[Federal Register Volume 70, Number 49 (Tuesday, March 15, 2005)]
[Notices]
[Pages 12772-12774]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-4987]


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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, 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 collection listed below is 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.

Social Security Benefits Application--20 CFR Subpart D, 404.310-404.311 
and 20 CFR Subpart F, 404.601-404.603--0960-0618

    One of the requirements for obtaining Social Security benefits is 
the filing of an application so that a determination may be made on the 
applicant's eligibility for monthly benefits. In addition to the 
traditional paper application, SSA has developed various options for 
the public to add convenience and operational efficiency to the 
application process. The total estimated number of respondents to all 
application collection formats is 3,874,369 with a cumulative total of 
1,008,180 burden hours. The respondents are applicants for retirement 
insurance benefits (RIB), disability insurance benefits (DIB), and/or 
spouses' benefits.
    Please note that burden hours for applications taken through the 
Modernized Claims System (MCS) are accounted for in the hardcopy 
collection formats. Guided by the MCS collection screens, an SSA 
representative interviews the applicant and inputs the information 
directly into the SSA's application database. MCS offers the 
representative prompts based on the type of application being filed and 
the circumstances of the applicant. These prompts facilitate a more 
complete initial application, saving both the agency and applicant 
time. MCS also propagates identity and similar information within the 
application, which saves additional time.

Internet Social Security Benefits Application (ISBA)

    Type of Request: Revision of an OMB-approved information 
collection. (ISBA collection only).
    ISBA, which is available through SSA's Internet site, is one method 
that an individual can choose to file an application for benefits. 
Individuals can use ISBA to apply for RIB, DIB and spouse's insurance 
benefits based on age. SSA gathers only information relevant to the 
individual applicant's circumstances and will use the information 
collected by ISBA to entitle individuals to RIB, DIB, and/or spouse's 
benefits. The respondents are applicants for RIB, DIB, and/or spouse's 
benefits.

[[Page 12773]]

    Number of Respondents: 200,000.
    Frequency of Response: 1.
    Average Burden Per Response: 21.9 minutes.
    Estimated Annual Burden: 73,000 hours.

Paper Application Forms

Application for Retirement Insurance Benefits (SSA-1)

    Form SSA-1 is used by SSA to determine an individual's entitlement 
to RIB. In order to receive Social Security retirement insurance 
benefits, an individual must file an application with the SSA. Form 
SSA-1 is one application that the Commissioner of Social Security 
prescribes to meet this requirement. The information that SSA collects 
will be used to determine entitlement to retirement benefits. The 
respondents are individuals who choose to apply for Social Security 
retirement insurance.
    Number of Respondents: 1,460,692.
    Frequency of Response: 1.
    Average Burden Per Response: 10.5 minutes.
    Estimated Annual Burden: 255,621 hours.

Application for Wife's or Husband's Insurance Benefits (SSA-2)

    SSA uses the information collected on Form SSA-2 to determine if an 
applicant (including a divorced applicant) can be entitled to benefits 
as the spouse of the worker and the amount of the spouse's benefits. 
The respondents are applicants for wife's or husband's benefits, 
including those who are divorced.
    Number of Respondents: 700,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 175,000 hours.

Application for Disability Insurance Benefits (SSA-16)

    Form SSA-16-F6 obtains the information necessary to determine 
whether the provisions of the Act have been satisfied with respect to 
an applicant for disability benefits, and detects whether the applicant 
has dependents who would qualify for benefits on his or her earnings 
record. The information collected on form SSA-16-F6 helps to determine 
eligibility for Social Security disability benefits. The respondents 
are applicants for Social Security disability benefits.
    Number of Respondents: 1,513,677.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 504,559 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.

1. Homeless Outreach Project and Evaluation (HOPE)

Background

    Congress passed the McKinney Act of 1987 in recognition of and in 
an effort to address situations and conditions facing people without 
permanent shelter. The Act funded 15 emergency services and nine 
individual titles to authorize the provision of specific programs by 
Federal agencies. The Act also established the Interagency Council on 
Homelessness (ICH) composed of leaders from 15 Federal agencies who are 
in charge of coordinating efforts to assist people who are homeless. 
During the past decade, SSA and other ICH agencies have compiled 
important data about people who are homeless and have carried out 
evaluations of services which have generated evidence about ``best'' or 
``promising practices'' well suited to combating homelessness.
    In fiscal year 2003, President George W. Bush announced an 
initiative to end chronic homelessness in 10 years. As a result, SSA 
developed Project HOPE and in May 2004 awarded 34 Cooperative 
Agreements to organizations which provide outreach, support services 
and benefit application assistance to the chronically homeless and 
other underserved populations. An additional 7 cooperative agreements 
were awarded in November 2004 for a total of 41. The goal of Project 
HOPE is to improve both the quantity and quality of applications for 
disability benefits. Project HOPE gives focused support to Cooperative 
(co-op) awardees via a training program and ongoing technical 
assistance.

Evaluation of Project HOPE

    SSA is undertaking the project HOPE evaluation to determine the 
effectiveness and the efficiency of the program. To obtain the 
information needed for the evaluation, SSA is developing an interactive 
Web site that will be used by co-op awardees to input client and 
program data, and by SSA to communicate project-wide announcements to 
the awardees. The respondents are HOPE grantees/non-profit social 
services organizations serving people who are homeless & disabled.
    Type of Request: New information collection.
    Number of Respondents: 41.
    Frequency of Response: 12.
    Average Burden Per Response: 65 minutes.
    Estimated Annual Burden: 533 hours.

2. Appointment of Representative--20 CFR 404.1707, 404.1720, 404.1725, 
410.684 and 416.1507--0960-0527

    The information collected by SSA on form SSA-1696-U4 is used to 
verify the applicant's appointment of a representative. It allows SSA 
to inform the representative of items which affect the applicant's 
claim. The affected public consists of applicants who notify SSA that 
they have appointed a person to represent them in their dealings with 
SSA when claiming a right to benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 551,520.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 91,920 hours.

3. Petition To Obtain Approval of a Fee for Representing a Claimant 
Before the Social Security Administration--20 CFR Subpart R--404.1720, 
404.1725, Subpart F, 410.686b, Subpart O, 416.1520 and 416.1525--0960-
0104

    A representative of a claimant for Social Security benefits must 
file either a fee petition or a fee agreement with SSA in order to 
charge a fee for representing a claimant in proceedings before SSA. The 
representative uses form SSA-1560 to petition SSA for authorization to 
charge and collect a fee. A claimant may also use the form to agree or 
disagree with the requested fee amount or other information the 
representative provides on the form. SSA uses the information to 
determine a reasonable fee that a representative may charge and collect 
for his or her services. The respondents are claimants, their attorneys 
and other persons representing them.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 34,624.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 17,312 hours.

[[Page 12774]]

4. Employee Work Activity Questionnaire--20 CFR 404.1574, 404.1592--
0960-0483

    When a possible unsuccessful work attempt or a subsidy is involved, 
as described in regulations 20 CFR 404.1574(a)(1), (2) and (3), form 
SSA-3033 is used to request a description of the employee's work 
effort. The data is evaluated to determine if the claimant meets the 
disability requirements of the law. The information is collected 
through form SSA-3033 or by telephone contact, only in cases where it 
cannot be obtained through electronic data matches with other Federal 
agencies and/or State agencies.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 15,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 3,750 hours.

5. Statement Regarding the Inferred Death of an Individual by Reason of 
Continued and Unexplained Absence--20 CFR 404.720 and 404.721--0960-
0002

    SSA will use the information collected on form SSA-723 in making 
its determination that the missing person may be presumed deceased and, 
if so, to establish a date of presumed death. The respondents are 
persons who have knowledge about the disappearance of the missing 
person.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 3,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 1,500 hours.

    Dated: March 9, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 05-4987 Filed 3-14-05; 8:45 am]
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