[Federal Register Volume 64, Number 93 (Friday, May 14, 1999)]
[Notices]
[Pages 26472-26474]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-12172]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
In compliance with Public Law 104-13, the Paperwork Reduction Act
of 1995, the Social Security Administration (SSA) is providing notice
of its information collections that require submission to the Office of
Management and Budget (OMB). SSA is soliciting comments on the accuracy
of the agency's burden estimate; 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.
I. The information collections listed below will be submitted to
OMB within 60 days from the date of this notice. Therefore, comments
and recommendations regarding the information collections would be most
useful if received by the Agency within 60 days from the date of this
publication. Comments should be directed to the SSA Reports Clearance
Officer at the address listed at the end of this publication. You can
obtain a copy of the collection instruments by calling the SSA Reports
Clearance Officer on (410) 965-4145, or by writing to him at the
address listed at the end of this publication.
1. Marriage Certification--0960-0009. Form SSA-3 is used by the
Social Security Administration (SSA) to determine whether the spouse's
claimant has the necessary relationship to the worker as required by
section 216 (h)(1) of the Social Security Act (the Act). The
respondents are applicants for Spouse's Benefits.
Number of Respondents: 180,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 15,000 hours.
2. Claimant's Work Background--0960-0300. The information collected
on Form HA-4633 is used by SSA in
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cases in which claimants for disability benefits have requested a
hearing on the decision regarding their claim, which is a statutory
right granted to claimants under the Act. A completed form provides an
updated summary of a claimant's past relevant work and helps the
Administrative Law Judge better decide whether or not the claimant is
disabled. The respondents are claimants who request a hearing on
entitlement to disability benefits, under titles II and/or XVI of the
Act.
Number of Respondents: 120,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 30,000 hours.
3. Report on Individual with Childhood Impairment--0960-0084. Form
SSA-1323 is used by SSA to determine the claimant's medical status
prior to making disability determinations. The respondents are public
and nonpublic schools and agencies who provide status reports on
claimants applying for disability benefits.
Number of Respondents: 7,000.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 2,333 hours.
4. Medicare Buy-In Part B Screening Guide--0960-0601. Pub. L. 105-
277 authorizes SSA to conduct a Medicare buy-in demonstration project
to evaluate means to promote the Medicare buy-in programs targeted to
elderly and disabled individuals under titles XVIII and XIX of the
Social Security Act. A lack of awareness about the Medicare buy-in
programs appears to be one of the major obstacles to enrollments. Other
obstacles to enrollment include the confusion of potential eligibles as
to how to apply for these programs and a preference for dealing with
SSA field offices rather than with local Medicaid offices.
SSA will screen respondents voluntarily for potential Medicare Part
B buy-in eligibility using a screening guide developed for this
purpose. The screening guide will collect information from SSA
beneficiaries regarding income, resources, marital status, and living
arrangements and also ask questions about their awareness of Medicare
Part B buy-in programs. SSA will gather this information to identify
and overcome obstacles to Medicare Part B buy-in enrollments and to
determine potential eligibility for Medicare Part B benefits. The
screening guide will be in use from March 1, 1999 through December 31,
1999.
Number of Respondents: 130,000.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 43,334 hours.
5. Supplemental Security Income Notice of Interim Assistance
Reimbursement (two forms)--0960-0546. Please note that these forms were
previously approved under 2 OMB numbers, form SSA-8125--0960-0546 and
form SSA-L8125-F6--0960-0563. However, because these forms are
interrelated, SSA is combining them under 0960-0546. Forms SSA-8125 and
SSA-L8125-F6 collect interim assistance reimbursement (IAR) information
from the States that provide such assistance. Form SSA-8125 is used in
situations where IAR can be distributed directly to the recipient after
the State has deducted the amount of assistance it provided. Form SSA-
L8125-F6 is used in situations where a recipient entitled to
underpayments has received IAR from a state and SSA will control the
benefit through the installment process. The respondents are states
that provide IAR to Supplemental Security Income (SSI) claimants.
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SSA-8125 SSA-L8125-F6
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Number of Respondents................... 50,000............................ 50,000.
Frequency of Response................... 1................................. 1.
Average Burden Per Response............. 10 minutes........................ 10 minutes.
Estimated Annual Burden................. 8,333 hours....................... 8,333 hours.
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6. State Report of Incorrect Bendex Information--0960-0517. SSA
uses the information collected on Form SSA-1086 to correct its master
database and to facilitate the electronic exchange of data. The
respondents are State agencies administering programs for Aid to
Families with Dependent Children.
Number of Respondents: 123.
Frequency of Response: 2.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 41 hours.
II. The information collections listed below have been submitted to
OMB for clearance. Written comments and recommendations on the
information collections would be most useful if received within 30 days
from the date of this publication. Comments should be directed to the
SSA Reports Clearance Officer and the OMB Desk Officer at the addresses
listed at the end of this publication. You can obtain copies of the OMB
clearance packages by calling the SSA Reports Clearance Officer on
(410) 965-4145, or by writing to him.
1. Request for Hearing--0960-0269. The information collected on
form HA-501 is used by SSA to process a request for hearing on an
unfavorable determination of entitlement or eligibility to benefits
administered by SSA. The respondents are individuals whose claims for
benefits are denied and who request a hearing on the denial.
Number of Respondents: 554,100.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Average Burden: 92,350 hours.
2. Petition to Obtain Approval of a Fee for Representing a Claimant
Before The Social Security Administration--0960-0104. SSA uses form
SSA-1560 if the representative files a fee petition to obtain approval
of a fee for representing a claimant. The representative must file
either a fee petition or a fee agreement with SSA in order to charge
for representing a claimant in proceedings before the Agency. The
information is reviewed by SSA to determine a reasonable fee for the
representative's services. The respondents are attorneys and other
persons representing Social Security claimants.
Number of Respondents: 34,624.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Average Burden: 17,312 hours.
3. Letter to Landlord Requesting Rental Information--0960-0454.
Form SSA-L5061 is used by SSA to provide a nationally uniform vehicle
for collecting information from landlords in making a rental subsidy
determination in the SSI Program. The responses are used in deciding
whether income limits are met. The respondents are landlords who
provide subsidized rental arrangements to SSI applicants and
recipients.
[[Page 26474]]
Number of Respondents: 49,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Average Burden: 8,167 hours.
4. Farm Arrangement Questionnaire--0960-0064. SSA needs the
information collected on form SSA-7157-F4 to determine if farm rental
income may be considered self-employment income for Social Security
coverage purposes. The respondents are individuals alleging self-
employment income from renting land for farming activities.
Number of Respondents: 38,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Average Burden: 19,000 hours.
5. State Contribution Return--0960-0041. SSA uses the information
on form SSA 3961 to identify and account for all contributions owed and
paid, under section 218 of the Social Security Act. The data is used to
balance each deposit made by a State and to allocate the deposited
contributions by specific liability. The form is ultimately used to
provide audit statements to State agencies and to perform Trust Fund
accounting. The respondents are State Social Security agencies (one
agency in each state, Puerto Rico, and the Virgin Islands) and each of
approximately 65 interstate instrumentalities.
Number of Respondents: 10,000.
Frequency of Response: 1.
Average Burden Per Response: 3 minutes.
Estimated Average Burden: 500 hours.
(SSA Address)
Social Security Administration, DCFAM, Attn: Frederick W. Brickenkamp,
6401 Security Blvd., 1-A-21 Operations Bldg., Baltimore, MD 21235
(OMB Address)
Office of Management and Budget, OIRA, Attn: Lori Schack, New Executive
Office Building, Room 10230, 725 17th St., NW.,
Washington, DC 20503
Dated: May 6, 1999.
Frederick W. Brickenkamp,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 99-12172 Filed 5-13-99; 8:45 am]
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