[Federal Register Volume 66, Number 16 (Wednesday, January 24, 2001)]
[Notices]
[Pages 7691-7692]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-2150]



[[Page 7691]]

=======================================================================
-----------------------------------------------------------------------

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 Public Law 
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. Therefore, your 
comments should be submitted to SSA within 60 days from the date of 
this publication. You can obtain copies 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. Notice Regarding Substitution of Party Upon Death of Claimant--
0960-0288. When a claimant for Social Security or Supplemental Security 
Income benefits dies while a request for a hearing is pending, the 
hearing will be dismissed unless an eligible individual makes a written 
request to SSA showing that he or she would be adversely affected by 
the dismissal of the deceased's claim. An individual may satisfy this 
requirement by completing an HA-539. SSA uses the information collected 
to document the individual's request to be made a substitute party for 
a deceased claimant, and to make a decision on whom, if anyone, should 
become a substitute party for the deceased. The respondents are 
individuals requesting hearings on behalf of deceased claimants for 
Social Security benefits.

    Number of Respondents: 10,548.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 879 hours.
    2. Report by Former Representative Payee--0960-0112. When a State 
mental institution or agency terminates its representative payee 
services, SSA requires a closeout report on funds held on behalf of 
Social Security beneficiaries. SSA uses the information, which is 
collected on form SSA-625, to determine the proper disposition of any 
conserved funds held by the representative payee. The respondents are 
State mental institutions or agencies that served as representative 
payees for Social Security beneficiaries.
    Number of Respondents: 8,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 2,000.
    3. State Agency Report of Obligations for SSA Disability Programs 
and Addendum, SSA-4513; Time Report of Personnel Services for 
Disability Determination Services, SSA-4514; and State Agency Schedule 
of Equipment Purchased for SSA Disability Programs, SSA-871--0960-0421.
    SSA uses the information collected on forms SSA-4513 and 4514 to 
conduct a detailed analysis and evaluation of the costs incurred by the 
State Disability Determination Services (DDSs) in making the disability 
determination for SSA. The data is also used to determine funding 
levels for each DDS. SSA uses the information collected on form SSA-871 
to budget and account for expenditures of funds for equipment purchases 
by the State DDSs that administer the disability determination program. 
The respondents are DDSs that have the responsibility for making 
disability determinations for SSA.

----------------------------------------------------------------------------------------------------------------
                                                        Frequency of      Average burden per   Estimated annual
                                   Respondents            response        response (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4513.....................                  54                    4                   90                  324
SSA-4514.....................                  54                    4                   90                  324
SSA-871......................                  54                    4                   30                  108
                              ----------------------------------------------------------------------------------
    Total burden.............  ...................  ...................  ...................                 756
----------------------------------------------------------------------------------------------------------------

    4. Request for Social Security Statement--0960-0466. Form SSA-7004 
is used by members of the public to request information about their 
Social Security earning records and to get an estimate of their 
potential benefits. SSA provides information, in response to the 
request, from the individual's personal Social Security record. The 
respondents are Social Security numberholders who have covered earnings 
on record.
    Number of Respondents: 3,000,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 250,000 hours.
    5. Certificate of Support--0960-0001. The information collected by 
form SSA-760-F4 is used to determine whether the deceased worker 
provided one-half support required for entitlement to parent's or 
spouse's benefits. The information will also be used to determine 
whether the Government pension offset would apply to the applicant's 
benefit payments. The respondents are parents of deceased workers or 
spouses who may be subject to Government pension offset.
    Number of Respondents: 18,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 4,500 hours.
    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 
packages by calling the SSA Reports Clearance Officer on (410) 965-
4145, or by writing to him at the address listed above.
    1. Internet Request for Replacement SSA-1099/SSA-1042S, Social 
Security Benefits Statement--0960-0583. The information requested by 
the Social Security Administration (SSA) via the

[[Page 7692]]

Internet will be used to verify identity and to provide replacement 
copies of Forms SSA-1099/SSA-1042, which are needed to prepare Federal 
tax returns. This Internet option to request a replacement SSA-1099/
SSA-1042S will eliminate the need for a phone call to a teleservice 
center or a visit to a field office. The respondents are beneficiaries 
who request a replacement SSA-1099/1042S via the Internet.
    SSA is publishing this notice because the previous notices (Vol. 
65, No. 197, page 60492, October 11, 2000; Vol. 65, No. 237, page 
77061, December 8, 2000) contained incorrect information on the public 
reporting burden. Following is the corrected public reporting burden:
    Number of Respondents: 21,000.
    Frequency of Response: 1.
    Average Burden Per Response: 1.5 minutes.
    Estimated Average Burden: 525 hours.
    2. Blood Donor Locator Service--0960-0501. Regulation 20 CFR 
401.200 requires that participating State agencies provide the Social 
Security Administration (SSA) Blood Donor Locator Service (BDLS) 
specific information on blood donors who have tested positive for Human 
Immunodeficiency Virus (HIV). SSA uses the information to identify the 
donor, and locate the donor's address in SSA records for the purpose of 
notifying the states and to assure that states meet regulatory 
requirements to qualify for using the BDLS. SSA will retain no record 
of the request or the information after processing has been completed. 
The respondents are participating State agencies acting on behalf of 
authorized blood donor facilities.
    Number of Respondents: 10.
    Frequency of Response: 5.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 12.5 hours.

    Dated: January 18, 2001.
Frederick W. Brickenkamp,
Reports Clearance Officer.
[FR Doc. 01-2150 Filed 1-23-01; 8:45 am]
BILLING CODE 4191-02-U