SSA uses Form SSA-2574 to collect
information about checking or savings accounts from both the SSI
applicants and recipients, and any other account holder(s) listed
on the account. After receiving the completed form, SSA can
determine if we should consider the account as a resource for the
SSI applicant or recipient. We use Form SSA-2574 to obtain the
information via personal interview, or by mail, from the SSI
applicant or recipient and from the joint owner of the account. The
respondents may complete the form by themselves or with help from
SSA employees. Respondents are SSI applicants and recipients, and
individuals who list themselves as joint owners of financial
accounts with SSI applicants and recipients.
US Code:
42
USC 1382 Name of Law: Social Security Act
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.