[Federal Register Volume 67, Number 239 (Thursday, December 12, 2002)]
[Notices]
[Pages 76429-76431]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-31313]


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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 Public Law 
104-13 effective October 1, 1995, The Paperwork Reduction Act of 1995. 
The information collection packages that may be included in this notice 
are for new information collections, revisions to OMB-approved 
information collections and extensions (no change) of OMB-approved 
information collections.
    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. The information can be mailed and/or faxed to the individuals 
at the addresses and fax numbers listed below:

(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, New 
Executive Office Building, Room 10235, 725 17th St., NW, Washington, DC 
20503, Fax: 202-395-6974.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance 
Officer, 1338 Annex Bldg., 6401 Security Blvd., Baltimore, MD 21235, 
Fax: 410-965-6400.

    I. The information collections listed below are pending at SSA and 
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-
0454, or by writing to the address listed above.
    1. State Partnership Initiative (SPI) Cooperative Agreements--0960-
0610. Executive Order 13078 dated March 13, 1998, Increasing Employment 
of Adults with Disabilities. This action orders that a National Task 
Force be established to create a coordinated and aggressive national 
policy to bring adults with disabilities into gainful employment at a 
rate that is as close as possible to that of the general adult 
population. E.O. 13078 specifies that the Task Force ``evaluate and, 
where appropriate, coordinate and collaborate on, research and 
demonstration priorities of Task Force member agencies related to 
employment of adults with disabilities.'' To comply with the EO, SSA 
released cooperative agreement announcements in 1998 to approximately 
650 State agencies nationwide to conduct demonstration projects that 
assist States in developing service delivery models that increase the 
rates of gainful employment of people with disabilities. Eighteen State 
agencies have been selected to participate in the demonstration 
projects. SSA has employed a monitoring and technical assistance 
contractor to collect information from the State awardees' databases on 
behalf of SSA. The Contractor will use the information to evaluate 
whether and to what extent the service delivery models achieve the 
overall goals of the demonstration projects and will report project 
results to SSA. SSA will use the results to conduct a net outcome 
evaluation to determine the long-term effectiveness of the 
interventions. Following is a table that outlines the public reporting 
burden of the 18 State agencies for this project:
    Type of Request: Revision of an OMB-approved Information 
Collection(s).

----------------------------------------------------------------------------------------------------------------
                                   Number of annual      Frequency of       Average burden     Estimated annual
       Title of collection             responses           response          per response           burden
----------------------------------------------------------------------------------------------------------------
Demonstration Site Form.........  16 (electronic)...  One Time..........  1 minute..........  1 hour.
                                  2 (manual)........  One Time..........  1 minute..........  1 hour.
Participant Demographic Data      3,080 (electronic)  One Time..........  15 minutes........  770 hours.
 Form.
                                  300 (manual)......  One Time..........  20 minutes........  100 hours.
Participant Employment Data Form  3,080 (electronic)  One Time..........  5 minutes.........  257 hours.
                                  300 (manual)......  One Time..........  7 minutes.........  35 hours.
Participant Update Form.........  12,320              Quarterly.........  4 minutes.........  821 hours.
                                   (electronic).
                                  1,200 (manual)....  Quarterly.........  5 minutes.........  100 hours.
Change in Employment Status.....  1,540 (electronic)  Completed only if.  3 minutes.........  77 hours.
                                  150 (manual).       employment changes  4 minutes.          10 hours.
State Quarterly & State           72................  Quarterly.........  15................  18 Hours.
 Semiannual & Annual Report.
                                  36................  Semiannual........  minutes...........  9 Hours.
                                  18................  Annual............  for each report...  4 Hours.
Stakeholder Interviews..........  50................  Varies per          10 minutes........  8 hours.
                                                       Stakeholder.
                                 ---------------------

[[Page 76430]]

 
      Total.....................  12,024............                                          2,211 Hours.
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    2. Claimant's Recent Medical Treatment--0960-0292. The information 
collected on Form HA-4631 is used to provide an updated medical history 
for a disability claimant who requests a hearing and to afford 
claimants their statutory right to a hearing and decision under the 
Social Security Act. This information is necessary to assure that the 
Social Security Administration has the most recent medical information 
before making a final determination on a claim. The respondents are 
claimants requesting hearings on entitlement to benefits based on 
disability under title II (Old-Age, Survivors and Disability Insurance) 
and/or title XVI (Supplemental Security Income) of the Social Security 
Act.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 309,490.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 51,582 hours.
    3. Report to U.S. SSA by Person Receiving Benefits for a Child or 
Adult Unable to Handle Funds; & Report to U.S. SSA-0960-0049. SSA needs 
the information on Forms SSA-7161-OCR-SM and SSA-7162-OCR-SM to 
determine continuing entitlement to Social Security benefits and 
correct benefit amounts for beneficiaries outside the U.S., as well as 
to monitor the performance of representative payees outside the U.S. 
The respondents are individuals outside the U.S. who are receiving 
benefits on their own behalf (or for someone else) under title II of 
the Social Security Act.
    Type of Request: Extension of an OMB-approved information 
collection(s):

------------------------------------------------------------------------
                                              SSA-7161-OCR- SAA-7162-OCR-
---------------------------------------------------SM------------SM-----
Number of Respondents.......................        30,000       205,000
Frequency of Response.......................             1             1
Average Burden Per Response (minutes).......            15             5
Estimated Annual Burden (hours).............         7,500        17,083
------------------------------------------------------------------------

    4. Partnership Questionnaire--0960-0025--20 CFR, Subpart K, 
404.1080-.1082. Form SSA-7104 is used to establish several aspects of 
eligibility for benefits, including accuracy of reported partnership 
earnings, the veracity of a retirement, and lag earnings where they are 
needed for insured status. The respondents are applicants for Old Age, 
Survivors and Disability Insurance Benefits.
    Type of Request: Extension of an OMB-approved information 
collection(s):
    Number of Respondents: 12,350.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes .
    Estimated Annual Burden: 6,175 hours.
    5. SSI-Quality Review Case analysis-0960-0133.
    The form SSA-8508 is used in a personal interview with a sample of 
Supplemental Security Income (SSI) recipients and covers all elements 
of SSI eligibility. The information is used to assess the effectiveness 
of SSI policies and procedures and to determine payment accuracy rates. 
The respondents are SSI recipients.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 12,000.
    6. SSI Wage Reporting Pilot--0960-NEW. SSA regulations at 20 CFR 
416.701-732 require that recipients of Supplemental Security Income 
(SSI) report changes, such as change in income, resources and living 
arrangements, that could affect the receipt and amount of payments. 
Currently, SSI recipients report changes on form SSA-8150, Reporting 
Events--SSI, or to a SSA teleservice representative through SSA's toll-
free telephone number or they visit their local Social Security Office. 
SSA is proposing to conduct a 6-month SSI wage reporting pilot to test 
a different method of collecting the information. During the pilot, a 
sample of individuals who need to report a change in earned income 
would call an SSA toll-free telephone number which will allow them to 
either speak their report (voice recognition technology) or key in the 
information using the telephone key pad. At the conclusion of the 
pilot, SSA will evaluate whether this is an effective method of 
reporting the information.
    Number of Respondents: 4,000.
    Frequency of Response: 6.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 2000 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 at 410-965-0454, 
or by writing to the address listed above.
    1. Statement of Marital Relationship (by One of the Parties)--20 
CFR, Subpart H 404.726--0960-0038. SSA uses the information collected 
on Form SSA-754 to determine whether the conditions for establishing a 
common-law marriage under state law are met. The respondents are 
applicants for spouse's benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 15,000 hours.
    2. Marital Relationship Questionnaire--20 CFR, Subpart R, 
416.1826--0960-0460. The information collected on Form SSA-4178 is 
needed by SSA to determine whether unrelated individuals of the 
opposite sex who are living together, and present themselves to the 
public as husband and wife, should be paid as a couple or two eligible 
individuals. The information is used to determine whether correct 
payment is being made to Supplemental Security Income (SSI) couples and 
individuals. The respondents are applicants for and recipients of SSI 
who are living together in a questionable relationship.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 5,100.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 425 hours.
    3. Statement of Living Arrangements, In-Kind Support and 
Maintenance--20 CFR, Subpart K, 416.1130-.1148--0960-0174. Form SSA-
8006 provides a national uniform vehicle for collecting

[[Page 76431]]

information from SSI applicants and recipients about whether they 
receive income from in-kind support and maintenance. Responses are used 
to determine eligibility for SSI benefits. The respondents are 
individuals applying for SSI or whose eligibility is being reevaluated.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 438,400.
    Frequency of Response: 1.
    Average Burden Per Response: 7 minutes.
    Estimated Annual Burden: 51,147 hours.
    4. Application for Widow's or Widower's Insurance Benefits--20 CFR, 
Subpart D, 404.335--.338--0960-0004. SSA uses the information collected 
on the Form SSA-10-BK to determine if the applicant meets the statutory 
and regulatory conditions for entitlement to widow(er)'s benefits. The 
respondents are applicants for Widow(er)'s benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 288,580.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 72,145 hours.
    5. Student Reporting Form--20 CFR, Subpart B, 404, and 20 CFR, 
Subparts D & E 422--0960-0088. Form SSA-1383 is used by Social Security 
student beneficiaries to report events or changes that may affect 
continuing entitlement to these benefits. The respondents are Social 
Security Student Beneficiaries.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 75,000.
    Frequency of Response: 1.
    Average Burden Per Response: 6 minutes.
    Estimated Annual Burden: 7,500 hours.
    6. Voluntary Customer Surveys in Accordance with E.O. 12862 within 
the Social Security Administration--0960-0526. These voluntary customer 
surveys will be used to ascertain customer satisfaction with the Social 
Security Administration in terms of timeliness, appropriateness, 
access, and other measures of quality service. Surveys will involve 
individuals that are the direct or indirect beneficiaries of SSA 
services. The average burden per response for these activities is 
estimated to range from 5 minutes for a simple comment card, to 2 hours 
for participation in a focus group.
    Type of Request: Extension of an OMB-approved information 
collection.

FY 2003:
    Number of Respondents: 1,526,892.
    Frequency of Response: 1.
    Average Burden Per Response: Varies (5 minutes to 2 hours).
    Estimated Annual Burden: 136,013 hours.

FY 2004:
    Number of Respondents: 1,527,732.
    Frequency of Response: 1.
    Average Burden Per Response: Varies (5 minutes to 2 hours).
    Estimated Annual Burden: 136,028 hours.

FY 2005:
    Number of Respondents: 1,169,592.
    Frequency of Response: 1.
    Average Burden Per Response: Varies (5 minutes to 2 hours).
    Estimated Annual Burden: 136,013 hours.
    7. Application for Supplemental Security Income--20 CFR, Subpart C, 
416.301-.360--0960-0444. The information collected on Form SSA-8001-F5 
is used to determine eligibility for Supplemental Security Income (SSI) 
and the amount of benefits payable. The respondents are applicants for 
SSI benefits.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 872,956.
    Frequency of Response: 1.
    Average Burden Per Response: 18 minutes.
    Estimated Annual Burden: 261,887 hours.
    8. Application for Supplemental Security Income--20 CFR, Subpart C, 
416.305-.335--0960-0229. The information collected using Form SSA-8000-
BK is needed and used to determine eligibility for Supplemental 
Security Income (SSI) and the amount of benefits payable. The 
respondents are applicants for SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 1,249,933.
    Frequency of Response: 1.
    Average Burden Per Response: 40 minutes.
    Estimated Annual Burden: 833,289 hours.
    9. Application for Wife's or Husband's Insurance Benefits--20 CFR, 
Subpart D, 404.330-.333; Subpart G, 404.603--0960-0008. SSA needs and 
uses the information collected on Form SSA-2-F6 to determine if an 
applicant (including a divorced applicant) can be entitled to benefits 
as the spouse of the worker and the amount of the spouse's benefits. 
The respondents are applicants for wife's or husband's benefits, 
including those who are divorced.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 700,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 175,000 hours.
    10. Supplemental Security Income Claim Information Notice--20 CFR, 
Subpart B, 416.210--0960-0324. Form SSA-L8050 is used by SSA to ensure 
that all sources of potential income, which can be used to provide for 
the support and maintenance of an individual receiving SSI, are 
utilized. SSI is intended to supplement other income available to an 
individual. The respondents are applicants/recipients of SSI who may be 
eligible for benefits from public or private programs.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 7,500.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 1,250 hours.

    Dated: December 6, 2002.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 02-31313 Filed 12-11-02; 8:45 am]
BILLING CODE 4191-02-P