OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Certificate of Coverage Request

ICR 201607-0960-003 · OMB 0960-0554 · Historical Active

Forms and Documents
Document
Name
Status
Supplementary Document
2016-09-30
Supporting Statement A
2016-09-30
IC Document Collections
IC ID
Document
Title
Status
9477 Unchanged
222537 New
222536 New
222535 New
222534 New
206903 Modified
206902 Unchanged
206901 Modified
206899 Unchanged
206898 Modified
206897 Unchanged
182116 Modified
ICR Details
0960-0554 201607-0960-003
Historical Active 201512-0960-007
SSA
Certificate of Coverage Request
Revision of a currently approved collection   No
Regular
Approved without change 12/12/2016
Retrieve Notice of Action (NOA) 09/30/2016
  Inventory as of this Action Requested Previously Approved
12/31/2019 36 Months From Approved 12/31/2016
82,094 0 81,900
54,966 0 54,833
0 0 0
The United States has agreements with 24 foreign countries to eliminate double Social Security coverage and taxation where, except for the provisions of the agreement, a worker would be subject to coverage and taxes in both countries. The country under whose system the period of work is covered issues a certificate of coverage. This certification serves as proof of exemption under the system of the other country's social security system. The information we collect assists SSA in determining a worker's coverage and in issuing a U.S. Certificate of Coverage as appropriate. Respondents are workers and employers wishing to establish exemption from foreign social security taxes.
US Code: 42 USC 433 Name of Law: Social Security Act
  
None
Not associated with rulemaking
  81 FR 46752 07/18/2016
81 FR 63837 09/16/2016
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 82,094 81,900 0 194 0 0
Annual Time Burden (Hours) 54,966 54,833 0 133 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The overall increase in burden hours is a result of adding a new agreement. We also show a decrease in burden for our Internet responses, which is a result of SSA replacing our current web tool with an enhance data collection system Office of International Programs Processing and Tracking System.
$88,300
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.
09/30/2016