[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
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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
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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]
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