Employer Verification of Earnings After Death

ICR 201911-0960-008

OMB: 0960-0472

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Justification for No Material/Nonsubstantive Change
2019-11-25
IC Document Collections
IC ID
Document
Title
Status
9361 Modified
ICR Details
0960-0472 201911-0960-008
Active 201901-0960-005
SSA
Employer Verification of Earnings After Death
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/15/2020
Retrieve Notice of Action (NOA) 01/02/2020
  Inventory as of this Action Requested Previously Approved
09/30/2022 09/30/2022 09/30/2022
54,998 0 54,998
9,166 0 9,166
0 0 0

When SSA records show a wage earner is deceased and we receive wage reports from an employer for the wage earner for a year subsequent to the year of death, SSA mails the employer Form SSA-L4112 (Employer Verification of Earnings After Death). SSA uses the information Form SSA-L4112 provides to verify wage information previously received from the employer is correct is correct for the employee and the year in question. The respondents are employers who report wages for employees who have died. We are making revisions to correct the name of the operation center on the return address.

US Code: 42 USC 405 Name of Law: Evidence, Procedure, and Certification for Payments
   US Code: 42 USC 432 Name of Law: Processing of Tax Data
   US Code: 42 USC 409 Name of Law: null
  
None

Not associated with rulemaking

  84 FR 4597 02/15/2019
84 FR 23623 05/22/2019
No

1
IC Title Form No. Form Name
Employer Verification of Earnings After Death SSA-L4112 Employer Verification of Earnings After Death

  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 54,998 54,998 0 0 0 0
Annual Time Burden (Hours) 9,166 9,166 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$116,811
No
    Yes
    Yes
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.
01/02/2020


© 2024 OMB.report | Privacy Policy