[Federal Register Volume 61, Number 248 (Tuesday, December 24, 1996)]
[Notices]
[Page 67865]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-32553]



[[Page 67865]]

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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 require(s) extension of the 
current OMB approval(s):

1. Letter to Employer Requesting Wage Information--0960-0138

    The information collected on form SSA-L4201 is used by the Social 
Security Administration to determine eligibility and proper payment for 
Supplemental Security Income (SSI) applicants/recipients. The 
respondents are employers of applicants for and recipients of SSI 
payments.
    Number of Respondents: 133,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 Minutes.
    Estimated Annual Burden: 66,500 hours.

2. Request for SSI Benefit Estimate--0960-0492

    The information collected on form SSA-3716 will be used by the 
Social Security Administration to comply with a request form an 
estimated of the impact of work on an SSI recipient's benefit. The 
respondents are SSI recipients who want to know how a job opportunity 
could affect the SSI benefits.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 4,167 hours.

3. Claimant's Medications--0960-0289

    The information on form HA-4632 is used by the Social Security 
Administration to compile a current list of medications used by a 
claimant. The list is provided to an Administrative Law Judge (ALJ), 
who is considering the disability aspects of the claim. The affected 
public consists of claimants for disability benefits, who have 
requested a hearing before an ALJ.
    Number of Respondents: 227,107.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 56,777 hours.

Social Security Administration

    To receive a copy of the form(s) or clearance package(s), call the 
SSA Reports Clearance Officer on (410) 965-4125 or write to her at the 
address listed below. 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, 1-A-21 Operations Building, 6401 Security Blvd. 
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.

    Dated: December 7, 1996.
Judith T. Hasche,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 96-32553 Filed 12-23-96; 8:45 am]
BILLING CODE 4190-23-P