[Federal Register Volume 63, Number 44 (Friday, March 6, 1998)]
[Notices]
[Pages 11325-11326]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-5811]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Collection 
Requests

    This notice lists information collection packages that will require 
submission to the Office of Management and Budget (OMB), in compliance 
with Public Law 104-13 effective October 1, 1995, The Paperwork 
Reduction Act of 1995.
    1. Function Report--Adult, SSA-3373-TEST; Function Report--Third 
Party, SSA-3380-TEST--0960-NEW. SSA will be testing new prototype 
disability forms. The information collected on the forms is needed for 
the determination of disability. The forms record information about the 
disability applicant's illnesses, injuries, conditions, impairment-
related limitations and ability to function. The respondents are Title 
II and Title XVI disability applicants or individuals who know about 
the applicant's impairment, limitations and ability to function.

------------------------------------------------------------------------
                                                                  Third 
                                                        Adult     party 
                                                        form      form  
------------------------------------------------------------------------
Number of respondents...............................     7,000     5,000
Frequency of response...............................         1         1
Average burden per response.........................    \1\ 20    \1\ 20
Estimated annual burden.............................  \2\ 2,33          
                                                             3  \2\ 1,66
                                                                       7
------------------------------------------------------------------------
\1\ Minutes.    \2\ Hours.                                              

    2. Symptoms Report--0960-NEW. SSA will be testing new prototype 
disability forms, including the SSA-3370-TEST. The information 
collected on the form is needed for the determination of disability. 
The form records information about the disability applicant's 
description of symptoms of his or her illness, injury or condition. The 
respondents are applicants for Title II and Title XVI disability 
benefits.
    Number of Respondents: 7,500.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 1,875 hours.
    3. Nursing Home Reporting Requirements Related to Supplemental 
Security Income (SSI) Recipients--0960-NEW. Public Law 103-387 requires 
long term, intermediate care and nursing home administrators to report 
SSI recipient admissions to SSA. SSA uses the information to determine 
whether SSI benefits should be reduced. The respondents are long term, 
intermediate care and nursing home administrators.
    Number of Respondents: 16,000.
    Frequency of Response: 2 per year.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 8,000 hours.
    4. Survey of Interest in International Social Security Agreements--
0960-NEW. Section 233 of the Social Security Act authorizes the U.S. to 
enter into agreements with foreign countries for the purpose of 
eliminating double social security coverage and taxation and closing 
gaps in benefit protection for workers who have divided their careers 
between the U.S. and another country. SSA negotiates these agreements 
for the U.S. SSA is now planning its agreement negotiating agenda for 
the next several years. Since U.S. businesses with overseas operations 
are primary stake-holders in these agreements, SSA needs to survey 
these companies to determine which countries they believe would be good 
candidates for new Social Security agreements. SSA uses the information 
together with estimates of potential foreign tax savings and benefit 
payments, to determine priorities for new Totalization agreement 
negotiations for fiscal years 1999 through 2003. The respondents are 
U.S. businesses with overseas operations who have requested 
certificates of U.S. coverage from SSA.
    Number of Respondents: 600.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 150 hours.
    5. Disability Hearing Officer's Report of Disability--0960-0507. 
The information of form SSA-1204-BK is used by the Disability Hearing 
Officer (DHO) to conduct an document disability hearings and to provide 
a structured format that concerns all conceivable issues relating to 
SSI claims for disabled children. The completed Form SSA-1204-BK will 
aid the DHO in preparing the disability decision and will provide a 
record of what transpired at the hearing. The respondents are DHOs in 
the State Disability Determination Services (DDS).
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 100,000 hours.
    6. Disability Hearing Officer's Report of Disability Heairng--0960-
0440. The information on form SSA-1205 is used by DHOs to conduct and 
record disability hearings. The form serves as a guide in conducting 
the hearings and ensures that all pertinent issues are considered. The 
respondents are DHOs in the State DDSs.
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 100,000 hours.
    7. Disability Hearing Officer's Decision--0960-0441. The DHO uses 
the information on form SSA-1207 and the supplements--which apply to 
the type of claim involved--in preparing

[[Page 11326]]

the disability decision. The form will aid the DHO in addressing the 
crucial elements of the case in a sequential and logical fashion. The 
respondents are DHOs in the State DDSs.
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 75,000 hours.
    8. Chinese Custom Marriage Statement (By One or Both of the 
Parties); and Statement Regarding Chinese Custom Marriage--0960-0086. 
The information on Forms SSA-1344 and 1345 is used by SSA to determine 
if an alleged spouse of the numberholder is legally married, in order 
to be paid Social Security benefits. The respondents are individuals 
applying for benefits based upon a Chinese custom marriage or 
individuals who attended the marriage ceremony.

------------------------------------------------------------------------
                                                      SSA-1344  SSA-1345
------------------------------------------------------------------------
Number of Respondents:..............................       100       100
Frequency of Response:..............................         1         1
Average Burden Per Response:........................     \1\14     \1\14
Estimated Annual Burden:............................     \2\23     \2\23
------------------------------------------------------------------------
\1\ Minutes.     \2\ Hours.                                             

    9. Student's Statement Regarding School Attendance--0960-0105. The 
information on Form SSA-1372 is used by SSA to determine if a claimant 
is entitled to Social Security benefits as a student. The respondents 
are student claimants for Social Security benefits.
    Number of Respondents: 200,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 33,333 hours.
    10. Application for Benefits under the Italy-U.S. International 
Social Security Agreement--0960-0445. The information on form SSA-2528 
is used by SSA to determine if a resident of Italy is eligible for 
Social Security benefits under the Italy-U.S. Social Security 
agreement. The respondents are Italian residents who file for U.S. 
benefits with the Italian Social Security Agency.
    Number of Respondents: 200.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 67 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.
    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: February 27, 1998.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 98-5811 Filed 3-5-98; 8:45 am]
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