[Federal Register Volume 71, Number 113 (Tuesday, June 13, 2006)]
[Notices]
[Pages 34181-34184]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-9147]


-----------------------------------------------------------------------

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 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 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, 
Fax: 202-395-6974.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance 
Officer, 1333 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. Special Benefits for Certain World War II Veterans--20 CFR 408, 
Subparts G, H, I, J & L--0960-0683. Title VIII of the Social Security 
Act, Special Benefits for Certain World War II Veterans (SVB), allows, 
under certain circumstances, the payment of SVB to qualified veterans 
who reside outside the United States. The accompanying regulations set 
out the requirements an individual must meet in order to establish 
continuing eligibility to, and insure correct payment amount of, SVB 
and/or State recognition payments.
    Additionally, they provide requirements that a State must meet in 
order to elect, modify, or terminate a Federal agreement. The 
respondents are individuals who receive Title VIII SVB, and/or States 
that elect Federal administration of their recognition payments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 60.
    Estimated Annual Burden: 22 hours.

[[Page 34182]]



----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden  per      Estimated
                   Section No.                      respondents      response        response     annual  burden
                                                                                     (minutes)
----------------------------------------------------------------------------------------------------------------
Sec.   408.704-.714.............................               1               1              60            1
Sec.   408.802(b)...............................               5               1              15            1.25
Sec.   408.814..................................               5               1              15            1.25
Sec.   408.820(c)...............................               5               1              15            1.25
Sec.   408.923(b)...............................               1               1              60            1
Sec.   408.931(b) &Sec.   408.932(d)............               1               1              60            1
Sec.   408.932(c)...............................               2               1              15             .50
Sec.   408.932(e)...............................               2               1              15             .50
Sec.   408.941(b) &.............................
Sec.   408.942..................................               2               1              15             .50
Sec.   408.944(a)...............................               2               1              30            1
Sec.   408.1000(a)..............................               1               1              60            1
Sec.   408.1007;................................
Sec.   408.1009(a)-(b)..........................               1               1              60            1
Sec.   408.1009(c)..............................               1               1              60            1
Sec.   408.1210(c)-(d)..........................               1               1             120            2
Sec.   408.1215.................................              10               1              15            2.50
Sec.   408.1230.................................              20               1              15            5.00
----------------------------------------------------------------------------------------------------------------

    2. Uniform Administrative Requirements for Grants and Agreements 
with Institutions of Higher Learning, Hospitals and Other Non-Profit 
Organizations--20 CFR 435--0960-0616. The information contained in 20 
CFR 435 of the Code of Federal Regulations provides SSA's standards in 
the administration of grants and agreements awarded to institutions of 
higher learning, hospitals, other non-profit and/or commercial 
organizations. It provides administrative guidelines and reporting, 
recordkeeping and disclosure requirements for applicable recipients of 
grants and agreements. Respondents are applicants and recipients for 
grants and agreements with SSA.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 196.
    Estimated Annual Burden: 12,871 hours.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                       Number of                                    burden  per      Estimated
            Section No.                responses       Frequency of  response        response      annual burden
                                                                                      (hours)         (hours)
----------------------------------------------------------------------------------------------------------------
435.21 Rec-kp.....................               1  N/A.........................              40              40
435.23 Rec-kp.....................             143  Quarterly (4)...............               1             572
435.25 Rpt........................             157  Biannually (2)..............               4           1,256
435.33 Rpt........................               1  Annually (1)................               1               1
435.44 Rpt........................               1  Annually (1)................               2               2
435.51 Rpt........................             196  Quarterly (4)...............              12           9,408
435.53 Rec-kp.....................             196  Annually (1)................               8           1,568
435.81 Rpt........................               1  Annually (1)................              16              16
435.82 Rpt........................               1  Annually (1)................               8               8
----------------------------------------------------------------------------------------------------------------

    3. Medical Consultant's Review of Psychiatric Review Technique 
Form--20 CFR 404.1520a, 404.1640, 404.1643, 404.1645, 416.920a--0960-
0677. SSA measures the performance of the State Disability 
Determination Services (DDSs) in the area of quality of documentation 
and determinations on claims. In mental claims, a Psychiatric Review 
Technique Form (PRTF) is completed by the DDS. The SSA-3023 is only 
completed when an adjudicating component's PRTF is in the file. An SSA-
3023 is required for each completed PRTF and is used by the regional 
review component to facilitate SSA's medical/psychological consultants' 
review of the PRTF for quality purposes. The respondents are medical/
psychological consultants who review the Psychiatric Review Technique 
Form for quality purposes.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 344.
    Frequency of Response: 194.
    Total Annual Responses: 66,736.
    Average Burden per Response: 12 minutes.
    Estimated Annual Burden: 13,347 hours.
    4. Privacy and Disclosure of Official Records and Information; 
Availability of Information and Records to the Public--20 CFR 
401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185--0960-0566. The 
Privacy Act of 1974 (5 U.S.C. 552a) authorizes SSA to collect certain 
information for access to and amendment or correction of records. The 
information collected is used by SSA to: (1) Identify individuals who 
request access to their records; (2) designate an individual to receive 
and review their medical records; (3) amend or correct records; (4) 
obtain consent from an individual to release his/her records to others 
(consent is submitted by letter in writing or by use of the SSA-3288, 
or other consent form). The Freedom of Information Act authorizes SSA 
to collect information needed to facilitate the release of information 
from SSA records. Respondents are individuals or businesses requesting 
access to, correction of, or disclosure of SSA records.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 3,028,500.
    Estimated Annual Burden: 159,133 hours.

[[Page 34183]]



----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
           Type of request                Number of     Frequency of      Average  burden  per     annual burden
                                         respondents      response              response              (hours)
----------------------------------------------------------------------------------------------------------------
Access to Records....................          10,000               1  11 minutes...............           1,833
Designating a Representative for                3,000               1  2 hours..................           6,000
 Disclosure of Records.
Amendment of Records.................             100               1  10.......................              17
Consent of Release of Records........       3,000,000               1  3 minutes................         150,000
FOIA Requests for Records............          15,000               1  5 minutes................           1,250
Waiver/Reduction of Fees.............             400               1  5 minutes................              33
                                      --------------------------------------------------------------------------
    Totals...........................       3,028,500  ..............  .........................         159,133
----------------------------------------------------------------------------------------------------------------

    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 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 of 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 
claims.
    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. SSA collects information using form SSA-1724 
when there is insufficient information in the file to identify the 
person(s) entitled to an underpayment, or that person's address. This 
information is needed when there is an underpayment due to a deceased 
beneficiary. 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 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

[[Page 34184]]

applying for SVB under Title VIII of the Social Security Act.
    Type of Request: Revision of an OMB-approved information 
collection.
    Estimated Annual Burden: 359 hours.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden  per      Estimated
                   Section No.                      respondents      response        response       annual hour
                                                                                     (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.   408.410-412..............................              20               1              15            5.00
Sec.   408.420(a), (b)..........................             230               1              15           58.00
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
                                                 ---------------------------------------------------------------
    Totals......................................           1,086  ..............  ..............          359
----------------------------------------------------------------------------------------------------------------

    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 a report is given to SSA 
when an individual 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-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 
SVB.
    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: June 6, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
 [FR Doc. E6-9147 Filed 6-12-06; 8:45 am]
BILLING CODE 4191-02-P