Application for Survivor's Benefits

ICR 201602-0960-015

OMB: 0960-0062

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2016-03-16
IC Document Collections
IC ID
Document
Title
Status
8991 Modified
ICR Details
0960-0062 201602-0960-015
Historical Active 201312-0960-006
SSA
Application for Survivor's Benefits
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 03/25/2016
Retrieve Notice of Action (NOA) 03/16/2016
  Inventory as of this Action Requested Previously Approved
06/30/2017 06/30/2017 06/30/2017
3,200 0 3,200
800 0 800
0 0 0

Surviving family members of armed services personnel can file for benefits at SSA or the Veterans Administration (VA) to be considered for benefits at either agency. If applicants go to the VA first, they complete form SSA-24, the Application for Survivor's Benefits. The VA then forwards form SSA-24 to SSA for processing. If applicants previously filed for benefits at SSA, the agency disregards this form. The respondents are survivors of deceased armed services personnel who are applying for benefits at the VA. This is a non-substantive Change Request to include a fillable modality for this ICR.

US Code: 38 USC 5105 Name of Law: Veterans' Benefits
   US Code: 42 USC 402 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  78 FR 79723 12/31/2013
79 FR 15782 03/21/2014
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,200 3,200 0 0 0 0
Annual Time Burden (Hours) 800 800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$4,298
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/16/2016


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