TN 30 (03-02)

A. Policy - who has authority to sign

The head of the State Agency designated to act on behalf of the State or the organization head in the direct line of authority above the designated State Agency is authorized to sign the State Agency Report of Obligations for SSA Disability Programs, the SSA-4513, report of actual expenditures. Where the designated State agency is a board, the executive officer of that board may be considered the “head of the State agency.”

B. Policy - designating signing authority - certificates of authority

To designate this signing authority to others, a Certificate of Authority must be submitted. This certificate must be furnished to SSA stating the name and official title of the person(s) authorized to sign the SSA-4513.
EXAMPLE: If the Division of Vocational Rehabilitation acts for the State, and the Division of Vocational Rehabilitation is part of the Department of Education, only the heads of the Department of Education or of the Division of Vocational Rehabilitation would be authorized, by reason of the office, to certify the SSA-4513. If a person other than the two officials mentioned is to certify the SSA-4513, then a certificate of authority must be furnished to SSA. A certificate of authority would be required, therefore, for the DDS Administrator since, in this example, the DDS was not specifically designated to act on behalf of the State.

C. Policy - acceptable certificate of authority

The format for an acceptable certificate of authority follows:

• “Pursuant to 20 CFR 404.1626(e) and 416.1026(e), I hereby certify that the following official(s) are authorized to certify estimates of anticipated costs and reports of actual expenditures on Form SSA-4513 (State Agency Report of Obligations for SSA Disability Programs).”

This format may be revised to conform to State regulations or specific needs.

In designating signing authority, the State may wish to include one or more officials on the Certificate of Authority to act as alternates to sign the forms in case of illness or emergency.

IMPORTANT: The Certificate of Authority must be signed by the person occupying the position of head of the State agency designated to act on behalf of the State or by the head of an organization in the direct line of authority above the designated agency.

D. Policy - forwarding certificate of authority

A new certificate of authority will be submitted whenever:

• the State designates a new official to certify the Form SSA-4513, or

• the name of the official authorized to certify the form has changed (e.g., name change due to marriage, etc.).

In addition, SSA requests updates and verification of Certificates of Authority on a yearly basis.

In filing Certificates of Authority, two copies are required. One should be forwarded to the appropriate SSA Regional Commissioner and one to SSA Headquarters at the following address: