[Federal Register Volume 69, Number 107 (Thursday, June 3, 2004)]
[Notices]
[Pages 31442-31444]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-12505]


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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 Pub. L. 104-
13, the Paperwork Reduction Act of 1995, effective October 1, 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 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 Building, 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. Statement of Agricultural Employer (Years prior to 1988); 
Statement of Agricultural Employer (1988 and Later)--0960-0036. The 
information on Forms SSA-1002 and SSA-1003 is used by the Social 
Security Administration (SSA) to resolve discrepancies when farm 
workers have alleged that their employers did not report their wages or 
reported them incorrectly. The respondents are agricultural employers.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                             Average
                                                                                 Frequency    burden   Estimated
                                                                       No. of        of        per       annual
                                                                    respondents   response   response    burden
                                                                                            (minutes)
----------------------------------------------------------------------------------------------------------------
SSA-1002..........................................................      75,000           1         10     12,500
SSA-1003..........................................................      50,000           1         30     25,000
                                                                   --------------
    Total.........................................................      25,000   .........  .........     37,500
----------------------------------------------------------------------------------------------------------------

    2. Representative Payee Evaluation Report--20 CFR 404.2065 and 
416.665--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.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 252,000.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Average Burden: 126,000 hours.

[[Page 31443]]

    3. Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution--20 CFR416.200 and 
416.203--0960-0293. Form SSA-4641-U2 provides financial institutions 
with the customer's authorization to disclose records. Responses to the 
questions are used, in part, to determine whether resource requirements 
are met in the Supplemental Security Income program. The respondents 
are financial institutions (banks, savings and loans, credit unions, 
etc.).
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 500,000.
    Frequency of Response: 1.
    Average Burden per Response: 6 minutes.
    Estimated Annual Burden: 50,000 hours.
    4. Agency/Employer Government Pension Offset Questionnaire--20 CFR 
404-408a--0960-0470. The information collected by form SSA-L4163 
provides SSA with accurate information from the agency paying a 
claimant's pension. This form is only used when (1) the claimant does 
not have the necessary information and (2) the pension-paying agency 
has not cooperated with the claimant in providing this information. 
Respondents are Federal, State, or local government agencies that have 
information needed by SSA to determine whether the Government Pension 
Offset provisions apply and if so, what is the amount of the offset.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 50 hours.
    5. Request for Correction of Earnings Record--20 CFR 404.820 and 
422.125--0960-0029. Form SSA-7008 is used by individual wage earners to 
request SSA review, and, if necessary, correction of the Agency's 
master record of their earnings. The respondents are individuals who 
question SSA's record of their earnings.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 37,500.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 6,250 hours.
    6. Beneficiary Recontact Report--20 CFR 404.703 and 404.705--0960-
0536. SSA collects the information on Form SSA-1587 to ensure that 
eligibility for benefits continues after entitlement is established. 
SSA asks representative payees of children ages 15-17 information about 
marital status to detect possible overpayments and avoid continuing 
payment to those no longer entitled. Studies show that the 
representative payees of children who marry often fail to report the 
marriage, which is a terminating event. The respondents are payees who 
receive Title II (Old-Age, Survivors and Disability Insurance) benefits 
on behalf of children ages 15-17.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 982,357.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Annual Burden: 49,118.
    7. Waiver of Your Right to Personal Appearance Before an 
Administrative Law Judge--0960-0284--20 CFR 404.948(b)(l)(i) and 
416.1448(b)(l)(i). Each claimant has a statutory right to appear in 
person (or through a representative) and present evidence about his/her 
claim at a hearing before an Administrative Law Judge (ALJ). If a 
claimant wishes to waive his/her statutory right to appear before an 
ALJ, he/she must complete a written request. The claimant may use Form 
HA-4608 for this request. The information collected is used to document 
an individual's claim to show that an oral hearing is not preferred in 
the appellate process. The respondents are applicants for Social 
Security and Supplemental Security Income benefits who request a 
hearing.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden Per Response: 2 minutes.
    Estimated Annual Burden: 400 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. Request for Waiver of Overpayment Recovery or Change in 
Repayment Notice--20 CFR 404.502-404.515 and 20 CFR 416.550-416.570--
0960-0037. Form SSA-632 collects information on the circumstances 
surrounding overpayment of Social Security Benefits to recipients. SSA 
uses the information to determine whether recovery of an overpayment 
amount can be waived or must be repaid and, if repaid, how recovery 
will be made. The respondents are recipients of Social Security, 
Medicare or Supplemental Security Income overpayments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 500,000.
    Frequency of Response: 1.
    Average Burden Per Response: 120 minutes.
    Estimated Annual Burden: 1,000,000 hours.
    2. Certificate of Responsibility for Welfare and Care of Child Not 
in Applicant's Custody--20 CFR 404.330 and 404.339--0960-0019. SSA uses 
the information collected on form SSA-781 to decide if ``in care'' 
requirements are met by the non-custodial parent who is filing for 
benefits based on having a child in care. The respondents are non-
custodial wage earners whose entitlement to benefits depends upon 
having an entitled child in care.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 14,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 2,333 hours.
    3. Application for Benefits Under the Italy-U.S. International 
Social Security Agreement--20 CFR 404.1925--0960-0445. The information 
collected on Form SSA-2528 is required by SSA in order to determine 
entitlement to benefits. The respondents are applicants for old-age, 
survivors or disability benefits, who reside in Italy.
    Type of Request: Extension of an OMB-approved collection.
    Number of Respondents: 200.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 67 hours.
    4. Real Property Current Market Value Estimate--0960-0471. The SSA-
L2794 is used to obtain current market value estimates of real property 
owned by applicants for, or beneficiaries of, Supplemental Security 
Income payments (or a person whose resources are deemed to such an 
individual). The value of an individual's resources, including non-home 
real property is one of the eligibility requirements for SSI payments. 
The respondents are individuals with knowledge of local real property 
values.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 5,438.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 1,813 hours.


[[Page 31444]]


    Dated: May 27, 2004.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 04-12505 Filed 6-2-04; 8:45 am]
BILLING CODE 4191-02-P