OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Request for Waiver of Overpayment Recovery or Change in Repayment Rate

ICR 201011-0960-011 · OMB 0960-0037 · Historical Active

Forms and Documents
Document
Name
Status
Form
 Modified
Form
 Modified
Supplementary Document
2011-01-06
Supporting Statement A
2011-03-28
IC Document Collections
IC ID
Document
Title
Status
8941 Modified
195878 New
195877 New
180027 Modified
ICR Details
0960-0037 201011-0960-011
Historical Active 200812-0960-008
SSA
Request for Waiver of Overpayment Recovery or Change in Repayment Rate
Revision of a currently approved collection   No
Regular
Approved without change 08/18/2011
Retrieve Notice of Action (NOA) 03/31/2011
  Inventory as of this Action Requested Previously Approved
08/31/2014 36 Months From Approved 08/31/2011
1,044,000 0 500,000
1,004,667 0 916,666
0 0 0
The overpaid individual uses the SSA–632–BK to request a waiver of recovery of an overpayment. The individual explains why they feel they are without fault in causing the overpayment and provides financial information, so SSA can determine whether recovery would cause financial hardship. If the individual agrees to repay the overpayment, they can use the SSA–632–BK to inform SSA they want to repay at a monthly rate that would take more than thirty-six months to recover the overpayment. The individual can also use the SSA–632–BK to request a different rate of recovery. In those cases, they must provide financial information to SSA for a determination of how much the overpaid person can afford to repay each month. Respondents are overpaid beneficiaries or claimants who are requesting a waiver of recovery of the overpayment, or a lesser rate of withholding.
US Code: 42 USC 1383 Name of Law: Social Security Act
   US Code: 42 USC 1395pp Name of Law: Social Security Act
   US Code: 42 USC 404 Name of Law: Social Security Act
  
None
Not associated with rulemaking
  76 FR 205 01/03/2011
76 FR 16847 03/25/2011
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 1,044,000 500,000 0 544,000 0 0
Annual Time Burden (Hours) 1,004,667 916,666 0 121,334 -33,333 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Using Information Technology
There has been a decrease to the burden hours for form SSA-632-BK, due to fewer respondents submitting request for Waiver of Overpayment Recovery. There has been a decrease in burden hours for the Change in Repayment request, due to fewer respondents requesting payment changes. There has been an increase in burden hours due to some Regional intranet applications (not nationwide) printing and mailing IC to respondents. This added an additional 44,000 respondents to the total. There been an increase in burden hours due to adding internet instructions to the collection.
$3,337,935
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.
03/31/2011