20 CFR 404.335 – 404.338, and 404.603
OMB No. 0960-0004
Justification
Introduction/Authoring Laws and Regulations
Sections 202(e) and 202(f) of the Social Security Act (Act) set forth the requirements for entitlement to widow(er)’s benefits, including the requirement to file an application. In addition, 20 CFR 404.335 - 404.338 of the Code of Federal Regulations state the policies for implementing the requirements from sections 202(e) and 202(f) of the Act, including the requirement to apply for benefits. To become entitled to benefits, 20 CFR 404.603 requires a claimant to file an application. Therefore, the Commissioner of the Social Security Administration (SSA) designated Form SSA-10-BK to meet the application requirement.
Description of Collection
For SSA to make a formal determination for entitlement to widow(er)’s benefits, we use Form SSA-10-BK to determine whether an applicant meets the statutory and regulatory conditions for entitlement to widow(er)’s Title II benefits. SSA employees interview individuals applying for benefits either face-to-face or via telephone and enter the information on the paper form or into the Modernized Claims System (MCS). The respondents are applicants for widow(er)’s benefits.
Use of Information Technology to Collect the Information
SSA collects the same information on the paper Form SSA-10-BK as we collect electronically using our Intranet MCS screens during a personal interview. In accordance with the agency’s Government Paperwork Elimination Act plan, we estimate approximately 95% of respondents use the electronic version. In addition, we made this form available on our website as a print-only PDF.
Why We Cannot Use Duplicate Information
The nature of the information we collect and the manner in which we collect it precludes duplication. SSA does not use another collection instrument to obtain similar data.
Minimizing Burden on Small Respondents
This collection does not affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not use Form SSA-10-BK, the public would have no way to apply for widow(er)’s insurance benefits. Because we only collect the information once, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.
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.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on December 17, 2015, at
80 FR 78811, and we received no public comments. The 30-day FRN published on
February 18, 2016 at 81 FR 8323. If we receive any comments in response to this Notice, we will forward them to OMB.
Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
Assurances of Confidentiality
SSA protects and holds confidential the information it collects 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.
Justification for Sensitive Questions
The information collection does not contain any questions of a sensitive nature.
Estimates of Public Reporting Burden
Modality of Completion |
Number of Responses |
Frequency of Response |
Average Burden Per Response (minutes) |
Estimated Total Annual Burden (hours) |
SSA-10-BK paper version |
2,045 |
1 |
15 |
511 |
SSA-10-BK MCS version |
453,509 |
1 |
14 |
105,819 |
Totals |
455,554 |
|
|
106,330 |
The total burden for this ICR is 106,330 hours. This figure represents burden hours, and we did not calculate a separate cost burden.
Annual Cost to the Respondents (Other)
This collection does not impose a known cost burden on the respondents.
Annual Cost To Federal Government
The annual cost to the Federal Government is approximately $2,504,028. This estimate is a projection of the costs for printing and distributing the collection instrument, and for collecting and processing the information.
Program Changes or Adjustments to the Information Collection Request
The burden increase stems from an increase in the number of respondents applying for widow(er)’s benefits.
Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
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.
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).
Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | 889123 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-24 |