[Federal Register Volume 69, Number 173 (Wednesday, September 8, 2004)]
[Notices]
[Pages 54338-54339]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-20264]


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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 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. Contact with the Representative Payee and Contact with 
Beneficiary--0960-0639. SSA will use the SSA-

[[Page 54339]]

L4945, Contact with the Representative Payee, and SSA-L4947, Contact 
with Beneficiary, to inform respondents and conduct quality reviews of 
payments made under the titles II and XVI (Old-Age, Survivors and 
Disability Insurance/Supplemental Security Income) programs. Cases for 
the review will be selected randomly and the information solicited will 
be used for verification of payment data on record in the claims folder 
and SSA's Master Beneficiary Record. Form SSA-L4945 will be used to 
notify Representative Payees who have the responsibility of managing 
payments for an SSA Beneficiary that the case has been selected for the 
review process and to request the required information. Form SSA-L4947 
will be used to notify beneficiaries that their case has been selected 
for the review process and request the needed information. Both letters 
contain information that must be verified and returned to SSA under the 
review process. The respondents are beneficiaries and representative 
payees for beneficiaries receiving title II and title XVI benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 200.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 50 hours.
    2. Early Intervention Project/Employment Services Provider Survey/
0960-NEW.

Background

    The Employment Services Provider Survey is being conducted as part 
of a process demonstration authorized by the Ticket to Work and Work 
Incentives Improvement Act of 1999. The process demonstration, Early 
Intervention (EI), will provide employment services and supports to 
certain applicants for Social Security disability insurance.
    The purpose of the Early Intervention Project is to encourage 
applicants to begin the return to work process immediately after the 
onset of a disability. Many experts believe early intervention to be 
one of the most important factors in successful rehabilitation. 
Therefore, EI will immediately focus on a person's ability to work as 
opposed to proving they are unable to work as they do during the 
existing title II disability determination process. The proposed 
process demonstration is necessary to test the instruments and 
procedures targeted towards these objectives.

The EI Survey

    Beginning in early 2005, EI will be piloted in three states. In New 
Mexico, EI will be piloted in the Albuquerque, Roswell/Carlsbad/Hobbs 
and Clovis areas. In Vermont, EI will be piloted throughout the entire 
state. In Wisconsin, EI will be piloted in the following counties: 
Green, Jefferson, Rock, Walworth, and Waukesha.
    Information collected through the IE survey will be used by SSA for 
the purposes of project design, implementation and evaluation. The 
information will assist in designing how linkages are formed between 
participants and providers for EI. SSA's EI project staff will use the 
information to identify appropriate employment service providers for 
project participants. Project evaluators will use the information 
collected from the survey as a baseline assessment of the provider 
market in each area. The respondents to the IE survey are employment 
service providers in the pilot states.
    Type of Request: New information collection.
    Number of Respondents: 150.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 75 hours.
    II. The information collection listed below has been submitted to 
OMB for clearance. Your comments on the 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 packages 
by calling the SSA Reports Clearance Officer at 410-965-0454, or by 
writing to the address listed above.
    1. Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution--20 CFR 416.200 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.

    Dated: September 1, 2004.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 04-20264 Filed 9-7-04; 8:45 am]
BILLING CODE 4191-02-P