[Federal Register Volume 62, Number 116 (Tuesday, June 17, 1997)]
[Notices]
[Pages 32850-32851]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-15841]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities; Request for Emergency 
Review by the Office of Management and Budget

    The Social Security Administration publishes a list of information 
collection packages that will require clearance by OMB in compliance 
with P.L. 104-13 effective October 1, 1995, The Paperwork Reduction Act 
of 1995. The information collection listed below has been submitted to 
OMB for emergency clearance. OMB approval has been requested by June 
12, 1997:
    0960-NEW. The information collected on forms SSA-3368, SSA-3369 and 
SSA-3820 will be used in the determination of disability by the State 
Disability Determination Services. The SSA-3368 will be used to develop 
medical evidence and to assess the alleged disability. The SSA-3369 
will be used to collect information about an individual's past work 
history. The SSA-3820 will be used to obtain various types of 
information about a child's condition, his/her treating sources and/or 
other medical sources of evidence. The respondents are applicants for 
disability benefits.

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                                     SSA-3368     SSA-3369     SSA-3820 
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Number of Respondents............    2,438,496    1,000,000      523,000
Frequency of Response............            1            1            1
Average Burden Per Response                                             
 (minutes).......................           45           30           20
Estimated Annual Burden (hours)..    1,828,872      500,000      174,333
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    To receive a copy of the form or clearance packages, call the SSA 
Reports Clearance Officer on (410) 965-4125 or write to him at the 
address listed below. Written comments and recommendations regarding 
the information collection(s) should be directed 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

[[Page 32851]]

10230, 725 17th St., NW, Washington, D.C. 20503

(SSA)

Social Security Administration, DCFAM, Attn: Nicholas E. Tagliareni, 
6401 Security Blvd., 1-A-21 Operations Bldg., Baltimore, MD 21235.

    Dated: June 11, 1997.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 97-15841 Filed 6-16-97; 8:45 am]
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