[Federal Register Volume 61, Number 213 (Friday, November 1, 1996)]
[Notices]
[Pages 56601-56602]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-28055]
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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(s).
(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 Funds You Provided to Another; Statement of Funds
You Received--0960-0481. The information collected on forms SSA-2854
and SSA-2855 is used by the Social Security Administration to determine
if money borrowed on an informal basis from a noncommercial lender
(friend or relative) is income to the borrower/claimant. The
information is needed to insure that an individual is properly eligible
for Supplemental Security Income (SSI) payments. The respondents are
applicants for and recipients of SSI payments.
Number of Respondents: 40,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 6,667 hours.
2. Physical Residual Functional Capacity Assessment; Mental
Residual Functional Capacity Assessment--0960-0431. The information
collected on forms SSA-4734-U8 and SSA-4734 SUP is needed by the Social
Security Administration to assist in the adjudication of disability
claims involving physical and/or mental impairments. The forms assist
the State Disability Determination Services (DDS) to evaluate
impairment(s) by providing a standardized data collection format to
present findings in a clear, concise and consistent manner. The
respondents are State DDSs administering title II and title XVI
disability programs.
Number of Responses: 1,693,425.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 564,475 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.
Submission for OMB Review; Comment Request
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. 104-
13 effective October 1, 1995, The Paperwork Reduction Act of 1995. The
information collection(s) listed below, which was published in the
Federal Register on September 3, 1996, has been submitted to OMB.
(Call the SSA Reports Clearance Officer on (410) 965-4125 for copies
of the form(s) or package(s).)
OMB Desk Officer: Laura Oliven.
SSA Reports Clearance Officer: Judith T. Hasche.
1. Application for Supplemental Security Income--0960-0229. The
information on form SSA-8000 is used by the Social Security
Administration to determine a claimant's eligibility for benefits and
the amount payable in claims for SSI. The respondents are certain
applicants for SSI.
Number of Respondents: 1,316,678.
Frequency of Response: 1.
Average Burden Per Response:
35 minutes for paper application
25 minutes for automated collection of information
Estimated Annual Burden: 581,533 hours.
2. Statement of Living Arrangements, In-Kind Support and
Maintenance--0960-0174. The information on form SSA-8006 is used by the
Social Security Administration to determine if an applicant or
recipient meets the income
[[Page 56602]]
criteria for eligibility to SSI benefits. The respondents are
individuals who apply for or are receiving SSI payments.
Number of Respondents: 438,400.
Frequency of Response: 1.
Average Burden Per Response: 7 minutes.
Estimated Annual Burden: 51,147 hours.
Written comments and recommendations regarding the information
collection(s) 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
Date: October 25, 1996.
Frederick W. Brickenkamp,
Team Leader, FMRCT, Social Security Administration.
[FR Doc. 96-28055 Filed 10-31-96; 8:45 am]
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