[Federal Register Volume 59, Number 174 (Friday, September 9, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-22105]


[[Page Unknown]]

[Federal Register: September 9, 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, August 26, 1994.

(Call Reports Clearance Officer on (410) 965-4142 for copies of 
package.)

    1. Application for Benefits Under the Federal Mine Safety and 
Health Act of 1977--0960-0118. The information on forms SSA-47, 48, and 
49 is used by the Social Security Administration to determine 
eligibility for benefits on a deceased coal mine worker's account. 
These three forms are used by widows, surviving children, or other 
dependents who may be entitled.
    Number of Respondents: 2,700 (900 each form).
    Frequency of Response: 1.
    Average Burden Per Response: 11 minutes.
    Estimated Annual Burden: 495 hours.
    2. Railroad Employment Questionnaire--0960-0078. The information on 
form SSA-671 is used by the Social Security Administration to 
coordinate with the Railroad Retirement Board to process certain claims 
for Social Security benefits. The respondents are those claimants who 
allege employment in the railroad industry.
    Number of Respondents: 125,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 10,417 hours.
    3. Beneficiary Recontact Report--0960-NEW. Form SSA-1587 will be 
sent by the Social Security Administration to payees who are receiving 
Social Security benefits on behalf of an entitled child aged 15-17 in 
order to determine if that child has married. If so, he or she is no 
longer entitled. The respondents will be such representative payees.
    Number of Respondents: 778,100.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 38,905.
    4. Followup Questionnaire Re: Receipt of SIPEBES--0960-NEW. The 
information on form SSA-7005-95 Test will be used by the Social 
Security Administration to determine the respondent's opinion about 
receiving an SSA-Initiated Personal Earnings and Benefit Estimate each 
year. The respondents will be SSA number holders who were previously 
contacted in 1994.
    Number of Respondents: 4,500.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 900 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: Office of Management and 
Budget, OIRA, New Executive Office Building, Room 10230, Washington, 
D.C. 20503.
    Dated: September 1, 1994.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 94-22105 Filed 9-8-94; 8:45 am]
BILLING CODE 4190-29-P