[Federal Register Volume 63, Number 25 (Friday, February 6, 1998)]
[Notices]
[Pages 6251-6253]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-2905]
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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 PL. 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
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current OMB approval(s) or are proposed new collection(s):
1. Request to have Supplemental Security Income Overpayment
Withheld from My Social Security Benefits--0960-0549. The information
on Form SSA-730-U2 is used by the Social Security Administration (SSA)
to verify that a beneficiary has freely, voluntarily and knowingly
requested that a Supplemental Security Income (SSI) overpayment be
recovered from his or her Old-Age, Survivors and Disability Insurance
benefits. The respondents are overpaid SSI beneficiaries who agree to
have the overpayments withheld from their Social Security benefits.
Number of Respondents: 10,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 833 hours.
2. Farm Self-Employment Questionnaire--0960-0061. The information
on Form SSA-7156 is used by SSA to determine whether an agricultural
trade or business exists and to verify possible covered earnings for
Social Security entitlement purposes. The respondents are claimants for
benefits who allege covered earnings from agricultural self-employment.
Number of Respondents: 47,500.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 7,917 hours.
3. Supplemental Statement Regarding Farming Activities of Person
Living Outside the U.S.A.--0960-0103. SSA uses Form SSA-7163A to
collect needed information whenever a Social Security beneficiary or
claimant reports work on a farm outside the U.S. The data are used for
the purpose of making a determination of work deduction. The
respondents are Social Security beneficiaries or claimants who are
engaged in farming activities outside the U.S.
Number of Respondents: 1,000.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 1,000 hours.
4. Earnings Record Information--0960-0505. The information on Form
SSA-L3231-C1 is used by SSA to ensure that the proper person is
credited with earnings reported for a minor under age 7. The
respondents are businesses reporting earnings for children under age 7.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 3,333 hours.
5. Employer Verification of Earnings After Death--0960-0472. The
information on Form SSA-L4112 is used by SSA to determine whether wages
reported by an employer are correct, when SSA records indicate that the
wage earner is deceased. The respondents are employers who report wages
for a deceased employee.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 8,333 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. Disability Report-Child--0960-0504. Form SSA-3820-BK is used by
the State Disability Determination Services to record claimants'
allegations and sources of evidence in determining eligibility for
children filing for SSI disability benefits. The respondents are SSI
claimants who live in Virginia and are applying for disabled child's
benefits.
Number of Respondents: 10,900.
Frequency of Response: 1.
Average Burden Per Response: 40 minutes.
Estimated Annual Burden: 7,267 hours.
2. Application for Child's Insurance Benefits--0960-0010. The
information collected on Form SSA-4-BK is used to entitle children of
living and deceased workers to Social Security benefits. The
respondents are children of living or deceased workers.
Number of Respondents: 1,740,000.
Frequency of Response: 1.
Average Burden Per Response: 10.5 or 15.5 minutes (depending on the
type of claim).
Estimated Average Burden: 372,417 hours.
3. Notice Regarding Substitution of Party Upon Death of Claimant--
0960-0288. The information collected on Form HA-539 is used to advise
claimants of their statutory right to a hearing and of a decision by
SSA on who, if anyone, should become a substitute party for the
deceased, as provided for in the Social Security Act. The respondents
are individuals requesting hearings on behalf of deceased claimants on
Social Security benefits issues.
Number of Respondents: 35,451.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Average Burden: 2,954 hours.
4. Certificate of Responsibility for Welfare and Care of Child Not
in Applicant's Custody--0960-0019. SSA uses the information collected
on Form SSA-781 to decide if ``in care'' requirements are met by
noncustodial parent(s) (or the spouse of a parent), who is filing for
benefits based on having a child in care. The respondents are
noncustodial wage earners whose entitlement to benefits depends upon
having an entitled child in care.
Number of Respondents: 14,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Average Burden: 2,333 hours.
5. Pain Report--Child--0960-0540. The information collected on Form
SSA-3371-BK is used by SSA to make a determination of disability for a
child under the SSI program. This information is essential to the
adjudication of a claim. The respondents are applicants for SSI child
disability benefits.
Number of Respondents: 250,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 62,500 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,
D.C. 20503
(SSA), Social Security Administration, DCFAM, Attn: Nicholas E.
Tagliareni 1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD
21235
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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: January 30, 1998.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 98-2905 Filed 2-5-98; 8:45 am]
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