[Federal Register Volume 70, Number 39 (Tuesday, March 1, 2005)]
[Notices]
[Pages 10017-10018]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-3892]


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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, 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, 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 a copy of the collection 
instrument by calling the SSA Reports Clearance Officer at (410) 965-
0454 or by writing to the address listed above.
    State Agency Ticket Assignment Form--Ticket to Work and Self 
Sufficiency Program--0960-0641. SSA uses the information collected on 
form SSA-1365 to determine proper assignment under the Ticket to Work 
program and payment option. This will be done through the contracted 
Program Manager. The State Vocational Rehabilitation Agency (VRA) 
completes the form and the beneficiary reviews the data. The 
beneficiary will sign the form to acknowledge the assignment of their 
ticket to that agency. Respondents are the State VRAs.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 82.
    Frequency of Response: 50.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 205 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. Application for Survivors Benefits--20 CFR 404.611 (a) and (c)--
0960-0062. The information collected by form SSA-24 is needed to 
satisfy the ``Joint Prescribed Application'' of Title 38 U.S.C. 5105. 
That provision requires that survivors who file with either SSA or the 
Department of Veterans Affairs (VA) shall be deemed to have filed with 
both agencies, and that each agency's forms must request sufficient 
information to constitute an application for both SSA and VA benefits. 
The respondents are survivors of members or former members of the armed 
services. When form SSA-24 is received by SSA from the VA, an earnings 
record is requested to determine if insured status exists so that the 
claimant will complete the appropriate SSA survivor application. If 
entitlement does not exist, SSA may disallow the claim. If an SSA 
survivor application has already been filed, form SSA-24 is treated as 
a duplicate application.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 3,200.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 800 hours.
    2. Continuing Disability Review Report--20 CFR 404.1589, 20 CFR 
416.989--0960-0072. We use form SSA-454-BK to collect information from 
individuals receiving disability benefits or their representatives. We 
evaluate the information to determine whether the individuals remain 
eligible for benefit payments. Adults are considered eligible for 
payment if they continue to be unable to do substantial gainful 
activity (SGA) by reason of their impairments. Title XVI children are 
considered eligible for payment if they still have marked and severe 
functional limitations by reason of their impairments. We obtain 
information concerning sources of medical treatment, participation in 
vocational rehabilitation programs (if any), attempts to work (if any), 
and the opinions of individuals regarding whether their conditions have 
improved.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 792,020.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 594,015 hours.
    Quarterly Statistical Report on Recipients and Payments Under 
State-Administered Assistance Programs for Aged, Blind and Disabled 
(Individuals and Couples) Recipients--20 CFR 416.2010, 20 CFR 
416.2098--0960-0130. The purpose of the statistical report is to obtain 
State data on expenditures and caseloads of State-administered 
supplementation under the Supplemental Security Income (SSI)

[[Page 10018]]

program. The statistics are needed to complement information available 
for the federally administered programs and to more fully explain the 
impact of the public income support programs on the needy, aged, blind, 
and disabled. In addition, the expenditure data are used to monitor 
State compliance with the mandatory pass-along provision.
    States use our publications, which are prepared from data submitted 
on this statistical report, for administrative purposes to compare 
their expenditures and caseloads with those of other States, to 
determine the feasibility of program change, and to keep abreast of 
program developments in other States. Federal personnel request data 
about State-administered supplementation programs to compare various 
State programs, to examine the relationship of State supplementation 
expenditures and caseloads to federally financed programs such as 
Medicaid, and to determine the effect of changes in SSI and other 
Federal programs on State supplementation programs. In addition, 
Federal and State personnel have used data obtained from this report in 
developing legislative proposals and budget estimates.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 31.
    Frequency of Response: 4.
    Average Burden per Response: 60 minutes.
    Estimated Annual Burden: 124 hours.

    Dated: February 23, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 05-3892 Filed 2-28-05; 8:45 am]
BILLING CODE 4191-02-P