[Federal Register Volume 68, Number 29 (Wednesday, February 12, 2003)]
[Notices]
[Pages 7160-7162]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-3511]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Notice of Office of 
Management and Budget (OMB) Approval, Proposed Request and Comment 
Request

    As required by the Paperwork Reduction Act of 1995 (44 U.S.C. 
3507), the Social Security Administration (SSA) is providing notice of 
OMB's approval of the information collections in the 20 CFR 422.527, 
Private Printing and Modification of Prescribed Application and Other 
Forms. In accordance with the Paperwork Reduction Act, persons are not 
required to respond to an information collection unless it displays a 
valid Office of Management and Budget control number. The OMB Number is 
0960-0663, which expires December 31, 2005.
    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, 1300 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

[[Page 7161]]

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. Claimant's Medications--0960-0289--20 CFR 404.1512 and 416.912. 
The information on form HA-4632 is used to process title II (Old-Age 
and Survivors Disability Insurance) and title XVI (Supplemental 
Security Income (SSI)) disability claims. Claimants provide an updated 
list of medications using form HA-4632. This information enables the 
Administrative Law Judge who conducts the hearing to fully inquire into 
medical treatment the claimant is receiving and the effect of 
medications on the claimant's medical treatment. The respondents are 
applicants for title II and title XVI benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 171,939.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 42,985 hours.
    2. Letter to Employer Requesting Wage Information--0960-0138. Form 
SSA-L4201-U2 is used to collect wage data from employers to establish 
and/or verify wage information for SSI claimants, beneficiaries and 
deemors. SSA uses the data to determine if an individual is eligible 
for SSI and, if so, to determine the amount of the payment due. The 
respondents are employers of applicants for and recipients of SSI 
payments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 133,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 66,500 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 package 
by calling the SSA Reports Clearance Officer at 410-965-0454, or by 
writing to the address listed above.

Action: Comment Request

    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.

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      Title of collection         Number of annual  responses      Frequency of  response      Average burden per response    Estimated annual  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      3,080 (electronic)...........  One Time....................  5 minutes...................  257 hours.
 Form.
                                 300 (manual).................  One Time....................  7 minutes...................  35 hours.
Participant Update Form........  3,080 (electronic)...........  Quarterly...................  4 minutes...................  821 hours.
                                 300 (manual).................  Quarterly...................  5 minutes...................  100 hours.
Change in Employment Status....  1,540 (electronic)...........  Completed only if employment  3 minutes...................  77 hours.
                                                                 changes.
                                 150 (manual).................  ............................  4 minutes...................  10 hours.
State Quarterly and State        72...........................  Quarterly, semiannual and     15 minutes for Each report..  18 hours.
 Semiannual and Annual Reports.                                  Annual.
                                 36...........................  ............................  ............................  9 hours.
                                 18...........................  ............................  ............................  4 hours.
Stakeholder Interviews.........  50...........................  Varies per Stakeholder......  10 minutes..................  8 hours.
                                --------------------------------
    Total......................  12,024.......................  ............................  ............................  2,211 hours.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    2. Claimant's Recent Medical Treatment--20 CFR, Subpart P, 404.1512 
and 20 CFR, Subpart I, 416.912--0960-0292. The information collected on 
form HA-4631 is used to provide an updated medical history for 
disability claimants who request 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 and/or title XVI 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.

[[Page 7162]]

    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; and 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.

------------------------------------------------------------------------
                                    SSA-7161-OCR-SM     SSA-7162-OCR-SM
------------------------------------------------------------------------
Number of Respondents...........              30,000             205,000
Frequency of Response...........                   1                   1
Average Burden Per Response                       15                   5
 (minutes)......................
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.
    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--0960-0960-0133. 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. Statement of Funds You Provided to Another, Statement of Funds 
You Received--20 CFR 416.1103(f)--0960-0481. SSI entitlement, and the 
amount of the SSI payment, is affected by any other income the 
applicant has. Forms SSA-2854 and SSA-2855 are used by SSA to collect 
information in situations where the SSI applicant alleges that money 
was borrowed on an informal basis from a noncommercial lender, e.g., a 
relative or friend, etc. These statements are completed by the 
borrower/claimant and by the lender and are required to determine 
whether the proceeds from the transaction are/are not income to the 
borrower/claimant. If the transaction constitutes a bona fide loan, the 
proceeds are not income to the SSI borrower/claimant. The respondents 
are applicants for SSI payments who borrow money on an informal 
(noncommercial) basis and by individuals who lend money informally to 
SSI applicants.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 40,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 6,667 hours.
    7. SSI Wage Reporting Pilot--0960-NEW--Background: 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 an SSA teleservice representative through 
SSA's toll-free telephone number or they visit their local Social 
Security Office.
    The SSI Wage Reporting Pilot: 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: 2,000 hours.

    Dated: February 6, 2003.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 03-3511 Filed 2-11-03; 8:45 am]
BILLING CODE 4191-02-P