Non-substantive change request 0017

Justification for Non-Substantive Changes for Form SSA-753

Statement Regarding Marriage

20 CFR 404.726

OMB # 0960-0017

Background

SSA uses Form SSA-753, Statement Regarding Marriage, to collect information from third parties to verify the applicant’s statement about intent, cohabitation, and holding out to the public as married, which are the basic tenets of a common-law marriage. SSA uses the information collected to determine if a valid marital relation exists, and if the common-law spouse is entitled to Social Security spouse or widow (er) benefits. The respondents are third parties who can confirm or deny an alleged common-law marriage.

SSA currently has a non-fillable, printable version of the SSA 753, for the respondents use. However we developed a fillable version to allow the respondents to complete the form electronically using a personal computer, or other computing device, print the completed form, and submit it to SSA. We developed this fillable version, as we want to ensure SSA provides effective communication and remains in compliance with the requirements of 45 CFR 85.51 of the Code of Federal Regulations and section 504 of the Rehabilitation Act of 1973. We propose the fillable PDF version as a more accessible modality. In addition, the new fillable modality will enhance our electronic services and recordkeeping efforts.

Revisions to the information Collection

• Change #1: SSA intends to provide Form SSA-753 in a fillable PDF file on our website, in addition to the non-fillable PDF version we currently provide.

Justification #1: This change will allow the respondents to continue to print and complete the form by hand, or electronically, then print and submit it to SSA for processing.

This action does not affect the public reporting burden.

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