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Federal forms, ICRs, and supporting documents

Information Collection Request

Certificate of Coverage Request

ICR 201809-0960-001 · OMB 0960-0554 · Historical Active

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2018-09-12
IC Document Collections
IC ID
Document
Title
Status
9477 Modified
222537 Unchanged
222536 Unchanged
222535 Unchanged
222534 Unchanged
206903 Unchanged
206902 Unchanged
206901 Modified
206899 Modified
206898 Unchanged
206897 Unchanged
182116 Modified
ICR Details
0960-0554 201809-0960-001
Historical Active 201607-0960-003
SSA
Certificate of Coverage Request
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 10/15/2018
Retrieve Notice of Action (NOA) 09/12/2018
In accordance with 5 CFR 1320, the information collection is approved.
  Inventory as of this Action Requested Previously Approved
12/31/2019 12/31/2019 12/31/2019
85,068 0 82,094
56,949 0 54,966
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. This is a Non-Substantive Change Request to add Brazil, Uruguay, Slovenia, and Iceland to countries with which the US has agreements.
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 85,068 82,094 0 2,974 0 0
Annual Time Burden (Hours) 56,949 54,966 0 1,983 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
When we last cleared this IC in 2016, the burden was 54,966 hours. However, we are currently reporting a burden of 56,949 hours. This change stems from adding new agreements with Brazil, Uruguay, Slovenia, and Iceland, increasing the number of respondents from 82,094 to 85,068. There is no change to the burden time per response.
$88,300
No
    Yes
    Yes
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.
09/12/2018