[Federal Register Volume 65, Number 146 (Friday, July 28, 2000)]
[Notices]
[Pages 46543-46544]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-19041]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages that will require clearance by the 
Office of Management and Budget (OMB) in compliance with Pub. L. 104-13 
effective October 1, 1995, The Paperwork Reduction Act of 1995. 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.
    Written comments and recommendations regarding the information 
collection(s) should be submitted to the SSA Reports Clearance Officer 
and to the OMB Desk Officer at the following addresses:

(OMB): Attn: Desk Officer for SSA, New Executive Office Building, Room 
10230, 725 17th St., NW, Washington, D.C. 20503
(SSA): Social Security Administration, DCFAM, Attn: Frederick W. 
Brickenkamp 1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 
21235

    I. The information collections listed below will be submitted to 
OMB within 60 days from the date of this notice. Your comments should 
be submitted to SSA within 60 days from the date of this publication. 
You can obtain a copy of the collection instruments by calling the SSA 
Reports Clearance Officer at 410-965-4145, or by writing to him at the 
address listed above.
    1. Statement for Continuing Eligibility, Supplemental Security 
Income (SSI) Cases--0960-0416. SSA uses form SSA-8203-BK for high-
error-profile (HEP) redeterminations completed by field offices. SSA 
employees conduct telephone or face-to face interviews with SSI 
recipients and representative payees of SSI recipients and document the 
information gathered during the interview on an SSA-8203-BK. 
Occasionally, due to systems limitations, the form is mailed to 
recipients for completion. A tear-off sheet (Pages 7 and 8 of the form) 
is given to recipients at the conclusion of a face-to-face interview or 
mailed to recipients at the completion of the telephone interview. It 
includes information about how, what, when, where, and why SSI 
recipients report when there is a change in income, resources, or 
living arrangements. The information collected is used to determine 
whether SSI recipients have met and continue to meet all statutory and 
regulatory requirements for SSI eligibility and whether they have been 
and are still receiving the correct payment amount. Periodic collection 
of this information is the only way SSA can make these determinations. 
The respondents are recipients of title XVI (SSI) benefits or their 
representative payees.
    Number of Respondents: 920,000.
    Frequency of Response: 1.
    Average Burden Per Response: 17 minutes.
    Estimated Annual Burden: 260,667 hours.
    2. Claimant's Statement About Loan of Food or Shelter (SSA-5062), 
and Statement About Food or Shelter Provided to Another (SSA-L5063)--
0960-0529. Forms SSA-5062 and SSA-L5063 are used to obtain statements 
about food and/or shelter provided to an SSI claimant. SSA uses the 
information to determine whether food and/or shelter are a bona fide 
loan or should be counted as income. This determination can affect 
eligibility for SSI and the amount of SSI benefits payable. The 
respondents are claimants for SSI benefits and individuals who provide 
(loan) food or shelter to SSI Claimants.

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                                                    SSA-5062   SSA-L5063
------------------------------------------------------------------------
Number of Respondents............................     65,540      65,540
Frequency of Response............................          1           1
Average Burden Per Response (minute).............         10          10
Estimated Annual Burden (hours)..................     10,923      10,923
------------------------------------------------------------------------

    II. The information collections listed below have been submitted to 
OMB for clearance. Your comments on the information collections would 
be most useful if received by OMB and SSA within 30 days from the date 
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 at the address listed above.
    1. Request for Withdrawal of Application--0960-0015. Form SSA-521 
is completed by SSA when an individual wishes to withdraw his or her 
application for Social Security benefits. The respondents are 
individuals who wish to withdraw their applications for benefits.
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 8,333 hours.
    2. Statement of Self-Employment Income--0960-0046. SSA uses the 
information on Form SSA-766 to expedite the payment of Social Security 
benefits to an individual who is self-employed and who is establishing 
insured status in the current year. The respondents are self-employed 
persons.
    Number of Respondents: 5,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 417 hours.
    3. Certification by Religious Group--0960-0093. The data that SSA 
collects via form SSA-1458 is used to determine if the religious group 
meets the qualifications set out in section 1402(g) of the Internal 
Revenue Code permitting its members to be exempt from payment of 
certain Social Security taxes. The respondents are spokespersons for a 
religious group or sect.
    Number of Respondents: 180.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 45 hours.
    4. You Can Make Your Payment by Credit Card--0960-0462. Forms SSA-
4588 and SSA-4589 provide information to SSA on the debtor's

[[Page 46544]]

name, Social Security Number, credit card number, the amount being paid 
and the credit card type so that a remittance can be credited to the 
debtor's account. The respondents are Title II (Old-Age, Survivors and 
Disability Insurance) and Title XVI (SSI) debtors, and citizens 
requesting material through SSA.
    Number of Respondents: 19,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 1,583 hours.
    5. Statement Regarding Contributions--0960-0020. To determine 
eligibility of child applicants to Social Security benefits, SSA must 
collect information about the source of support and the amount of 
contributions. SSA uses the form SSA-783 for this purpose. The 
respondents are individuals who provide information to SSA about the 
child's sources of support.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 7,500 hours.
    6. Medical Parking Permit Application--0960-NEW. SSA issues medical 
parking assignments at SSA-owned and leased facilities to individuals 
who have a medical condition that meets the criteria for medical 
parking. In order to issue a medical parking permit, SSA must obtain 
medical evidence from the applicant's physician. SSA uses the 
information collected on form SSA-3192 to determine whether the 
individual qualifies for a medical parking permit and to issue the 
permit. The respondents are physicians of applicants for medical 
parking permits.
    Number of Respondents: 144.
    Frequency of Response: 1.
    Average Burden Per Response: 1 hour.
    Estimated Annual Burden: 144 hours.
    7. Authorization for Source to Release Information to SSA--0960-
NEW. SSA must obtain sufficient medical evidence to make eligibility 
determinations for Social Security disability benefits and SSI 
payments. For SSA to obtain medical evidence, an applicant must 
authorize his or her medical source(s) to release the information to 
SSA. The applicant may use one of the forms SSA-827, SSA-827-OP1 or 
SSA-827-OP2 to provide consent for the release of information. 
Generally, the State Disability Determination Services completes the 
form(s), based on information provided by the applicant, and sends the 
form(s) to the designated medical source(s).
    Number of Respondents: 3,853,928.
    Frequency of Response (Average per case): 4.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 770,786 hours.
    8. Lump-Sum Death Payment Application (Modernized Claims System)--
0960-NEW. The information is collected through a computerized system 
and is required to authorize payment of the lump-sum death benefit to a 
widow, widower, or children as defined in Section 202(i) of the Social 
Security Act. The respondents are widows, widowers or children who 
apply for a lump-sum death payment.
    Number of Respondents: 833,000.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 277,667 hours.
    9. Electronic Death Registration (EDR) Survey--0960-NEW.

Background Information

    In January 1997, the report ``Toward an Electronic Death 
Registration System in the United States: Report of the Steering 
Committee to Reengineer the Death Registration Process'' was prepared 
by a task force representing Federal agencies (the National Center for 
Health Statistics and the Social Security Administration) and 
professional organizations representing funeral directors, physicians, 
medical examiners, coroners, hospitals, medical records professionals, 
and vital records and statistics officials (NAPHSIS). The committee 
examined in detail the feasibility of developing electronic death 
registration in the United States. The conclusion of the report was 
that the introduction of automated registration processes in the States 
is a viable means to resolve several historical and continuing problems 
in the process of death registration.
    Death certificates are used in the United States for administrative 
and public health purposes. For nearly a century the States have 
maintained centralized vital records agencies to collect, process and 
archive death certificates. Death records are universally recognized as 
the primary source of death information, but registration processes 
remain labor intensive, employ disparate and limited automated 
procedures, and require several professionals at different locations to 
complete each of the more than 2.3 million death certificates 
registered each year.
    Even though each State has laws requiring the registration of death 
records within a specific time period, a significant number of 
certificates are not appropriately filed, may contain incorrect or 
inconsistent entries, or are not finalized until many weeks after the 
death occurred.
    The States and Federal agencies understand the shortcomings of 
death registration methods currently practiced in the United Sates. Now 
that recent advances in computer and network access technology allow 
for the practical and efficient development and implementation of 
automated systems to register death information, several registration 
areas have independently pioneered electronic death registration 
methods. These different approaches will serve as the basis for 
developing standardized EDR attributes, methods and processes in order 
that the States may successfully implement electronic death 
registration to satisfy administrative and statistical death 
information needs.

Information Collection

    In support of the EDR project, SSA entered into a contract with the 
National Association for Public Health Statistics and Information 
Systems to foster the adoption of a standardized form of EDR throughout 
the country. As the beginning step in the process, this survey is 
planned to provide a current picture of the readiness of the States to 
adopt EDR. This will, in turn, assist SSA to direct available funding 
anticipated in future years to those States that demonstrate sufficient 
resources, available technical expertise, and the political will and 
statutory readiness to implement EDR within the contract timeframe. 
Respondents to the survey will be officials from States, U.S. 
Territories and the city of New York with the knowledge and expertise 
to complete the survey. One survey will be sent to each State and 
territory and New York City.
    Number of Respondents: 55.
    Frequency of Response: 1.
    Average Burden Per Response: 2 hours.
    Estimated Annual Burden: 110 hours.

    Dated: July 21, 2000.
Frederick W. Brickenkamp,
SSA Reports Clearance Officer.
[FR Doc. 00-19041 Filed 7-27-00; 8:45 am]
BILLING CODE 4191-02-P