[Federal Register Volume 66, Number 91 (Thursday, May 10, 2001)]
[Notices]
[Pages 23963-23965]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-11753]


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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

[[Page 23964]]

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 OMB Desk Officer and the SSA 
Reports Clearance Officer and at the following addresses:

(OMB) Office of Management and Budget, Attn: Desk Officer for SSA, New 
Executive Office Building, Room 10230, 725 17th St., NW, Washington, DC 
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. Report of Student Beneficiary About to Attain Age 19--0960-0274. 
The information collected by the Social Security Administration (SSA) 
on form SSA-1390 is used to determine a student's eligibility for 
Social Security benefits for those attaining age 19. The affected 
public is comprised of student beneficiaries about to attain age 19.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 4,167 hours.
    2. Certificate of Coverage Request Form--0960-0554. The United 
States (U.S.) has Social Security agreements with 18 countries. These 
agreements eliminate double Social Security coverage and taxation where 
a period of work would be subject to coverage and taxes in both 
countries. The individual agreements contain rules for determining the 
country under whose laws the period of work will be covered and to 
whose system taxes will be paid. The agreements further provide that 
upon the request of the worker or employer, the country under whose 
system the period of work is covered will issue a certificate of 
coverage. The certificate serves as proof of exemption from coverage 
and taxation under the system of the other country. The information 
collected is needed to determine if a period of work is covered by the 
U.S. system under an agreement and to issue a certificate of coverage. 
The respondents are workers and employers wishing to establish an 
exemption from foreign Social Security taxes.
    Number of Respondents: 40,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 20,000 hours.
    3. Medical Report (General)--0960-0052. The information collected 
on form SSA-3826-F4 is used by SSA to determine the claimant's physical 
status prior to making a disability determination and to document the 
disability claims folder with the medical evidence. The respondents are 
physicians, hospitals, directors and medical records librarians.
    Number of Respondents: 750,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 375,000 hours.
    4. Representative Payee Evaluation Report--0960-0069. The 
information on form SSA-624 is used by SSA to accurately account for 
the use of Social Security benefits and Supplemental Security Income 
payments received by representative payees on behalf of an individual. 
The respondents are individuals and organizations who received form 
SSA-623 or SSA-6230 and failed to respond, provided unacceptable 
responses that could not be resolved, or reported a change in custody.
    Number of Respondents: 250,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Average Burden: 125,000 hours.
    5.Chinese Custom Marriage Statement; Statement Regarding Marriage--
0960-0086. The information collected on Forms SSA-1344 and SSA-1345 is 
used to determine whether the spouse/claimant is (or was) legally 
married to the numberholder for the purpose of paying Social Security 
Benefits. The respondents are individuals who were married in a Chinese 
custom marriage.

------------------------------------------------------------------------
                                                  SSA-1344     SSA-1345
------------------------------------------------------------------------
Number of Respondents:........................           10           10
Frequency of Response:........................            1            1
Average Burden Per Response:..................       \1\ 14       \1\ 14
Estimated Annual Burden:......................      \2\ 2.3     \2\ 2.3
------------------------------------------------------------------------
\1\ Minutes.
\2\ Hours.

    6. State Agency Ticket Assignment Form--0960-NEW.
    The information collected on this form will be used by SSA's 
contracted Program Manager (PM) to perform the task of assigning 
beneficiaries' tickets and monitoring the use of tickets under the 
Ticket to Work and Self-Sufficiency Program. The State Vocational 
Rehabilitation (VR) agency answers the questions and the beneficiary 
reviews the data and if in agreement will sign the form acknowledging 
their Ticket assignment. The respondents are State VR agencies.
    Number of Respondents: 21.
    Frequency of Response: 4,048 annually per respondent.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 4,250 hours.
    Please note that the Ticket to Work Program is being implemented in 
stages. The above represents the initial phase of the program with 13 
participating states that includes 21 State VR agencies. As the program 
continues to be phased in, each initial program year will result in a 
large number of new tickets for the participating State VRs because 
existing clients will also be brought into the program.
    7. Statement for Determining Continuing Eligibility, Supplemental 
Security Income Payment--0960-0145--Forms SSA-8202-F6 and SSA-

[[Page 23965]]

8202-OCR-SM. SSA uses form SSA-8202-F6 to conduct low-and middle-error-
profile (LEP-MEP) telephone or face-to-face redetermination (RZ) 
interviews with Supplemental Security Income (SSI) recipients and 
representative payees. The information collected during the interview 
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. Form SSA-8202-OCR-SM (Optical Character Recognition-Self 
Mailer) collects information similar to that collected on Form SSA-
8202-F6. However it is used exclusively in LEP RZ cases on a 6-year 
cycle. The respondents are recipients of SSI benefits or their 
representative payees.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                                     Frequency      burden per       Estimated
                                                    Respondents      response        response     annual  burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8202-F6.....................................         920,000               1              18         276,000
SSA-8202-OCR-SM.................................         800,000               1               9         120,000
                                                 ---------------------------------------------------------------
    Total Burden................................  ..............  ..............  ..............         396,000
----------------------------------------------------------------------------------------------------------------

    8. Statement For Determining Continuing Eligibility for 
Supplemental Security Income Payments--0960-0416. SSA uses form SSA-
8203-BK for high-error-profile (HEP) redeterminations. The information 
is normally completed in field offices by personal contact (face-to-
face or telephone interview) using the automated Modernized SSI Claim 
System (MSSICS). The paper form is used only when a systems limitation 
prevents the interview from being completed on MSSICS. When the paper 
form is used, 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 is mailed 
to recipients at the completion of the telephone interview. The tear-
off includes information about how, what, when, where, and why SSI 
recipients report when there is a change in income, resources, or 
living arrangements. The respondents are recipients of title XVI SSI 
benefits.
    Number of Respondents: 920,000.
    Frequency of Response: 1.
    Average Burden Per Response: 18 minutes.
    Estimated Annual Burden: 276,000 hours.
    9. Summary of Evidence--0960-0430. The information on Form SSA-887 
is used by State Disability Determination Services (DDS) to provide 
claimants with a list of medical/vocational reports pertaining to their 
disability. The form will aid claimants in reviewing the evidence in 
their folders and will be used by hearing officers in preparing for and 
conducting hearings. The respondents are State DDSs that make 
disability determinations.
    Number of Respondents: 49,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Average Burden: 12,250 hours.
    10. Notice Regarding Substitution of Party Upon Death of Claimant-- 
Reconsideration of Disability Cessation--0960-0351. The Social Security 
Administration uses the form SSA-770 to obtain information from 
substitute parties regarding their intention to pursue the appeals 
process for an individual who has died. The respondents are such 
parties.
    Number of Respondents: 1,200.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 200 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 Direct Deposit Application--0960-NEW. SSA uses Direct 
Deposit/Electronic Funds Transfer (DD/EFT) enrollment information 
received from beneficiaries to facilitate DD/EFT of their social 
security benefits with a financial institution. The respondents are 
Social Security beneficiaries who use the Internet to enroll in DD/EFT.
    Number of Respondents: 3,485.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Average Burden: 581 hours.
    2. Request To Have Supplemental Security Income Overpayment 
Withheld from My Social Security Benefits--0960-0549. Form SSA-730-U2 
is used by SSA to confirm that a request has been made by a Social 
Security beneficiary for SSA to recover his/her SSI overpayment from 
title II benefits and that the request was made voluntarily by the 
beneficiary. The respondents are Social Security beneficiaries who 
received SSI overpayments.
    Number of Respondents: 10,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Average Burden: 833 hours.
    3. Farm Self-Employment Questionnaire--0960-0061. Section 211(a) of 
the Social Security Act requires the existence of a trade or business 
as a prerequisite for determining whether an individual or partnership 
may have ``net earnings from self-employment.'' Form SSA-7156 elicits 
the information necessary to determine the existence of an agricultural 
trade or business and subsequent covered earnings for Social Security 
entitlement purposes. The respondents are applicants for Social 
Security benefits whose entitlement depends on whether the worker has 
covered earnings from self-employment as a farmer.
    Number of Respondents: 47,500.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Average Burden: 7,917 hours.

    Dated: May 4, 2001.
Frederick W. Brickenkamp,
Reports Clearance Officer.
[FR Doc. 01-11753 Filed 5-9-01; 8:45 am]
BILLING CODE 4191-02-U