[Federal Register Volume 65, Number 39 (Monday, February 28, 2000)]
[Notices]
[Pages 10589-10590]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-4573]


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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. Application for Social Security Disability Benefits--0960-0060. 
The Social Security Administration (SSA) uses the information collected 
on form SSA-16 to determine eligibility for Social Security disability 
benefits. The respondents are applicants for such benefits.
    Number of Respondents: 1,185,942.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Average Burden: 395,314 hours.
    2. Appointment of Representative-0960-0527. The information on Form 
SSA-1696 is used by SSA to verify the applicant's appointment of a 
representative. The form allows SSA to inform the representative of 
issues that affect the applicant's claim. The respondents are 
applicants who notify SSA that they have appointed a person to 
represent them.
    Number of Respondents: 412,653.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Average Burden: 68,776 hours.
    3. Request to be Selected as Payee--0960-0014. The information 
collected on Form SSA-11-BK is used to determine the proper payee for a 
Social Security beneficiary, and it is designed to aid in the 
investigation of a payee applicant. The form will establish the 
applicant's relationship to the beneficiary, the justification, the 
concern for the beneficiary and the manner in which the benefits will 
be used. The respondents are applicants for selection as representative 
payee for Old Age, Survivors and Disability Insurance, Supplemental 
Security Income (SSI), Black Lung benefits and title-VIII Special 
Veterans Benefits.
    Number of Respondents: 2,121,686.
    Frequency of Response: 1.
    Average Burden Per Response: 10.5 minutes.
    Estimated Annual Burden: 371,295 hours.
    4. Application for Special Benefits for World War II Veterans-0960-
0615. The information collected on Form SSA-2000 will be used by the 
Social Security Administration to elicit the information necessary to 
determine entitlement of an individual to benefits under title VIII of 
the Social Security Act. Respondents are certain World War II Veterans 
as identified under title VIII.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 4,000 hours.
    5. Claim for Amount Due in the Case of a Deceased Beneficiary-0960-
0101. Section 204 (d) of the Social Security Act provides that if a 
beneficiary dies before payment of Social Security benefits has been 
completed, the amount due will be paid to the persons meeting specified 
qualifications. The information collected on Form SSA-1724 is used by 
the Social Security Administration to determine whether an individual 
is entitled to the underpayment. The respondents are applicants for the 
underpayment of a deceased beneficiary.
    Number of Respondents: 300,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 50,000 hours.
    6. Third party Liability Information Statement-0960-0323. Form SSA-
8019 is used by the Social Security Administration to gather 
information or to make changes in existing information about third 
party insurance (excluding Medicare or Medicaid), which could be 
responsible for payment for a beneficiary's medical care. The 
respondents are third-party insurers other than Medicare or Medicaid.
    Number of Respondents: 95,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 7,917 hours.
    II. The information collection listed below has been submitted to 
OMB for clearance. Written comments and recommendations on the 
information collection 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 package by calling the SSA Reports Clearance Officer on (410) 
965-4145, or by writing to him.
    Letter to Employer Requesting Wage Information-0960-0138. The 
information collected on form SSA-L4201 is used by SSA to determine 
eligibility and proper benefit payments for SSI applicants/recipients. 
The respondents are employers of applicants for and recipients of SSI 
payments.
    Number of Respondents: 133,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 66,500 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: Desk Officer for SSA, 
New Executive Office Building, Room 10230, 725 17th St., NW, 
Washington, D.C. 20503.

    Dated: February 22, 2000.
Frederick W. Brickenkamp,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 00-4573 Filed 2-25-00; 8:45 am]
BILLING CODE 4191-02-U