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Federal forms, ICRs, and supporting documents

Information Collection Request

Internet Request for Replacement of Form SSA-1099/SSA-1042S

ICR 201210-0960-007 · OMB 0960-0583 · Historical Active

Forms and Documents
Document
Name
Status
Supplementary Document
2013-01-08
Supporting Statement A
2012-12-12
IC Document Collections
IC ID
Document
Title
Status
9556 Modified
204529 New
204528 New
204527 New
204526 New
ICR Details
0960-0583 201210-0960-007
Historical Active 200907-0960-008
SSA
Internet Request for Replacement of Form SSA-1099/SSA-1042S
Revision of a currently approved collection   No
Regular
Approved without change 02/19/2013
Retrieve Notice of Action (NOA) 01/15/2013
  Inventory as of this Action Requested Previously Approved
02/29/2016 36 Months From Approved 02/28/2013
1,775,803 0 136,455
102,579 0 22,743
0 0 0
Title II recipients use Forms SSA-1099 and SSA-1042S, Social Security Benefit Statement, to determine if their Social Security benefits are taxable and the amount they need to report to the Internal Revenue Service. In cases where the original forms are unavailable (e.g., lost, stolen, mutilated), an individual may use SSA's Internet request form or automated telephone application to request a replacement SSA-1099 and SSA-1042S. SSA uses the information from the Internet and automated telephone requests to verify the identity of the requestor and to provide replacement copies of the forms. The Internet and automated telephone options educe requests to the National 800 Number Network (N8NN) and visits to local Social Security field offices. The respondents are applicants for, or claimants of, SSI payments.
US Code: 26 USC 6050F Name of Law: Internal Revenue Code
   US Code: 42 USC 405 Name of Law: Social Security Act
  
None
Not associated with rulemaking
  77 FR 67438 11/09/2012
78 FR 1296 01/08/2013
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 1,775,803 136,455 0 1,630,413 8,935 0
Annual Time Burden (Hours) 102,579 22,743 0 78,347 1,489 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
There has been an increase in burden hours. This increase stems from an increase in the number of respondent requesting replacement Forms SSA-1099 and SSA-1042S via the Internet. The increase is also due to the addition of respondents who request Forms SSA-1099 and SSA-1042S via the automated telephone application.
$0
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.
01/15/2013