[Federal Register Volume 68, Number 56 (Monday, March 24, 2003)]
[Notices]
[Pages 14269-14271]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-6890]


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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 Pub. L. 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. Disability Report--20 CFR 404.1512 and 416.912, 20 CFR 404.916(c) 
and 416.1416(c)--Appeal--0960-0144

    SSA uses form SSA-3441 to secure updated resource and condition 
information from claimants seeking reconsideration of denied disability 
benefits. The claimant also has the option of providing the information 
during a personal interview or through SSA's Internet application. This 
information assists the State Disability Determination Services (DDS) 
and Administrative Law Judges (ALJ) in preparing for the appeals and 
hearings and in issuing a decision on whether or

[[Page 14270]]

not an individual is entitled to or continues to be entitled to 
disability benefits. SSA requests completion of the SSA-3441 when 
individuals appeal denial of Social Security Disability Income (SSDI) 
and Supplemental Security Income (SSI) benefits following a previous 
denial. The respondents are applicants for reconsideration of initial 
denial of disability benefits; reconsideration of disability cessation 
and individuals requesting hearings before an ALJ.
    Type of Request: Revision of a currently approved OMB information 
collection.
    SSA will collect this information using both the traditional paper 
format and via electronic formats through SSA information gathering 
systems and an online Internet collection as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden
                                                     Number of     Frequency of    per response      Estimated
                                                    respondents      response      (in minutes)    annual burden
----------------------------------------------------------------------------------------------------------------
SSA-3441 (Paper Form)...........................       1,079,338               1              30         539,669
Electronic Disability Collection System (EDCS)..          16,790               1              30           8,395
I3441 (Internet Form)...........................          16,690               1              60          16,690
                                                 --------------------------------
    Total Burden Hours--........................         564,754  ..............  ..............
----------------------------------------------------------------------------------------------------------------

2. Driver's License Signature Proof-of-Concept Study--20 CFR 404.610--
0960-NEW

    SSA plans to explore the feasibility of providing an electronic 
alternative to the traditional pen-and-ink signature by conducting a 
Proof-of-Concept (POC) test using an individual's driver's license or 
State-issued identity card number as an electronic signature. If the 
applicant voluntarily decides to provide the driver's license or State-
issued identity card number, an SSA employee will verify the validity 
of the number with the issuing State motor vehicle agency by submitting 
the information electronically to the State that issued the license 
through a connection with the American Association of Motor Vehicle 
Administrators (AAMVA). If the State confirms that the number is valid 
and the name provided matches that on its records, the SSA interviewer 
will annotate SSA's electronic claims record that the application was 
signed by electronic signature. The respondents to this collection are 
applicants that apply for Social Security Retirement benefits within a 
test State and opt to participate in the POC.
    Type of Request: New information collection.
    Number of Respondents: 93,000.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 4,650 hours.

3. Request for Workers' Compensation/Public Disability Information--20 
CFR, Subpart E, 404.408--0960-0098

    SSA uses form SSA-1709 to request and/or verify information about 
workers' compensation or public disability benefits given to Social 
Security disability recipients so that the proper adjustment is made to 
their monthly benefits. The respondents are Federal, State, and local 
agencies administering Workers' Compensation or public disability 
benefits, private workers, insurance carriers and public or private 
self-insured companies.
    Type of Request: Extension of an OMB-approved information 
collection:
    Number of Respondents: 140,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 35,000 hours.

4. Self-Employment/Corporate Officer Questionnaire--20 CFR 404.435(e) 
404.446--0960-0487

    Form SSA-4184 is used to develop earnings data and corroborate the 
claimant's allegations of retirement when the claimant is self-employed 
or a corporate officer. The information collected is used to determine 
benefit amounts. The respondents are self-employed individuals and 
corporate officers.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 20,000.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 6,667 hours.

5. Claim for Amount Due in the Case of a Deceased Beneficiary--20 CFR 
405.503(b)--0960-0101

    Section 204(d) of the Social Security Act provides that if a 
beneficiary dies before payment of Social Security benefits has been 
completed, the amount due will be paid to the persons meeting specified 
qualifications. The information collected on Form SSA-1724 is used by 
SSA to determine whether an individual is entitled to the underpayment. 
The respondents are applicants for the amounts of an underpayment of a 
deceased beneficiary.
    Type of Request: Revision of a currently approved OMB information 
collection.
    Number of Respondents: 300,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 50,000 hours.
    II. The information collection listed below has been submitted to 
OMB for clearance. Your comments on this information collection 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

Statement of Income and Resources--0960-0124
    The information collected on form SSA-8010-BK is used in 
Supplemental Security Income (SSI) claims and redeterminations to 
obtain information about the income and resources of: Ineligible 
spouses, parents/spouses of parents, and children living in the 
claimant's/beneficiary's household; essential persons; and sponsors of 
aliens (including spouses of sponsors who live with the sponsor). The 
information is needed to make initial or continuing eligibility 
determinations for SSI claimants/beneficiaries who are subject to 
deeming. If eligible, the information is used to determine the amount 
of the SSI payment. The respondents are persons whose income and/or 
resources must be considered in determining the

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eligibility of SSI claimants or beneficiaries.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 341,000.
    Frequency of Response: 1.
    Average Burden Per Response: 25 minutes.
    Estimated Annual Burden: 142,083 hours.

    Dated: March 18, 2003.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 03-6890 Filed 3-21-03; 8:45 am]
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