[Federal Register Volume 59, Number 58 (Friday, March 25, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-6948]


[[Page Unknown]]

[Federal Register: March 25, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Social Security Administration

 

Agency Forms Submitted to the Office of Management and Budget for 
Clearance

    Normally on Fridays, the Social Security Administration publishes a 
list of information collection packages that have been submitted to the 
Office of Management and Budget (OMB) for clearance in compliance with 
Public Law 96-511, The Paperwork Reduction Act. The following clearance 
packages have been submitted to OMB since the last list was published 
in the Federal Register on Friday, March 4, 1994.
(Call Reports Clearance Officer on (410) 965-4142 for copies of 
package.)
    1. Study on the Use of the SSA-4122 (Your SSI Folder)--960-NEW. The 
information on form SSA-103 will be used by the Social Security 
Administration to determine how effective the SSA-4122 is in reducing 
field office and quality review development, and whether it improves 
the recipient's reporting of changes.
    Number of Respondents: 1,000.
    Frequency of Response: One time only.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 250 hours.
    2. SSA/DDS Cost-effectiveness Measurement System Data Reporting 
Form--0960-0384. Form SSA-1461 is used by the Social Security 
Administration (SSA) to obtain cost information from 52 State agencies 
which make disability determinations for SSA. The information on this 
form is used to assist SSA in making DDS funding allocations, setting 
cost effectiveness goals and measuring the cost effectiveness of those 
agencies. The respondents are those 52 State agencies.
    Number of Respondents: 52.
    Frequency of Response: Quarterly.
    Average Burden Per Response: 5.2 hours.
    Estimated Annual Burden: 1,082 hours.
    3. Psychiatric Review Technique--0960-0413. The information on form 
SSA-2506 is used by the Social Security Administration (SSA) to 
evaluate the severity of mental impairments in adults who have filed 
for disability benefits. The affected public consists of State 
Disability Determination Services agencies who make these evaluations 
and report their findings to SSA.
    Number of Respondents: 54 State agencies.
    Frequency of Response: 11,023 per State agency.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 148,809 hours.
    4. You Can Make Your Payment by Credit Card--0960-0462. The 
information on forms SSA-4588 and SSA-4589 is used by the Social 
Security Administration (SSA) to record payments received via credit 
cards from individuals who have been overpaid by SSA. The respondents 
are overpaid individuals who wish to repay SSA by using their credit 
cards.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 1,000 hours.
    OMB Desk Officer: Laura Oliven.
    Written comments and recommendations regarding these information 
collections should be sent directly to the appropriate OMB Desk Officer 
designated above at the following address: OMB Reports Management 
Branch, New Executive Office Building, room 3208, Washington, DC 20503.

    Dated: March 21, 1994.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 94-6948 Filed 3-24-94; 8:45 am]
BILLING CODE 4190-29-P