[Federal Register Volume 61, Number 192 (Wednesday, October 2, 1996)] [Notices] [Pages 51481-51483] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 96-25186] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION Agency Information Collection Activities: Proposed Collection Request 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 Public Law 104-13 effective October 1, 1995, The Paperwork Reduction Act of 1995. The information collection(s) listed below requires extension of the current OMB approval. (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 collection(s).) 1. Privacy and Disclosure of Official Records and Information; Availability of Information and Records to the Public--20 CFR 401 and 402;--0960-NEW. The respondents are individuals requesting access to their SSA records, correction of their SSA records and disclosure of SSA records. The information is required to: (a) Identify individuals who request access to their records; Number of Respondents: 10,000. Frequency of Response: On occasion. Average Burden Per Response: 11 minutes. Estimated Annual Burden: 1,833 hours. (b) Designate an individual to receive and review a recordholder's sensitive medical records in accordance with 20 CFR 401.55, and for the disclosure of such records to the recordholder by his/her designee. Number of Respondents: 3,000. Frequency of Response: On occasion. Average Burden Per Response: 2 hours (This includes the time needed for the designee to review the recordholder's medical records.) Estimated Annual Burden: 6,000. (c) Correct or amend records; Number of Respondents: 100. Frequency of Response: On occasion. Average Burden Per Response: 10 minutes. [[Page 51482]] Estimated Annual Burden: 17 hours. (d) Obtain consent from an individual to release his/her records to others. Consents are submitted by letter in writing or by use of an SSA-3288; Number of Respondents: 200,000. Frequency of Response: On occasion. Average Burden Per Response: 3 minutes. Estimated Annual Burden: 10,000 burden hours. (e) Facilitate the release of information under the Freedom of Information Act (FOIA); Number of Respondents: 15,000. Frequency of Response: On occasion. Average Burden Per Response: 5 minutes. Estimated Annual Burden: 1,250 hours. (f) Grant a waiver or reduction of fees for records requested under FOIA. Number of Respondents: 400. Frequency of Response: On occasion. Average Burden Per Response: 5 minutes. Estimated Annual Burden: 33 hours. 2. Report of New Information in Disability Cases--0960-0071. The information collected on form SSA-612 is needed by the Social Security Administration to determine whether an event or change in circumstances will affect an individual's disability benefits. The information will be used to determine continued eligibility for disability payments. The respondents are disabled social security beneficiaries or their representative payees. Number of Respondents: 200,000. Frequency of Response: 1. Average Burden Per Response: 5 minutes. Estimated Annual Burden: 16,667. 3. Instructions for Completion of Federal Assistance Application Form SSA-96 for SSA Research and Demonstration Grant Programs--0960- 0184. The information collected on form SSA-96 is needed by the Social Security Administration to evaluate and select grant proposals for funding. The respondents are applicants for federal assistance, including State and local governments, educational institutions and other nonprofit and for-profit organizations. Number of Respondents: 200. Frequency of Response: On occasion. Average Burden Per Response: 14 hours. Estimated Annual Burden: 2,800 hours. 4. Request to be Selected as Payee--0960-0014. The information collected on form SSA-11-BK is needed by the Social Security Administration to determine the proper payee for a Social Security beneficiary. The information is used to establish an applicant's relationship to the beneficiary, his/her justification and concern for the beneficiary, and the manner in which the benefits will be used. The respondents are applicants for representative payee of individuals receiving title II, title XVI and Black Lung benefits. Number of Respondents: 1,709,657. Frequency of Response: 1. Average Burden Per Response: 11 minutes. Estimated Annual Burden: 313,437. 5. Supplemental Security Income Claim Information Notice--0960- 0324. The information collected on form SSA-L8050-U3 will be used by the Social Security Administration to ensure that all sources of potential income which can be used to provide for an individual's own support and maintenance are utilized. The respondents are applicants for SSI and recipients who are potentially eligibility for benefits from other public or private programs. Number of Respondents: 7,500. Frequency of Response: 1. Average Burden Per Response: 10 minutes. Estimated Annual Burden: 1,250 hours. 6. Supplemental Security Income--Quality Review Case Analysis; 0960-0133. The information collected on form SSA-8508-BK is used by the Social Security Administration to assess the effectiveness of SSI policies and procedures and to establish payment accurate rates. The respondents are a random sample of SSI recipients. Number of Respondents: 14,000. Frequency of Response: 1. Average Burden Per Response: 60 minutes. Estimated Annual Burden: 14,000 hours. 7. Marital Relationship Questionnaire--0960-0460. The information collected on form SSA-4178 is needed by the Social Security Administration to determine whether unrelated individuals of the opposite sex who are living together present themselves to the public as husband and wife. The information is used to determine whether correct payment is being made to SSI couples and individuals. Number of Respondents: 5,100. Frequency of Response: 1. Average Burden Per Response: 5 minutes. Estimated Annual Burden: 425 hours. Written comments and recommendations regarding the information collection(s) 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. Agency Information Collection Activities: Submission for OMB Review; Comment Request The information collections listed below, which were published in the Federal Register on August 2, 1996, have been submitted to OMB. OMB Desk Officer: Laura Oliven. SSA Reports Clearance Officer: Judith T. Hasche. 1. Reporting Changes That Affect Your Social Security--0960-0073. The information collected by the Social Security Administration on form SSA-1425 is used to determine a beneficiary's continuing entitlement to Social Security benefits and to determine the proper benefit amount. The respondents are Social Security beneficiaries who need to report an event which could affect their payments. Number of Respondents: 70,000. Frequency of Response: On occasion. Average Burden Per Response: 5 minutes. Estimated Annual Burden: 5,833 hours. 2. Student Reporting Form--0960-0088. The information collected by the Social Security Administration on form SSA-1383 is used to determine if an event or change will affect a student's eligibility for Social Security benefits and to determine the correct benefit amount. The respondents are student beneficiaries or their representative payees who report an event or change. Number of Respondents: 75,000. Frequency of Response: On occasion. Average Burden Per Response: 6 minutes. Estimated Annual Burden: 7,500 hours. 8. Psychiatric Review Technique--0960-0413. The information collected on form SSA-2506 by the Social Security Administration is needed to assist in the adjudication of claims involving mental impairments. The information is used to identify the need for additional evidence for the determination of impairment severity; to [[Page 51483]] consider aspects of the mental impairment relevant to the individual's ability to work; and to organize and present the findings in a clear, concise manner. The respondents are State Disability Determination Services administering title II and title XVI disability programs. Number of Responses: 796,346. Frequency of Response: 1. Average Burden Per Response: 15 minutes. Estimated Annual Burden: 199,087. 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, 725 17th St., NW, 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: September 25, 1996. Judith T. Hasche, Reports Clearance Officer, Social Security Administration. [FR Doc. 96-25186 Filed 10-1-96; 8:45 am] BILLING CODE 4190-29-P