[Federal Register Volume 62, Number 116 (Tuesday, June 17, 1997)]
[Notices]
[Pages 32849-32850]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-15764]


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SOCIAL SECURITY ADMINISTRATION


Information Collection Activities: Proposed Collection Requests 
and Comment Requests

    This notice lists information collection packages that will require 
submission to the Office of Management and Budget (OMB), as well as 
information collection packages submitted to OMB for clearance, in 
compliance with Pub.L. 104-13 effective October 1, 1995, The Paperwork 
Reduction Act of 1995.
    I. The information collection(s) listed below require(s) 
extension(s) of the current OMB approval(s) or are proposed new 
collection(s):
    1. Application for Lump-Sum Death Payment--0960-0013. The 
information collected on Form SSA-8-F4 is required to authorize payment 
of the lump-sum death benefit to a widow, widower, or children as 
defined in Section 202(i) of the Social Security Act. The respondents 
are widows, widowers or children who receive lump-sum death benefits.
    Number of Respondents: 735,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 122,500.
    2. Statement Regarding Contributions--0960-0020. Form SSA-783 
collects the information necessary to make a determination of one-half 
support, or contributions to support, in order to entitle certain child 
applicants to Social Security benefits. The respondents are children 
who apply for Social Security benefits.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 7,500.
    3. Application for Search of Census Record for Proof of Age--0960-
0097. The information collected on Form SSA-1535-U3 is required to 
provide the Census Bureau with sufficient identifying information, 
which will allow an accurate search of census records to establish 
proof of age for an individual applying for Social Security benefits. 
It is used for individuals who must establish age as a factor of 
entitlement. The respondents are individuals applying for Social 
Security Benefits.
    Number of Respondents: 18,000.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 3,600.
    4. Claimant's Statement About Loan of Food or Shelter, and 
Statement About Food or Shelter Provided to Another--0960-0529. The 
information on Forms SSA-5062 and SSA-L5063 will be used by the Social 
Security Administration to determine whether food or shelter provided 
to a recipient of supplemental security income (SSI) payments should be 
counted as income. The respondents are SSI recipients who receive food 
or shelter and individuals who provide it to them.
    Number of Respondents: 131,080.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 21,847.
    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: 
Nicholas E. Tagliareni, 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.
    II. The information collection(s) listed below have been submitted 
to OMB:
    1. Certification by Religious Group--0960-0093. The information 
collected by the Social Security Administration on form SSA-1458 is 
used to determine if the religious group of which an individual is a 
member qualifies for a self-employment tax exemption under Section 
1402(g) of the Internal Revenue Code. The respondents are spokespersons 
for religious groups.
    Number of Respondents: 180.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 45 hours.
    2. RSI/DI Quality Review Case Analysis Questionnaires and Annual 
Earnings Test Questionnaire--0960-0189. The information collected on 
forms SSA-2930, SSA-2931 and SSA-2932 is used by the Social Security 
Administration to establish a national payment accuracy rate for all 
cases in payment status and to serve as a source of information 
regarding problem areas in the Retirement and Survivors Insurance (RSI) 
program and Disability Insurance programs. The information is also used 
to measure the accuracy rate for newly adjudicated RSI/DI cases. The 
information collected on form SSA-4659 is used to evaluate the annual 
earnings test (AET) process to determine the effectiveness of the AET 
process. The results will be used to develop ongoing improvements in 
the process. The respondents are RSI and DI beneficiaries.

[[Page 32850]]



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                                                                SSA-2930     SSA-2931     SSA-2932     SSA-4659 
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Number of Respondents.......................................        5,500        2,750        1,375          740
Frequency of Response.......................................            1            1            1            1
Average Burden Per Response (minutes).......................           20           30           30           20
Estimated Annual Burden (Hours).............................        1,833        1,375          688          247
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    3. Questionnaire for Children Claiming SSI Benefits--0960-0499. The 
information collected on form SSA-3881 is used by the Social Security 
Administration to evaluate disability in children who apply for 
supplement security income payments. The respondents are individuals 
who apply for supplement security income benefits for a disable child.
    Number of Respondents: 455,000.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 151,667 hours.
    4. Consent for Release of Information--0960-0567. The information 
collected on form SSA-3288 is used by the Social Security 
Administration (SSA) to ensure that an individual consents to the 
release of his/her personal information to another individual. The 
respondents are individuals assenting to the disclosure of information 
from their social security records to someone else.
    Number of Respondents: 200,000.
    Frequency of response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 10,000 hours.
    5. Request for Self-Employment Information (SSA-2765), Request for 
Employment Information (SSA-3365), Request for Employer Information 
(SSA-4002)--0960-0508. The information is needed by SSA when earnings 
information reported to the agency is incomplete or incorrect. The 
information is used to post the reported earnings to the appropriate 
earnings record. The respondents are employers of the wage earners or 
employees and self-employed individuals for whom the earnings were 
reported.
    Number of Respondents: 3,000,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 500,000 hours.
    6. State Vocational Rehabilitation Agency Claim (SSA-199) and 
Subpart V--Payments for Vocational Rehabilitation Services, 20 CFR 
Sections 404.2104, 404.2108, 404.2113, 404.2117 404.2121, 416.2204, 
416.2208, 416.2213 and 416.2217--0960-0310. The information collected 
on form SSA-199 and through these current rules is used by the Social 
Security Administration to determine if State vocational rehabilitation 
agencies are providing appropriate services, including referrals when 
necessary, and whether those claims for services should be paid.
    Number of Respondents: 80-100.
    Frequency of Response: On occasion.
    Average Burden Per Response: Varies from 23 minutes to 4 hours.
    Estimated Annual Burden: 8,465 hours.
    Written comments and recommendations regarding the information 
collection(s) should be directed within 30 days to the OMB Desk Officer 
and SSA Reports Clearance Officer 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, 
DC 20503
(SSA)
    Social Security Administration, DCFAM, Attn: Nicholas E. 
Tagliareni, 1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 
21235

    To receive a copy of any of the forms or clearance packages, call 
the SSA Reports Clearance Officer on (410) 965-4125 or write to him at 
the address listed above.

    Dated: June 10, 1997.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 97-15764 Filed 6-16-97; 8:45 am]
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