country’s name (i.e. French, Portuguese, etc…) in the blank space. This language clarifies where SSA will route the money.

Change 13: We updated the language in the second paragraph of the second page.

The old language reads:

“The banking system in the country where your account is located will process your benefit payment and should generally post to your account on the regular payment date. However, delays in direct deposit can occur when a payment date falls on a holiday in the country of the receiving bank. With direct deposit, you will have immediate access to your money. This is the safest way of receiving your benefits.”

The new language reads:

“You will receive your payment through the _____banking system and will usually be in your bank account shortly after the regular payment date. With direct deposit, you will have immediate access to your money. This is the safest way of receiving your benefits.”

Justification 13: The new language will include a country’s name (i.e. French, Portuguese, etc…) in the blank space. The new language is more concise and better explains through which banking system the claimant receives their money.

Change 14: We updated the language in the third paragraph of the second page.

The old language reads:

“With direct deposit, your U.S. Social Security payment is automatically converted (if applicable) to the currency of the country in which your account is in at a good exchange rate a few days before your payment date.”

The new language reads:

“With direct deposit, your U.S. Social Security payment converts automatically to _____ (if applicable) at the daily international exchange rate before deposited to your account.”

Justification 14: The new language will include the appropriate currency name (i.e. Euros, Dollars etc…) in the blank space. The new language is more concise and better explains the exchange rate and the currency for the benefits received.

We will implement these changes immediately upon OMB approval, and make the newer versions of this form available for download. Since the form is available online, there is no “old stock” to destroy.

Change 15: We are updating the Privacy Act Statement on the form.

Justification 15: SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statement on agency forms. As a result, SSA is adding a Privacy Act Statement to this form.