[Federal Register Volume 62, Number 124 (Friday, June 27, 1997)]
[Notices]
[Page 34735]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-16749]


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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 Public Law 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):
    Waiver of Benefit Payments--0960-0533. Form SSA-149 is required to 
document the fact that benefits due are not being paid, because the 
beneficiary (for personal reasons) has requested nonreceipt. Personal 
reasons can range from religious, patriotic, or political beliefs to 
situations where continued receipt of payment causes some adverse 
effect. The respondents are beneficiaries who waive entitlement to 
benefit payments.
    Number of Respondents: 100.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Average Burden: 8 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: 
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. Application for Special Age 72-or-Over Monthly Payments--0960-
0096. The information collected on form SSA-19 is used by SSA to 
determine entitlement of individuals to special age 72-or-over 
payments. The respondents are applicants who file for the special 
payment.
    Number of Respondents: 15.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Average Burden: 5 hours.
    2. State Agency Report of Obligations for SSA Disability Program--
0960-0421. The information collected on form SSA-4513 is used by SSA in 
a detailed analysis and evaluation of costs incurred by the State 
Disability Determination Services (DDS) in making determinations of 
disability for SSA and to determine funding levels for each DDS. The 
respondents are State DDS offices.
    Number of Respondents: 54.
    Frequency of Response: 4.
    Average Burden Per Response: 1 hour.
    Estimated Annual Burden: 216 hours.
    3. Statement for Determining Continuing Eligibility for 
Supplemental Security Income Payments--0960-0416. The information 
collected by the Social Security Administration on form SSA-8203 is 
used to determine whether SSI recipients have met and continue to meet 
all statutory and regulatory requirements for SSI eligibility and 
whether they have been and are still receiving the correct payment 
amount. The information collected will also assist agencies 
administering Medicaid programs in ascertaining the legal liability of 
third parties to pay for care and services. The respondents are 
recipients of SSI benefits or their representative payees.
    Number of Respondents: 552,000.
    Frequency of Response: 1.
    Average Burden Per Response: 17 minutes.
    Estimated Annual Burden: 156,400 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 20, 1997.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 97-16749 Filed 6-26-97; 8:45 am]
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