[Federal Register Volume 61, Number 106 (Friday, May 31, 1996)]
[Notices]
[Pages 27380-27382]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-13595]



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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Collection 
Request

    Normally on Fridays, the Social Security Administration publishes a 
list of information collection packages that will require submission to 
the Office of Management and Budget (OMB) for clearance in compliance 
with Pub. L. 104-13 effective October 1, 1995, The Paperwork Reduction 
Act of 1995. Since the last list was published in the Federal Register 
on May 17, 1996, the information collections listed below have been 
proposed or will require extension of the current OMB approvals:

(Call the SSA Reports Clearance Officer on (410) 965-4125 for a copy of 
the form(s) or package(s), or write to her at the address listed below 
the information collections.)
    1. Statement of Income and Resources--0960-0124. The form SSA-8010 
is used to obtain information about income and resources of individuals 
whose income may be ``deemed'' (considered available) to applicants/
recipients of SSI. The information is used by the Social Security 
Administration to make initial or continuing eligibility determinations 
and to determine the amount of the SSI payment. The respondents are 
individuals whose income may be ``deemed'' to the SSI applicant/
recipient.
    Number of Respondents: 355,000.
    Frequency of Response: 1.
    Average Burden Per Response: 25 minutes.
    Estimated Annual Burden: 147,917 hours.
    2. Application for Supplemental Security Income--0960-0444. The 
information collected on the SSA-8001 is used by the Social Security 
Administration to determine whether applicants for SSI benefits meet 
all statutory and regulatory requirements for eligibility and, if so, 
the amount of benefits payable. The respondents are applicants for SSI 
benefits.

[[Page 27381]]

    Number of Respondents: 1,781,849.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 445,462.
    3. Application for Widow's or Widower's Insurance Benefits--0960-
0004. The information collected on form SSA-10 is used by the Social 
Security Administration to determine whether applicants for widow's/
widower's benefits meet all the statutory and regulatory requirements 
for eligibility. The respondent's are surviving widow's and widower's 
age 60 or older, or age 50, if disabled.
    Number of Respondents: 640,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 160,000 hours.
    4. Request for Waiver and Recovery Questionnaire--0960-0037. The 
form SSA-632 collects information on the circumstances surrounding 
overpayments of Social Security benefits to recipients. The information 
is used by the Social Security Administration to determine if recovery 
of the overpayment amount can be waived or must be repaid, and if so, 
how recovery will be made. The respondents are recipients who have been 
overpaid Social Security, Medicare, Black Lung or SSI benefits.
    Number of Respondents: 500,000.
    Frequency of Response: On occasion.
    Average Burden Per Response: 25 minutes.
    Estimated Annual Burden: 208,333 hours.
    5. Application for Parent's Insurance Benefits--0960-0012. The 
information collected on form SSA-7 is used by the Social Security 
Administration to determine entitlement of an individual to parent's 
insurance benefits. The respondents are parents who were dependent on 
the worker for at least one-half of their support.
    Number of Respondents: 1,400.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 350 hours.
    6. Permanent Residence in the U.S.--0960-451. The information 
collected by the Social Security Administration is used to determine if 
aliens meet the statutory and regulatory requirements for eligibility 
to SSI benefits. The respondents are aliens who are apply for and are 
recipients of SSI payments.
    Number of Respondents: 271,800.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 22,650 hours.
    Written comments and recommendations regarding these information 
collections 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: Judith 
T. Hasche, 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.
    The information collections listed below, which were published in 
the Federal Register on March 29 and April 5, 1996, have been submitted 
to OMB.
    1. Videoconference Evaluation Recontact Survey--0960-NEW. The 
purpose of the survey is to obtain public reaction to conducting 
business using videoconferencing technology. The information will be 
used by the Social Security Administration to determine the 
effectiveness of using videoconferencing for conducting claims and 
hearing interviews. The respondents are applicants for Social Security 
disability benefits and Supplemental Security Income disability 
benefits.
    Number of Respondents: 400.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 100 hours.
    2. Application for a Social Security Card--0960-0066. The 
information collected on form SS-5 is used by the Social Security 
Administration to assign Social Security Numbers so that individuals 
may obtain employment, report earnings, open back accounts, pay taxes, 
apply for benefits, and for other purposes. The respondents are 
individuals who apply for Social Security Numbers.
    Number of Respondents: 20,000,000.
    Frequency of Response: 1.
    Average Burden Per Response: 8 minutes.
    Estimated Annual Burden: 2,666,667 hours.
    3. Statement Regarding Date of Birth and Citizenship--0960-0016. 
The information collected on form SSA-702 is used by the Social 
Security Administration in conjunction with other evidence to establish 
a claimant's age or citizenship when better proofs are not available. 
The respondents are individuals who have knowledge of the birth and 
citizenship of an applicant.
    Number of Respondents: 18,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 3,000.
    4. Application for Mother's or Father's Insurance Benefits--0960-
0003. The information collected on form SSA-5 is used by the Social 
Security Administration to determine an applicant's eligibility to 
mother's or father's insurance benefits. The respondents are 
individuals who wish to file an application for such benefits.
    Number of Respondents: 180,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 45,000 hours.
    5. Marriage Certification--0960-0009. The information collected on 
form SSA-3 is needed to provide evidence of an alleged marriage. Social 
Security uses the information to update records of marital status of an 
individual. The respondents are persons who apply for Social Security 
benefits and allege a current marriage.
    Number of Respondents: 200,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 16,667 hours.
    6. Report on Individual with Childhood Impairment--0960-0084. The 
information collected on form SSA-1323 is used to determine the dates 
and results of psychometric testing and how the impairment affects the 
individual's progress in school. The respondents are public and private 
school officials and agencies which provide medical treatment to the 
applicant or claimant for benefits.
    Number of Responses: 7,000.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 2,333.
    7. Report on Individual with Mental Impairment--0960-0058. The 
information collected on form SSA-824 is used to determine a claimant's 
physical and mental status prior to making a disability determination. 
The respondents are treating physicians, medical directors, medical 
record libraries, and other health professionals.
    Number of Responses: 50,000.
    Frequency of Response: 1.
    Average Burden Per Response: 36 minutes.
    Estimated Annual Burden: 30,000.
    8. Claimant's Recent Medical Treatment--0960-0292. The information 
collected on form HA-4631

[[Page 27382]]

is used by the Social Security Administration to provide an updated 
medical history for a disability claimant who requests a hearing. The 
respondents are claimants for disability benefits who have requested a 
hearing and do not have updated medical evidence in file.
    Number of Respondents: 211,006.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 35,168.
    9. Request for Review of Hearing Decision/Order--0960-0277. The 
information collected on form HA-520 is needed in order to afford 
claimants their statutory right under the Social Security Act to 
request review of a hearing decision. The data will be used to 
determine the course of action appropriate to resolve each issue. The 
respondents are claimants denied benefits or dissatisfied with a 
decision made regarding their claim.
    Number of Respondents: 87,632.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 14,605.
    10. Claimant's Work Background--0960-0300. The information 
collected on form HA-4633 is used by the Social Security Administration 
in cases in which claimants for disability benefits have requested a 
hearing on the decision regarding their claim. A completed form 
provides an updated summary of a claimant's past relevant work and 
helps the Administrative Law Judge to better decide whether or not the 
claimant is disabled. The respondents are claimants who have requested 
a hearing and whose relevant work background is not in file.
    Number of Respondents: 200,958.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 50,240.
    11. Medical Use Report, 20 CFR 416.268--0960-0552. The information 
required by this regulation is used by the Social Security 
Administration to determine if an individual is entitled to special 
Supplemental Security Income (SSI) payments. The respondents are SSI 
recipients whose payments were stopped based on earnings.
    Number of Respondents: 25,000.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 1,250 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: Judith T. Hasche, 
6401 Security Blvd, 1-A-21 Operations Bldg., Baltimore, MD 21235

    Dated: May 23, 1996.
Judith T. Hasche,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 96-13595 Filed 5-30-96; 8:45 am]
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