[Federal Register Volume 64, Number 168 (Tuesday, August 31, 1999)]
[Notices]
[Pages 47558-47559]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-22623]


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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, 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. Statement of Living Arrangements, In-Kind Support and 
Maintenance-0960-0174. Form SSA-8006 provides a nationally-uniform 
vehicle for collecting information from SSI applicants and recipients 
about whether they receive income from in-kind support and maintenance. 
Responses are used to determine eligibility for SSI benefits payable. 
The respondents are individuals applying for SSI or whose eligibility 
is being reevaluated.
    Number of Respondents: 438,400.
    Frequency of Response: 1.
    Average Burden Per Response: 7 minutes.
    Estimated Annual Burden: 51,147 hours.
    2. Quickstart Enrollment Form-0960-0564. The information collected 
on this form is needed by SSA to facilitate electronic transmission of 
data for direct deposit of funds to a payee's account. The respondents 
are Social Security and SSI recipients requesting direct deposit to 
their financial institutions.
    Number of Respondents: 3,950,000.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 197,500 hours.
    3. Supplemental Security Income Claim Information Notice-0960-0324. 
The information collected on Form SSA-L8050-U3 will be used by SSA to 
ensure that all sources of potential income which can be used to 
provide for an individual's own support and maintenance are utilized. 
The respondents are applicants for SSI and recipients who are 
potentially eligible for benefits from other public or private 
programs.
    Number of Respondents: 7,500.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 1,250 hours.
    4. Marital Relationship Questionnaire-0960-0460. The information 
collected on Form SSA-4178 is needed by SSA to determine whether 
unrelated individuals of the opposite sex who are living together, and 
present themselves to the public as husband and wife, should be paid as 
a couple or two eligible individuals. The information is used to 
determine whether correct payment is being made to SSI couples and 
individuals. The respondents are applicants for and recipients of SSI 
who are living together in a questionable relationship.
    Number of Respondents: 5,100.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 425 hours.
    5. Letter to Employer Requesting Information About Wages Earned by 
Beneficiary--0960-0034. The information on Form SSA-L725 is used by SSA 
to establish the exact amount of wages earned by a beneficiary and to 
determine the amount of benefit payment, should one be due. The 
respondents are employers of the beneficiaries.
    Number of Respondents: 150,000.
    Frequency of Response: 1.
    Average Burden Per Response: 40 minutes.
    Estimated Annual Burden: 100,000 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. Application for Widow's or Widower's Insurance Benefits--0960-
0004. 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: 288,580.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 72,145 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. Application for Supplemental Security Income--0960-0444. The 
information collected on Form SSA-8001 is used by SSA to determine 
whether applicants for SSI benefits meet all statutory and regulatory 
requirements for eligibility and, if so, the amount of benefits 
payable. The respondents are applicants for SSI benefits.
    Number of Respondents: 1,011,046.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.

[[Page 47559]]

    Estimated Annual Burden: 252,762 hours.
    4. Disability Evaluation Study--0960-NEW. The Social Security 
Administration is sponsoring the Disability Evaluation Study (DES), a 
national disability study of the civilian non-institutionalized 
population of working-age adults aged 18-69. The DES will provide a key 
source of data for disability program and policy goals of critical 
interest to SSA, Congress, and others. SSA will collect information 
from individuals, aged 18 to 69 years, and their medical providers. SSA 
will use the information to:
     Estimate and project the size of the potential pool of 
eligible persons, that is, severely impaired working age individuals 
who, but for work or other reasons, meet SSA's definition of 
disability;
     Determine what enables individuals with severe impairments 
to work;
     Construct self-reported disability measures to be included 
on national surveys to monitor future program changes and changes in 
the pool of eligible persons;
     Examine relationships between disability and retirement 
for older workers;
     Evaluate ways to improve the current disability decision 
process, such as use of additional objective performance measures.
    Following is a listing of the information that will be collected 
and the burden imposed on the public:

----------------------------------------------------------------------------------------------------------------
                                                                                          Average     Estimated
                                                               Number of    Frequency      burden       annual
                     Title of collection                      respondents  of response   hours per      burden
                                                                                          response      hours
----------------------------------------------------------------------------------------------------------------
Pilot Study:
    Focus groups, cognitive laboratory studies, and pretest.          100            1         2.00          200
    In-person canvassing for area probability sample........       11,795            1         0.08          944
    Initial Screening.......................................       11,882            1         0.50        5,941
    Follow-up Screening, Comprehensive Survey Interview,            1,800            1         1.50        2,700
     Forms for obtaining informed consent, release of
     medical records, and release of SSA records............
    Medical Examination.....................................        1,000            1         2.00        2,000
    Provide Medical Records.................................        2,000            1         0.50        1,000
                                                             ---------------------------------------------------
      Total (Pilot).........................................       28,577  ...........  ...........       12,785
                                                             ===================================================
Main Study:
    In-person canvassing for area probability sample........       55,405            1         0.08        4,432
    Initial Screening.......................................       56,031            1         0.50       28,016
    Follow-up Screening, Comprehensive Survey Interview,           10,000            1         1.50       15,000
     Forms for obtaining informed consent, release of
     medical records, and release of SSA records............
    Medical Examination.....................................        5,500            1         2.00       11,000
    Provide Medical Records.................................       11,000            1         0.50        5,500
                                                             ---------------------------------------------------
      Total (Main)..........................................      137,936  ...........  ...........       63,948
                                                             ===================================================
      Total (Overall).......................................      166,513  ...........  ...........       76,733
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    (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: August 25, 1999.
Frederick W. Brickenkamp,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 99-22623 Filed 8-30-99; 8:45 am]
BILLING CODE 4190-29-P