[Federal Register Volume 60, Number 206 (Wednesday, October 25, 1995)]
[Notices]
[Pages 54750-54751]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-26424]



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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 as amended (P.L. 104-13 effective 10/1/95), The Paperwork 
Reduction Act. The following clearance packages have been submitted to 
OMB since the last list was published in the Federal Register on 
October 6, 1995.

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

OMB Desk Officer: Laura Oliven
SSA Reports Clearance Officer: Charlotte S. Whitenight

    1. Statement by School Official About Student's Attendance and 
Statement to U.S. Social Security Administration by School Outside the 
U.S. About Student's Attendance--0960-0090. The information on forms 
SSA-1371 and SSA-1371FC is used by the Social Security Administration 
to determine a student's alleged full time attendance at an educational 
institution in cases where such attendance is needed for continued 
entitlement to benefits. The respondents are the school officials who 
provide the information on these forms.

Number of Respondents: 5,000
Frequency of Response: 1 

[[Page 54751]]

Average Burden Per Response: 10 minutes
Estimated Annual Burden: 833 hours

    2. Report of Continuing Disability Interview--0960-0072. The 
information on form SSA-454 is used by the Social Security 
Administration to determine whether a person who receives Social 
Security Disability benefits is still unable to work because of his/her 
disability. It will be used to make a determination as to whether the 
Disability benefits should continue or terminate. The affected public 
will consist of approximately 300,000 Social Security Disability 
benefit recipients.

Number of Respondents: 300,000
Frequency of Response: 1
Average Burden Per Response: 30 minutes
Estimated Annual Burden: 150,000 hours

    3. Medical Report (Individual With Childhood Impairment)--0960-
0102. The information on form SSA-3827 is used by the Social Security 
Administration to determine if an individual with a childhood 
impairment medically qualifies for benefits or payments under the 
provisions of the Social Security Act. Without this data, SSA would not 
by able to properly evaluate the medical aspects of an individual's 
claim or application. The respondents will be attending physicians/
medical sources.

Number of Respondents: 12,000
Frequency of Response: 1
Average Burden Per Response: 30 minutes
Estimated Annual Burden: 6,000 hours

    4. Agreement to Sell Property--0960-0127. The information on form 
SSA-8060 is used by the Social Security Administration when individuals 
or couples who are otherwise eligible for Supplemental Security Income 
(SSI) benefits, but whose resources exceed the allowable limit, may 
receive conditional payments if they agree to dispose of their excess 
nonliquid resources and make repayment. The respondents will be 
applicants for and recipients of SSI benefits.

Number of Respondents: 20,000
Frequency of Response: 1
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 3,333 hours

    5. Application for Survivors Benefits--0960-0062. The information 
on form SSA-24 is used by the Social Security Administration to 
determine if an individual who is filing for benefits from the 
Department of Veterans Affairs (DVA) may also be entitled by SSA. The 
respondents are claimants for VA benefits.

Number of Respondents: 3,200
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 800 hours

    6. Modified Benefit Formula Questionnaire--0960-0395. The 
information on form SSA-150 is used by the Social Security 
Administration to determine the correct formula to be used in computing 
the Social Security benefit of someone who also receives a benefit from 
employment not covered by Social Security. The respondents will be 
people who are entitled to both types of benefits.

Number of Respondents: 90,000
Frequency of Response: 1
Average Burden Per Response: 8 minutes
Estimated Annual Burden: 12,000 hours

    7. Modified Benefit Formula Questionnaire, Employer--0960-0477. The 
information on form SSA-50 is used by the Social Security 
Administration to verify the claimant's allegation that he or she 
received a pension based on union-covered employment after 1956. It 
also shows whether or not the individual became eligible for that 
pension before 1985. The respondents will be persons who are first 
eligible for both Social Security benefits and a pension from 
noncovered employment after 1985.

Number of Respondents: 30,000
Frequency of Response: 1
Average Burden Per Response: 20 minutes
Estimated Annual Burden: 10,000 hours

    8. Report of Student Beneficiary About to Attain Age 19--0960-0274. 
The information on form SSA-1390 is used by the Social Security 
Administration to determine whether a student beneficiary is entitled 
to benefits for the month of attainment of age 19 and subsequent 
months. The respondents will be student beneficiaries about to attain 
age 19.

Number of Respondents: 50,000
Frequency of Response: 1
Average Burden Per Response: 5 minutes
Estimated Annual Burden: 4,167 hours

    9. Reconsideration Disability Report--0960-0144. The information on 
form SSA-3441 is used by the Social Security Administration to 
determine if the claimant's medical or vocational situation changed 
after the initial disability determination. This form also elicits 
additional sources of medical and vocational evidence which were not 
considered in the initial determination. The respondents are disability 
beneficiaries who request a reconsideration.

Number of Respondents: 400,000
Frequency of Response: 1
Average Burden Per Response: 30 minutes
Estimated Annual Burden: 200,000 hours

    Written comments and recommendations regarding these information 
collections should be sent within 30 days of the date of this 
publication. Comments may be directed to OMB and SSA at the following 
addresses:

(OMB)
    Office of Management and Budget, OIRA, Attn: Laura Oliven, New 
Executive Office Building, Room 10230, Washington, D.C. 20503
(SSA)
    Social Security Administration, DCFAM, Attn: Charlotte S. 
Whitenight, 6401 Security Blvd, 1-A-21 Operations Bldg., Baltimore, MD 
21235

    Dated: October 18, 1995.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 95-26424 Filed 10-24-95; 8:45 am]
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