[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]


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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.

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    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

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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]
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