[Federal Register Volume 61, Number 90 (Wednesday, May 8, 1996)]
[Notices]
[Pages 20872-20873]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-11447]



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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Collection 
Request

    Normally on Fridays, the Social Security Administration (SSA) 
publishes a list of information collection packages that will require 
submission to the Office of Management and Budget (OMB) for clearance 
in compliance with P.L. 104-13 effective October 1, 1995, The Paperwork 
Reduction Act of 1995. Since the last list was published in the Federal 
Register on April 26, 1996, the information collection listed below has 
been proposed.

(Call the SSA Reports Clearance Officer on (410) 965-4123 for a copy 
of the form(s) or package(s), or write to her at the address listed 
below the information collection.)

    Modified Benefit Formula Questionnaire-Foreign Pension--0960-NEW. 
The information collected on form SSA-308 is used by SSA to determine 
exactly how much (if any) of a foreign pension may be used to reduce 
the amount of Social Security retirement or disability benefits under 
the modified benefit formula. The respondents are applicants for Social 
Security retirement/disability benefits.
    Number of Respondents: 50,000
    Frequency of Response: 1
    Average Burden Per Response: 10 minutes
    Estimated Annual Burden: 8,333 hours
    Written comments and recommendations regarding this information 
collection should be sent within 60 days from the date of this 
publication, directly to the SSA Reports Clearance Officer at the 
following address: Social Security Administration, DCFAM, Attn: 
Charlotte S. Whitenight, 6401 Security Blvd., 1-A-21 Operations Bldg., 
Baltimore, MD 21235.
    In addition to your comments on the accuracy of the agency's burden 
estimate, we are soliciting comments on the need for the information; 
its practical utility; ways to enhance its quality, utility and 
clarity; and on ways to minimize burden on respondents, including the 
use of automated collection techniques or other forms of information 
technology.
Agency Information Collection Activities: Submission for OMB Review; 
Comment Request
    The information collections listed below, which were published in 
the Federal Register on March 15, 1996 have been submitted to OMB.

(Call Reports Clearance Officer on (410) 965-4123 for copies of 
package.)


[[Page 20873]]


    OMB Desk Officer: Laura Oliven
    SSA Reports Clearance Officer: Charlotte S. Whitenight.
    1. Application for Benefits Under a U.S. International Social 
Security Agreement--0960-0448. The information collected on form SSA-
2490 is used by the Social Security Administration to determine a 
claimant's eligibility for U.S. Social Security benefits under the 
provisions of an international social security agreement. It is also 
used to take an application for benefits from a foreign country under 
an agreement. The respondents are individuals who are applying for 
benefits from either the United States and/or a foreign country with 
which the United States has an agreement. The United States currently 
has 17 such agreements.
    Number of Respondents: 20,000
    Frequency of response: 1
    Average Burden Per Response: 30 minutes
    Estimated Annual Burden: 10,000 hours.

    2. Self-Employment/Corporate Officer Questionnaire--0960-0487. The 
information collected on form SSA-4187 is used by the Social Security 
Administration to develop a claimant's earnings or corroborate his or 
her allegation of retirement when he or she is self-employed or a 
corporate officer. The affected public consists of claimants for 
benefits who provide the additional information to support their 
allegation concerning earnings or employment.
    Number of Respondents: 50,000
    Frequency of Response: 1
    Average Burden Per Response: 20 minutes
    Estimated Annual Burden: 16,667 hours.

    3. Statement Regarding the Inferred Death of an Individual by 
Reason of Continued and Unexplained Absence--0960-0002. The information 
collected on form SSA-723 is used to determine if the Social Security 
Administration may infer that a missing person is deceased. The 
respondents are individuals who know or are related to the missing 
person.
    Number of Respondents: 3,000
    Frequency of Response: 1
    Average Burden Per Response: 30 minutes
    Estimated Annual Burden: 1,500 hours.

    4. Partnership Questionnaire--0960-0025. The form SSA-7104 is used 
to collect information which is needed to evaluate partnership 
relationships to determine which portion of the partnership income 
should be credited to each partner. The affected public consists of 
claimants for social security benefits who are involved in a 
partnership.
    Number of Respondents: 12,350
    Frequency of Response: 1
    Average Burden Per Response: 30 minutes
    Estimated Annual Burden: 6,175 hours.

    5. Annual Earnings Operations Direct Mail Followup--0960-0369. The 
information collected on forms SSA-L9778, SSA-L9779, SSA-L9780 and SSA-
L9781 will be used to determine if the recipients have underestimated 
their earnings for the current year. This will allow benefits to be 
withheld if necessary, and will thereby avoid many overpayments. The 
affected public is beneficiaries who are likely to underestimate their 
earnings.
    Number of Respondents: 400,000
    Frequency of Response: 1
    Average Burden Per Response: 10 minutes
    Estimated Annual Burden: 66,667 hours.

    6. Medical Report on Adult or Child With Allegation of Human 
Immunodeficiency Virus (HIV) Infection--0960-0503. The information on 
forms SSA-4814 and SSA-4815 is used by the Social Security 
Administration to determine if an individual claiming to have HIV 
infection meets the requirements for presumptive disability benefits.

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                                        SSA-4814            SSA-4815    
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Number of Respondents............  25,000............  7,500.           
Frequency of Response............  1.................  1.               
Average Burden Per Response......  10 minutes........  10 minutes.      
Estimated Annual Burden..........  4,167 hours.......  1,250 hours.     
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    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: May 2, 1996.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 96-11447 Filed 5-7-96; 8:45 am]
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