[Federal Register Volume 64, Number 209 (Friday, October 29, 1999)]
[Notices]
[Pages 58464-58466]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-28434]


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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

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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. Partnership Questionnaire--0960-0025. Form SSA-7104 is used to 
establish several aspects of eligibility for benefits, including 
accuracy of reported partnership earnings, the veracity of a 
retirement, and lag earnings where they are needed for insured status. 
The respondents are applicants for old age and disability benefits.
    Number of Respondents: 12,350.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 6,175 hours.
    2. Report of New Information in Disability Cases--0960-0071. The 
information collected on Form SSA-612 is used to update the disability 
records of respondents, based on changes reported. The respondents are 
applicants for and recipients of Title II Disability Benefits.
    Number of Respondents: 27,000.
    Frequency of Response: 1.
    Average Burden Per Response: 6 minutes.
    Estimated Annual Burden: 2,700 hours.
    3. Claimant's Recent Medical Treatment--0960-0292. The information 
collected on Form HA-4631 is used to provide an updated medical history 
for a disability claimant who requests a hearing and to afford 
claimants their statutory right to a hearing and decision under the 
Social Security Act. The respondents are claimants requesting hearings 
on entitlement to benefits based on disability under title II (Old-Age, 
Survivors and Disability Insurance) and/or title XVI (Supplemental 
Security Income) of the Social Security Act.
    Number of Respondents: 309,490.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 51,582 hours.
    4. Supplemental Security Income (SSI)--Quality Review Case 
Analysis--0960-0133. Form SSA-8508-BK is used with a sample of SSI 
recipients in a personal interview and covers all elements of SSI 
eligibility. The information obtained is used to assess the 
effectiveness of SSI policies and procedures and to establish payment 
accuracy rates. The respondents are SSI Recipients.
    Number of Respondents: 15,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 15,000 hours.
    5. Psychiatric Review Technique--0960-0413. The information 
collected on Form SSA-2506 is needed by the Social Security 
Administration to facilitate in the adjudication of claims involving 
mental impairments. The information is used to identify the need for 
additional evidence for the determination of impairment severity; to 
consider aspects of mental impairment relevant to the individual's 
ability to work; and to organize and present the findings in a clear, 
concise manner. The respondents are State Disability Determination 
Services administering titles II and XVI disability programs.
    Number of Respondents: 1,005,804.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 251,451 hours.
    6. Instructions for Completion of Federal Assistance Application 
Form SSA-96 for SSA Research and Demonstration Grant Programs--0960-
0184. The information collected on Form SSA-96 is needed by the SSA to 
evaluate and select grant proposals for funding. The respondents are 
applicants for Federal assistance, including State and Local 
governments, educational institutions and other nonprofit and for-
profit organizations.
    Number of Respondents: 150.
    Frequency of Response: 1.
    Average Burden Per Response: 14 hours.
    Estimated Annual Burden: 2,100 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. 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

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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.

(SSA Address)
    Social Security Administration, DCFAM, Attn: Frederick W. 
Brickenkamp, 1-A-21 Operations Bldg., 6401 Security Blvd., 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: October 22, 1999.
Frederick W. Brickenkamp,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 99-28434 Filed 10-28-99; 8:45 am]
BILLING CODE 4191-02-U