OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Advanced Notice of Termination of Child's Benefits, and Student's Statement Regarding School Attendance

ICR 200805-0960-001 · OMB 0960-0105 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form SSA-1372-BK SSA-1372-BK (Domestic)--Individuals/Households Form Unchanged Available
Form SSA-1372-BK-FC SSA-1372-BK-FC (Foreign Claims)--State/Local/Tribal Government Form Unchanged Available
Form SSA-1372-BK-FC SSA-1372-FC (Foreign Claims)--Individuals/Households Form Unchanged Available
Form SSA-1372-BK SSA-1372-BK (Domestic)--State/Local/Tribal Government Form Unchanged Available
SSA-1372-BK--Currently Approved Version.pdf Supplementary Document Uploaded 2008-05-07 Repair queued
SSA-1372 Revision.pdf Supplementary Document Uploaded 2008-05-07 Repair queued
Justification for Revision--0105.doc Justification for No Material/Nonsubstantive Change Uploaded 2008-05-06 Repair queued
Supporting_Statement--0105[1].doc Supporting Statement A Uploaded 2008-02-04 Available
IC Document Collections
IC IDCollectionTypeStatusForm
9072 SSA-1372-BK (Domestic)--Individuals/Households Form Unchanged
182804 SSA-1372-BK-FC (Foreign Claims)--State/Local/Tribal Government Form Unchanged
182797 SSA-1372-FC (Foreign Claims)--Individuals/Households Form Unchanged
182786 SSA-1372-BK (Domestic)--State/Local/Tribal Government Form Unchanged
ICR Details
0960-0105 200805-0960-001
Historical Active 200711-0960-004
SSA
Advanced Notice of Termination of Child's Benefits, and Student's Statement Regarding School Attendance
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/14/2008
Retrieve Notice of Action (NOA) 05/07/2008
  Inventory as of this Action Requested Previously Approved
04/30/2011 04/30/2011 04/30/2011
200,000 0 200,000
36,666 0 36,666
0 0 0
The information collected on Forms SSA-1372-BK and SSA-1372-BK-FC is needed to determine whether children of an insured worker are eligible for student benefits. The data allows SSA to determine student entitlement and whether entitlement will end. The respondents are student claimants for Social Security benefits, their respective schools and, in some cases, their representative payees.
US Code: 42 USC 402 Name of Law: null
  
None
Not associated with rulemaking
  72 FR 59133 10/18/2007
73 FR 1253 01/07/2008
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 200,000 200,000 0 0 0 0
Annual Time Burden (Hours) 36,666 36,666 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The increase in the public reporting burden from 33,333 to 36,666 is due to an increase in the average burden per response by one minute. SSA is now asking the respondents to annotate the student’s expected graduation date to the page of the form that the school official keeps for future reporting purposes. SSA estimates that it may take up to one minute for the school official to complete that extra step. Also, the other changes in the burden are due to conversion of this ICR to ROCIS. Prior to ROCIS we were unable to split this ICR into it's component ICs. Through ROCIS we have created four ICs in order to show both the burden per respondent type and per form.
$1,232,000
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 [email protected]
  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.
05/07/2008