[Federal Register Volume 71, Number 63 (Monday, April 3, 2006)]
[Notices]
[Pages 16606-16608]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-4740]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed 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 new information collections, approval of existing 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 SSA Reports Clearance Officer. The information can be 
mailed and/or faxed to the individuals at the addresses and fax numbers 
listed below:
    (SSA), Social Security Administration, DCFAM, Attn: Reports 
Clearance Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, 
MD 21235. Fax: 410-965-6400.
    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.  Request for Withdrawal of Application--20 CFR 404.640--0960-
0015. The filing of an application for Social Security benefits may be 
to the claimant's disadvantage. The withdrawal procedure provides a 
method for overcoming and nullifying this disadvantage. The SSA-521 
collects the required information to effectuate withdrawal from 
benefits or of an application for benefits. The respondents are 
applicants or claimants for Social Security benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 8,333 hours.

    2. Statement of Claimant or Other Person--20 CFR 404.702, 416.570--
0960-0045. The SSA-795 is used to obtain information from claimants or 
other persons having knowledge of facts in connection with claims for 
Social Security or Supplemental Security Income (SSI) benefits when 
there is no standard form which collects the needed information. The 
information is used by SSA to process claims for benefits or for 
ongoing issues related to the above programs. The respondents are 
applicants/beneficiaries for Social Security benefits or SSI payments, 
or others who are in a position to provide information pertinent to the 
claim(s).
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 305,500.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 76,375 hours.

    3. Application for Search of Census Records for Proof of Age--20 
CFR 404.716--0960-0097. The information collected on Form SSA-1535-U3 
is needed to provide sufficient identifying information to allow an 
accurate search of census records to establish proof of age for an 
individual applying for Social Security benefits. It is used for 
individuals who must establish proof of age as a factor of entitlement, 
and cannot otherwise document their date of birth. The respondents are 
applicants for Social Security benefits who must establish their date 
of birth as a factor of entitlement.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 18,030.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 3,606 hours.

    4. Claim for Amounts Due in the Case of a Deceased Beneficiary--20 
CFR 404.503(b)--0960-0101. Completion of the SSA-1724 to assure proper 
payment of an underpayment due to a deceased beneficiary is required 
when there is insufficient information in the file to identify the 
person(s) entitled to the underpayment, or that person's address. 
Generally, the SSA-1724 is used in cases where a surviving widow(er) is 
not already entitled to a monthly benefit on the same earnings record, 
or is not filing for a lump-sum death payment as a living-with spouse. 
The respondents

[[Page 16607]]

are applicants for underpayments in cases of deceased beneficiaries.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 300,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 50,000 hours.

    5. Statement of Care and Responsibility for Beneficiary--20 CFR 
404.2020, 404.2025, 408.620, 408.625, 416.620, 416.625--0960-0109. Form 
SSA-788 is used to obtain information from the beneficiary's custodian 
about the representative payee applicant's concern and responsibility 
for the beneficiary. The respondents are individuals who have custody 
of the beneficiary where someone else has filed to be the beneficiary's 
representative payee.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 130,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 21,667 hours.

    6. Self-Employment/Corporate Officer Questionnaire--20 CFR 
404.435(e), 404.446--0960-0487. Form SSA-4184 is used to develop 
earnings 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 the benefit amount. The respondents are 
self-employed individuals or corporate officers who apply for 
retirement or survivors' insurance benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 16,667 hours.

    7. Application for Special Benefits for World War II Veterans--20 
CFR 408, Subparts B, C and D--0960-0615. Title VIII of the Social 
Security Act (Special Benefits for Certain World War II Veterans) 
allows for the payment of a monthly benefit to a qualified World War II 
veteran who resides outside the United States. The regulations set out 
the requirements an individual must meet in order to qualify for and 
become entitled to Special Veterans Benefits (SVB). SSA-2000-F6 is the 
application used to elicit the information necessary to determine 
entitlement to SVB. The respondents are individuals who are applying 
for SVB under Title VIII of the Social Security Act.
    Type of Request: Revision of an OMB-approved information 
collection.

 
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                                                                                  Average burden     Estimated
                   Section No.                       Number of     Frequency of    per response     annual hour
                                                    respondents      response        (minutes)        burden
----------------------------------------------------------------------------------------------------------------
Sec.   408.202(d); Sec.   408.210; Sec.                      325               1              20             108
 408.230(a); Sec.   408.305; Sec.  Sec.
 408.310-.315...................................
Sec.   408.232(a)...............................               5               1              15            1.25
Sec.   408.320..................................               5               1              15            1.25
Sec.   408.340..................................               5               1              15            1.25
Sec.   408.345..................................               2               1              15             .50
Sec.   408.351(d) & (f).........................               2               1              30            1.00
Sec.   408.355(a)...............................               5               1              15            1.25
Sec.   408.360(a)...............................               2               1              15             .50
Sec.   408.404(c)...............................              20               1              15            5.00
Sec.  Sec.   408.410-412........................              20               1              15            5.00
Sec.   408.420(a), (b)..........................             230               1              15           58.00
Sec.  Sec.   408.430 & .432.....................             215               1              30          108.00
Sec.   408.435(a), (b), (c).....................             230               1              15           58.00
Sec.   408.437(b), (c), (d).....................              20               1              30           10.00
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    Totals......................................           1,086  ..............  ..............             359
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    Estimated Annual Burden: 359 hours.
    8. Prohibition of Payment of SSI Benefits to Fugitive Felons and 
Parole/Probation Violators--20 CFR 416.708(o)--0960-0617. Section 
1611(e)(4) of the Social Security Act precludes eligibility for SSI 
benefits for certain fugitives and probation/parole violators. 
Regulations at 20 CFR 416.708(o) require that an individual report to 
SSA that he or she is fleeing to avoid prosecution for a crime, fleeing 
to avoid custody or confinement after conviction of a crime, or 
violating a condition of probation or parole. The respondents are SSI 
applicants/recipients or representative payees of SSI recipients who 
are reporting that a recipient is a fugitive felon or probation/parole 
violator.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden Per Response: 1 minute.
    Estimated Annual Burden: 17 hours.
    9. Application for SSA Employee Testimony--20 CFR 403.100-155--
0960-0619. SSA's regulations at 20 CFR 403.100-155 establish policies 
and procedures whereby an individual, organization, or governmental 
entity may request official Agency information, records, or testimony 
of an agency employee in a legal proceeding to which the agency is not 
a party. The request, which must be in writing to the Commissioner, 
must fully set out the nature and relevance of the sought testimony. 
Respondents are individuals or entities who request testimony from SSA 
employees in a legal proceeding.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 100.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 100 hours.
    10. Representative Payee Report-Special Veterans Benefits--20 CFR 
408.665--0960-0621. Title VIII allows the payment of monthly benefits 
by the Commissioner of Social Security to qualified World War II 
veterans who reside outside the U.S. A representative payee may be 
appointed to receive and manage the monthly payment for the 
beneficiary's use and benefit. The SSA-

[[Page 16608]]

2001-F6 is completed by the payee to determine if he has used the 
benefits properly and continues to demonstrate strong concern for the 
beneficiary. Respondents are persons or organizations who act on behalf 
of beneficiaries receiving Special Veterans Benefits.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 100.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 17 hours.

    Dated: March 27, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-4740 Filed 3-31-06; 8:45 am]
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