Letter to Landlord Requesting Rental Information

Forms and Documents

Document Name	Status
Form SSA-L5061 Letter to Landlord Requesting Rental Information Form and Instruction	Modified
Form SSA-L5061 Letter to Landlord Requesting Rental Information Form and Instruction	New
Addendum 0454.doc Supplementary Document	2011-05-31
Supporting Statement 0454 (revised).doc Supporting Statement A	2011-08-10

IC Document Collections

IC ID	Document Title	Status
9335	Letter to Landlord Requesting Rental Information Form and Instruction	Modified
198822	Letter to Landlord Requesting Rental Information Form and Instruction	New

ICR Details

OMB Control No: 0960-0454	ICR Reference No: 201105-0960-001
Status: Historical Active	Previous ICR Reference No: 200808-0960-001
Agency/Subagency: SSA	Agency Tracking No:
Title: Letter to Landlord Requesting Rental Information
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/03/2011
	Date Received in OIRA: 08/25/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2014	36 Months From Approved	12/31/2011
Responses	51,000	0	49,000
Time Burden (Hours)	8,500	0	8,167
Cost Burden (Dollars)	0	0	0

---

Abstract: SSA uses the information Form SSA-L5061 to identify rental subsidy arrangements involving applicants for and recipients of Supplemental Security Income (SSI) payments. SSA uses the information to determine an income value for these subsidies, eligibility for payments, and the correct amount payable. The respondents are landlords of the SSI claimants.

---

Authorizing Statute(s): US Code: 42 USC 1383 Name of Law: Social Security Act
   US Code: 42 USC 1382a Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 30747	05/26/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 48200	08/08/2011
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Letter to Landlord Requesting Rental Information	SSA-L5061, SSA-L5061 MSSICS Screens	Letter to Landlord Requesting Rental Information ,   Letter to Landlord Requesting Rental Information
Letter to Landlord Requesting Rental Information	SSA-L5061	Letter to Landlord Requesting Rental Information

---

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	51,000	49,000	0	-536	2,536	0
Annual Time Burden (Hours)	8,500	8,167	0	-89	422	0
Annual Cost Burden (Dollars)	0	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There has been an increase in burden hours. The change stems from the increase in people applying for Supplemental Security Income. There has been a decrease in burden hours, because we are now showing burden hours for both electronic and paper.

---

Annual Cost to Federal Government: $226,380

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(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: 08/25/2011

---