[Federal Register Volume 64, Number 130 (Thursday, July 8, 1999)]
[Notices]
[Pages 36941-36942]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-17401]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    In compliance with Pub. L. 104-13, the Paperwork Reduction Act of 
1995, 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. Application for Widow's or Widower's Insurance Benefits-0960-
0004. The Social Security Administration (SSA) uses the information 
collected on Form SSA-10-BK to determine whether the applicant meets 
the statutory and regulatory conditions for entitlement to widow(er)'s 
benefits. The respondents are applicants for widow(er)'s benefits.
    Number of Respondents: 288,850.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 72,213 hours.
    2. Request for Waiver of Overpayment Recovery or Change in 
Repayment Notice-0960-0037. Form SSA-632 collects information on the 
circumstances surrounding overpayment of Social Security Benefits to 
recipients. SSA uses the information to determine whether recovery of 
an overpayment amount can be waived or must be repaid and, if repaid, 
how recovery will be made. The respondents are recipients of Social 
Security, Medicare, Black Lung or Supplemental Security Income 
overpayments.
    Number of Respondents: 500,000.
    Frequency of Response: 1.
    Average Burden Per Response: 120 minutes.
    Estimated Annual Burden: 1,000,000 hours.
    3. Voluntary Customer Surveys in Accordance with E.O. 12862 within 
the Social Security Administration--0960-0526. These voluntary customer 
surveys will be used to ascertain customer satisfaction with the Social 
Security Administration in terms of timeliness, appropriateness, 
access, and other measures of quality service. Surveys will involve 
individuals that are the direct or indirect beneficiaries of SSA 
services. The average burden per response for these activities is 
estimated to range from 5 minutes for a simple comment card to 2 hours 
for participation in a focus group.

FY 2000:
    Number of Respondents: 1,328,264.
    Frequency of Response: 1.
    Estimated Annual Burden: 123,231 Hours.
FY 2001:
    Number of Respondents: 1,325,760.
    Frequency of Response: 1.
    Estimated Annual Burden: 122,274 Hours.
FY 2002:
    Number of Respondents: 1,327,400.
    Frequency of Response: 1.
    Estimated Annual Burden: 121,734 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 a copy of the OMB 
clearance packages by calling the SSA Reports Clearance Officer on 
(410) 965-4145, or by writing to him.
    1. Marriage Certification--0960-0009. Form SSA-3 is used by the 
Social Security Administration (SSA) to determine whether the 
claimant's spouse 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 cases in which claimants for 
disability benefits have requested a hearing, which is a statutory 
right granted to claimants under the Act, on the decision regarding 
their claim. 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.

[[Page 36942]]

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: 43,333 hours.
    5. 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.

(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: Desk Officer 
for SSA, New Executive Office Building, Room 10230, 725 17th St., NW, 
Washington, DC 20503

    Dated: July 1, 1999.
Nicholas E. Tagliareni,
Director, Center for Publications Management, Social Security 
Administration.
[FR Doc. 99-17401 Filed 7-7-99; 8:45 am]
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