[Federal Register Volume 71, Number 152 (Tuesday, August 8, 2006)]
[Notices]
[Pages 45090-45091]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-12803]


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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 new information collections and revisions to 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 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 
instrument by calling the SSA Reports Clearance Officer at 410-965-0454 
or by writing to the address listed above.
    1. Vendor List Registration Form--0960-NEW. The Social Security 
Administration (SSA) maintains an Employer Wage Reporting and 
Instructions Vendor Web site. On this site, relevant vendors are 
allowed to list their products and services free of charge. Vendors 
wishing to list their information on the site can submit these requests 
via a written registration form, and will soon be able to use a new 
electronic means of submitting the information through the Web site 
itself. The respondents are vendors dealing with vendors who offer 
employer wage reporting services and want SSA to list their information 
on its Web site.
    Type of Request: New information collection.
    Number of Respondents: 500.
    Frequency of Response: 1.
    Average Burden Per Response: 8 minutes.
    Estimated Annual Burden: 67 hours.
    II. The information collections listed below have been submitted to 
OMB for clearance. Your comments on the information collections would 
be most

[[Page 45091]]

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. Function Report--Adult--20 CFR 404.1512 and 419.912--0960-0681. 
Form SSA-3373 is used to collect information about a disability 
applicant's impairment-related limitations and ability to function. It 
documents the types of information specified in SSA regulations and 
provides disability interviewers with a convenient means to record 
information about how the claimant's condition affects his or her 
ability to function. This information, together with medical evidence, 
forms the evidentiary basis upon which the initial disability process 
is founded. The respondents are Title II and Title XVI benefits 
applicants.
    Type of Request: Revision to an OMB-approved information 
collection.
    Number of Respondents: 4,005,367.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 4,005,367 hours.
    2. Certificate of Incapacity--5 CFR 890.302(d)--0960-NEW. Rules 
governing the Federal Employee Health Benefits (FEHB) plan state that 
for federal employees' children ages 22 or over to retain health 
benefits, they must be incapable of self-support due to a disability 
that (1) pre-dated the child's 22nd birthday, (2) is very serious, and 
(3) can be expected to last at least one year. Form SSA-604, the 
Certificate of Incapacity, is used by physicians to document and 
certify such a disability for their patients who are children of 
federal employees.
    The respondents are physicians of federal employees' children ages 
22 or over who are seeking to retain health benefits under their 
parent's FEHB coverage.
    Type of Request: New information collection.
    Number of Respondents: 38.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 29 hours.
    3. SSA Survey of Ticket to Work Beneficiaries--0960-NEW. The Social 
Security Administration (SSA) plans to survey two groups of Social 
Security beneficiaries who qualified for the Ticket to Work program. 
The first group consists of those beneficiaries who did choose to enter 
the program, while those in the second group did not. The information 
gathered by the survey will be used to assess and contrast the social 
and media interaction preferences of these beneficiaries, both on a 
general level and specifically in relation to media preferences for the 
Ticket to Work program. SSA will use this information to determine what 
role, if any, the type of media outlet SSA used played in a 
beneficiary's decision to join the Ticket to Work program and to 
improve interactions with potential Ticket to Work program 
participants. The respondents are Social Security beneficiaries who 
qualified for the Ticket to Work program.
    Type of Request: New information collection.
    Number of Respondents: 800.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 200 hours.

    Dated: August 2, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
 [FR Doc. E6-12803 Filed 8-7-06; 8:45 am]
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