[Federal Register Volume 60, Number 47 (Friday, March 10, 1995)]
[Notices]
[Pages 13161-13162]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-5829]



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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 
P.L. 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 February 10, 1995. (Call Reports 
[[Page 13162]] Clearance Officer on (410) 965-4142 for copies of 
package.)
    1. Real Property Current Market Value--0960-0471. The information 
on form SSA-2794 is used by the Social Security Administration to 
determine the value of non-home real property owned by applicants for 
or recipients of Supplemental Security Income. The respondents are 
persons experienced in estimating the current market of real property.

Number of Respondents: 6,188
Frequency of Response: 1
Average Burden Per Response: 20 minutes
Estimated Annual Burden: 2,063 hours

    2. Employer Verification of Earnings After Death--0960-0472. The 
information on form SSA-L4112 is used by the Social Security 
Administration to determine whether wages reported by an employer are 
correct, when SSA records indicate the wage earner is deceased. The 
respondents are employers who report wages for a deceased employee.

Number of Respondents: 50,000
Frequency of Response: 1
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 8,333 hours

    3. Farm Self-Employment Questionnaire--0960-0061. The information 
on form SSA-7156 is used by the Social Security Administration to 
determine whether an agricultural trade or business exists and possible 
covered earnings for Social Security entitlement purposes. The 
respondents are claimants for benefits who allege covered earnings from 
agricultural self-employment.

Number of Respondents: 47,500
Frequency of Response: 1
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 7,917 hours

    4. SSI PE Returned Check Questionnaire--0960-NEW. The information 
on form SSA-281 will be used by the Social Security Administration to 
improve the accuracy of the SSA PE returned check process. The purpose 
of the questionnaire is to collect statistical information needed to 
identify areas which are deficient, thereby improving service to the 
public and reducing Government expenditures. The respondents are SSI 
beneficiaries or their representative payees.

Number of Respondents: 1,000
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 250 hours

    5. Report by Former Representative Payee--0960-0112. The 
information on form SSA-625 is used by the Social Security 
Administration to determine if State institutions or agencies which 
were formerly payees for Social Security benefits have properly used 
such funds. The respondents are State institutions or agencies who have 
terminated representative payee services.
Number of Respondents: 8,000
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 2,000 hours

    6. Certificate of Support--0960-0001. The information on form SSA-
760 is used by the Social Security Administration to determine if a 
parent of a deceased wage earner or a spouse receiving a Government 
pension meets the one-half support requirement for entitlement to 
benefits. The respondents are parents of deceased wage earners and 
spouses who are entitled to receive a Government pension.

Number of Respondents: 18,000
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 4,500 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: March 6, 1995.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 95-5829 Filed 3-9-95; 8:45 am]
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