Annual Earnings Test Direct Mail Follow-up Program Notices

Forms and Documents

Document Name	Status
Form SSA-L9778 SSA-L9778 Form and Instruction	Modified
Form SSA-L9790 SSA-L9790 Form and Instruction	Modified
Form SSA-L9785 SSA-L9785 Form and Instruction	Modified
Form SSA-L9784 SSA-L9784 Form and Instruction	Modified
Form SSA-L9781 SSA-L9781 Form and Instruction	Modified
Form SSA-L9779 SSA-L9779 Form and Instruction	Modified
Supporting Statement - 0369 (2014).doc Supporting Statement A	2014-05-29

IC Document Collections

IC ID	Document Title	Status
9243	SSA-L9778 Form and Instruction	Modified
195826	SSA-L9790 Form and Instruction	Modified
195825	SSA-L9785 Form and Instruction	Modified
195824	SSA-L9784 Form and Instruction	Modified
195823	SSA-L9781 Form and Instruction	Modified
195822	SSA-L9779 Form and Instruction	Modified

ICR Details

OMB Control No: 0960-0369	ICR Reference No: 201402-0960-011
Status: Historical Active	Previous ICR Reference No: 201312-0960-009
Agency/Subagency: SSA	Agency Tracking No:
Title: Annual Earnings Test Direct Mail Follow-up Program Notices
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 without change	Conclusion Date: 07/03/2014
	Date Received in OIRA: 06/02/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	36 Months From Approved	08/31/2014
Responses	736,072	0	736,072
Time Burden (Hours)	122,680	0	122,680
Cost Burden (Dollars)	0	0	0

---

Abstract: SSA developed the Annual Earnings Test Direct Mail Follow-up Program to improve beneficiary reporting on work and earnings during the year and earnings information at the end of the year. SSA may reduce benefits payable under the Social Security Act when an individual has wages or self-employment income exceeding the annual exempt amount. SSA identifies beneficiaries likely to receive more than the annual exempt amount, and requests more frequent estimates of earnings from them. When applicable, SSA also requests a future year estimate to reduce overpayments due to earnings. SSA sends letters (SSA-L9778, SSA-L9779, SSA-L9781, SSA-L9784, SSA L9785, and SSA-L9790) to beneficiaries requesting earnings information the month prior to their attainment of full retirement age. We send each beneficiary a tailored letter that includes relevant earnings data from SSA records. The Annual Earnings Test Direct Mail Follow-up Program helps to ensure Social Security payments are correct, and enables us to prevent earnings-related overpayments, and avoid erroneous withholding. The respondents are working Social Security beneficiaries with earnings over the exempt amount.

---

Authorizing Statute(s): US Code: 42 USC 405 Name of Law: The Social Security Act
   US Code: 42 USC 403 Name of Law: The 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:
	79 FR 15782	03/21/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 30922	05/29/2014
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
SSA-L9790	SSA-L9790	Retirement, Survivors and Disability Insurance: Nonwork Months Form
SSA-L9779	SSA-L9779	Retirement, Survivors and Disability Insurance: Earnings Estimate Form
SSA-L9781	SSA-L9781	Retirement, Survivors and Disability Insurance: Earnings Estimate Form
SSA-L9785	SSA-L9785	Retirement, Survivors and Disability Insurance: Earnings Estimate Form
SSA-L9778	SSA-L9778	Retirement, Survivors and Disability Insurance: Earnings Estimate Form
SSA-L9784	SSA-L9784	Retirement, Survivors and Disability Insurance: Earnings Estimate Form

---

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	736,072	736,072	0	0	0	0
Annual Time Burden (Hours)	122,680	122,680	0	0	0	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: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $2,085,537

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: 06/02/2014

---