[Federal Register Volume 63, Number 101 (Wednesday, May 27, 1998)]
[Notices]
[Pages 29051-29053]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-13964]
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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. Medical Report (General)--0960-0052. The information on Form
SSA-3826 is used by the Social Security Administration (SSA) to
determine the claimant's physical status prior to making a disability
determination and to document disability claims folders with the
medical evidence. The respondents are physicians, hospitals, directors
and medical records librarians.
Number of Respondents: 750,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 375,000 hours.
2. Payment of Certain Travel Expenses--0960-0434. SSA uses the
information required by 20 CFR, sections 404.999(d) and 416.1499 to
reimburse a claimant who has been required to travel over 75 miles to
appear at a medical examination or a disability hearing. The
respondents are claimants who travel more than 75 miles in order to
attend a medical examination or a disability hearing.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 8,333 hours.
3. Social Security Request for Information--0960-0531. The
information on Form SSA-6231 is used by SSA to complete or to clarify
data on Forms SSA-623 or SSA-6230, previously provided by
representative payees. The respondents are representative payees who
furnished incomplete or unclear information.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 25,000 hours.
4. Statement Regarding Student's Attendance--0960-0113. The
information on Form SSA-2434 is used to determine student entitlement
status for the children of coal miners, the children of their widows or
the brothers of deceased coal miners eligible for black lung benefits.
The respondents are dependents of deceased coal miners as cited above,
who are attending school and about to attain age 18.
[[Page 29052]]
Number of Respondents: 50.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 8 hours.
5. Request for the Correction of Earning Records-- 0960-0029. Form
SSA-7008 is used by individual wage earners to request SSA for review,
and if necessary, correction of the Agency's master record of their
earnings. The respondents are individuals who question SSA's record of
their earnings.
Number of Respondents: 375,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 62,500 hours.
6. Plan for Achieving Self Support--0960-0559. The information on
form SSA-545 is collected by SSA when a Supplemental Security Income
(SSI) applicant/recipient desires to use available income and resources
to obtain education and/or training in order to become self-supportive.
The information is used to evaluate the recipient's plan for achieving
self-support to determine whether the plan may be approved under the
provisions of the SSI program. The respondents are SSI applicants/
recipients who are blind or disabled.
Number of Responses: 7,000.
Frequency of Response: Varies per individual.
Average Burden Per Response: 2 hours.
Estimated Annual Burden: 14,000 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. Statement of Agricultural Employer (Years prior to 1988);
Statement of Agricultural Employer (1988 and Later)--0960-0036. The
information on Forms SSA-1002 and SSA-1003 is used by the Social
Security Administration (SSA) to resolve discrepancies when farm
workers have alleged that their employers did not report their wages or
reported them incorrectly. The respondents are agricultural employers.
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SSA-1002 SSA-1003
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Number of Respondents....... 75,000.............. 50,000.
Frequency of Response....... 1................... 1.
Average Burden Per Response. 10 minutes.......... 30 minutes.
Estimated Annual Burden..... 12,500 hrs.......... 25,000 hrs.
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2. Beneficiary Recontact Report--0960-0502. The information on Form
SSA-1588-OCR-SM is used by SSA to recontact mothers, fathers or
children ages 15-17, who receive their benefits directly, to determine
if they are still entitled to benefits. The respondents are
beneficiaries who are in the ``high risk'' area and, therefore, are
most prone to overpayments.
Number of Respondents: 163,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 13,583 hours.
3. Information About Joint Checking/Savings Account--0960-0461. The
information collected on Form SSA-2574 is used by SSA to determine
whether a joint bank account should be counted as a resource of a
Supplemental Security Income (SSI) claimant or applicant in determining
eligibility for SSI. The respondents are applicants for and recipients
of SSI payments and individuals who are joint owners of financial
accounts with SSI applicants/recipients.
Number of Respondents: 200,000.
Frequency of Response: 1.
Average Burden Per Response: 7 minutes.
Estimated Annual Burden: 23,333 hours.
4. Agency/Employer GPO Questionnaire--0960-0470. The information on
Form SSA-4163 is used by SSA to determine the need for and the amount
of any offset of benefits for certain individuals receiving Government
pensions and receiving or applying for Social Security benefits. The
respondents are State governments or their political subdivisions.
Number of Respondents: 1,000.
Frequency of Response: 1.
Average Burden Per Response: 3 minutes.
Estimated Annual Burden: 50 hours.
5. Authorization for the Social Security Administration to Obtain
Records from a Financial Institution and Request for Records--0960-
0293. The information on Form SSA-4641 is used by SSA to determine
whether an applicant meets the resource eligibility requirements for
SSI and Aid to Families with Dependent Children (AFDC). This
information is only used as part of the quality review of the AFDC
program. The respondents are financial institutions.
Number of Respondents: 500,000.
Frequency of Response: 1.
Average Burden Per Response: 6 minutes.
Estimated Annual Burden: 50,000 hours.
6. Statement of Household Expenses and Contributions--0960-0456.
The information on Form SSA-8011-F3 is used by SSA to obtain or
corroborate contributions made by the claimant/recipient toward
household expenses. SSA uses the information to correctly determine the
amount of unearned income received by the claimant/recipient in order
to determine the individual's eligibility and payment amount under the
SSI program. The respondents are household members of SSI claimants/
recipients.
Number of Respondents: 400,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 100,000 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.
[[Page 29053]]
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: May 19, 1998.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 98-13964 Filed 5-26-98; 8:45 am]
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