[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] ======================================================================= ----------------------------------------------------------------------- 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 ---------------------------------------------------------------------------------------------------------------- (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