Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits (Schedule SSA)

Forms and Documents

Document Name	Status
11-1-07 memo.pdf Supplementary Document	2007-12-04
0606 supporting statement.doc Supporting Statement A	2007-08-23
Addendum 0606 (F).doc Supplementary Document	2007-08-22

IC Document Collections

IC ID	Document Title	Status
9597	Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits Other-Information Exchange Agreement	Modified

ICR Details

OMB Control No: 0960-0606	ICR Reference No: 200708-0960-012
Status: Historical Active	Previous ICR Reference No: 200602-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits (Schedule SSA)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/07/2007
	Date Received in OIRA: 08/23/2007
Terms of Clearance: This ICR is approved consistent with 11/1/07 memo and signed MOU between IRS and SSA. SSA shall continue to work towards 100% electronic transfer of information from IRS to SSA and report on progress in the next submission. SSA should also work closely with IRS to ensure the smooth and timely implementation of IERS (IRS ERISA Residual Solution) for FY 2009 and any associated changes to the Schedule SSA form and how it is processed.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2010	36 Months From Approved	12/31/2007
Responses	88,000	0	88,000
Time Burden (Hours)	220,000	0	220,000
Cost Burden (Dollars)	12,194,000	0	12,194,000

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Abstract: Annual Registration Statement Identifying Separated Participants With Deferred Benefits, Schedule SSA—0960–0606. Schedule SSA is a form filed annually as part of a series of pension plan documents required by section 6057 of the IRS Code. Administrators of pension benefit plans are required to report specific information on future plan benefits for those participants who left plan coverage during the year. SSA maintains the information until a claim for Social Security benefits has been approved. At that time, SSA notifies the beneficiary of his/her potential eligibility for payments from the private pension plan. The respondents are administrators of pension benefit plans or their service providers employed to prepare the Schedule SSA on behalf of the pension benefit plan. Below are the estimates of the cost and hour burdens for completing and filing Schedule SSA(s). We have used an average to estimate the hour burden. However, the burden may be greater or smaller depending on whether the respondent is a large or small pension benefit plan and how many Schedule SSA’s are filed in a given year.

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Authorizing Statute(s): US Code: 26 USC 6057 Name of Law: null
   US Code: 42 USC 1320b-1 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 20154	04/23/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 46529	08/20/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits	Form 5500 (IRS Form)	Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits (Schedule SSA)

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ICR Summary of Burden

	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	88,000	88,000	0	0	0	0
Annual Time Burden (Hours)	220,000	220,000	0	0	0	0
Annual Cost Burden (Dollars)	12,194,000	12,194,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $7,752

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/23/2007

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