[Federal Register Volume 72, Number 10 (Wednesday, January 17, 2007)]
[Notices]
[Pages 2081-2083]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-555]


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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 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. Questionnaire about Employment or Self-Employment Outside the 
United States--20 CFR 404.401(b)(1), 404.415, 404.417--0960-0050. The 
information collected on the SSA-7163 is needed to determine whether 
work performed by beneficiaries outside the United States is cause for 
deductions from their monthly Social Security Title II benefits; to 
determine which of two work tests (foreign test or regular test) is 
applicable; and to determine the months, if any, for which deductions 
should be imposed. The respondents are Title II beneficiaries living 
and working outside the United States.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 20,000.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 4,000 hours.
    2. Complaint Form for Allegations of Discrimination in Programs or 
Activities Conducted by the Social Security Administration--0960-0585. 
The information collected on form SSA-437 is used by SSA to investigate 
and formally resolve complaints of discrimination based on race, color, 
sex, age, religion, disability, retaliation, and national origin, 
including limited or no ability with English in any program or activity 
conducted by SSA. A person who believes that he or she has been 
discriminated against on any of the above bases may file a written 
complaint of discrimination. The information will be used to identify 
the complainant; identify the alleged discriminatory act; ascertain the 
date of such alleged act; obtain the identity of any individual(s) with 
information about the alleged discrimination; and ascertain other 
relevant information that would assist in the investigation and 
resolution of the complaint. The respondents are individuals who 
believe they have been discriminated against by SSA or by SSA's 
employees, contractors or agents in programs or activities conducted by 
SSA.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 140.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 140 hours.
    3. Work Incentives Planning and Assistance Program (formerly the 
BPAO Program)--0960-0629. Like the Benefits Planning Assistance 
Outreach (BPAO) program which it replaces, the Work Incentives Planning 
and Assistance (WIPA) program collects identifying information from the 
project sites and the community work incentives coordinators. In 
addition, data are collected from the beneficiaries on background 
employment, training, benefits and work incentives. SSA is interested 
in identifying beneficiary outcomes under the WIPA program to determine 
the extent to which beneficiaries with disabilities achieve their 
employment, financial and health care goals. The data will also be 
valuable to SSA in its analysis and future planning for Social Security 
Disability Insurance and Supplemental Security Income (SSI) programs.
    Type of Request: Revision of an OMB-approved information 
collection.
    Estimated Annual Burden: 5,019 hours.

[[Page 2082]]



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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Respondent                         annual         response        response     annual  burden
                                                     responses                       (minutes)         hours
----------------------------------------------------------------------------------------------------------------
Site............................................             147               1               2               5
CWIC............................................             422               1               2              14
Beneficiary.....................................          60,000               1               5           5,000
                                                 ---------------------------------------------------------------
    Totals......................................          60,569  ..............  ..............           5,019
----------------------------------------------------------------------------------------------------------------

    4. Expanded Monitoring Site Review Questionnaire for Volume and Fee 
for Service Payees (SSA-637); Expanded Monitoring Site Review 
Beneficiary Interview Form (SSA-639)--20 CFR 404.2035, 404.2065, 
416.665, 416.701, 416.708--0960-0633. In situations where a Social 
Security beneficiary or SSI recipient is incompetent or physically 
unable to take care of his or her own affairs, SSA may pay Social 
Security benefits and/or SSI payments to a relative, another person, or 
an organization when the best interest of the beneficiary will be 
served. In certain situations, SSA conducts site reviews to ensure that 
payees are carrying out their responsibilities according to 
representative payment policies and procedures. SSA is also able to 
identify poor payee performance, uncover misuse and initiate corrective 
action. Triennial site reviews are conducted for fee-for-service payees 
and all volume payees (i.e., organizations serving 100 or more 
beneficiaries and individuals serving 20 or more beneficiaries). The 
reviews include a face-to-face meeting with the payee (and appropriate 
staff), examination/verification of a sample of beneficiary records and 
supporting documentation, and usually include beneficiary (if competent 
adult) or custodian (if different from payee) interviews. Forms SSA-637 
and SSA-639 are used to record the information collected during these 
interviews. The respondents are certain representative payees and also 
competent Social Security beneficiaries.
    Type of Request: Revision of an OMB-approved information 
collection.
    Estimated Annual Burden: 3,538 hours.

----------------------------------------------------------------------------------------------------------------
                                                                                     Time per
                    Form No.                         Number of        Reports        response       Total hours
                                                    respondents      annually        (minutes)
----------------------------------------------------------------------------------------------------------------
SSA-637.........................................           1,763               1              75           2,204
SSA-639.........................................           8,001               1              10           1,334
                                                 ---------------------------------------------------------------
    Totals......................................           9,764  ..............  ..............           3,538
----------------------------------------------------------------------------------------------------------------

    5. Direct Deposit Sign-Up Form (Country)--31 CFR 210--0960-0686. 
This form captures the direct deposit information for an account at a 
foreign financial institution. Our International Direct Deposit program 
allows beneficiaries living abroad to have their benefits deposited to 
an account at a financial institution outside the U.S. Routing account 
number information varies slightly for each country, so we use a 
variation of the SF-1199 A for each country. The respondents are Social 
Security beneficiaries residing abroad.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 5,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 417 hours.
    6. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. When a valid agreement is in place, prison officials will 
verify the identity of certain incarcerated U.S. citizens who need 
replacement Social Security cards. Information the prison officials 
provide will be taken from the official prison files and will be 
transcribed on their letterhead. This information will be used to 
establish the applicant's identity in the Social Security card process. 
The respondents are prison officials that certify identity of prisoners 
applying for replacement Social Security cards.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 200.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 10,000 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. Certification of Period of Temporary Institutionalization and 
Need to Maintain Home--20 CFR 416.212(b)(1)--0960-0516. SSA is required 
by law to collect the information necessary to establish eligibility 
for continued SSI payments for temporarily institutionalized 
individuals. Sections 1611(e)(1)(G)&(H) of the Social Security Act 
require the Commissioner to establish procedures for determining that a 
physician has certified that the period of confinement is not likely to 
exceed 3 months, and for determining that the recipient needs to 
continue to maintain and provide for the expense of a home or living 
arrangement.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 60,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 5,000 hours.
    2. Blood Donor Locator Service (BDLS)--20 CFR 401.200--0960-0501. 
This regulation requires requesting State agencies to provide the names 
and Social Security Numbers of blood donors, and a statement that the 
donor's blood tested positive for Human Immunodeficiency Virus (HIV) to 
SSA's Blood Donor Locator Service when blood donor facilities have 
identified donors as testing positive for HIV. This information is used 
by SSA to furnish the State agencies with the blood

[[Page 2083]]

donors' address information for the purpose of notifying them. 
Respondents are State agencies acting on behalf of blood donor 
facilities.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 10.
    Frequency of Response: 5.
    Number of Responses: 50.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 13 hours.
    3. Pre-1957 Military Service--Federal Benefit Questionnaire--20 CFR 
404.1301-404.1371--0960-0120. Sections 217(a) through (e) of the Social 
Security Act provide for the crediting of military service before 1957 
to the wage earner's record. This form collects specific information 
about other Federal, military or civilian benefits the wage earner may 
receive when the applicant indicates both pre-1957 military service and 
the receipt of Federal benefit. This data is then used in the claims 
adjudication process to grant gratuitous military wage credits when 
applicable. This form is used to solicit sufficient information to make 
a determination of eligibility. Respondents are applicants for Social 
Security benefits on a record where the wage earner has pre-1957 
military service.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 5,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 833 hours.
    4. Statement of Household Expenses and Contributions--20 CFR 
416.1130-416.1148--0960-0456. SSA needs the information about household 
expenses and contributions, which is collected on Form SSA-8011-F3, to 
determine whether the individual receives in-kind support and 
maintenance. This is necessary to determine eligibility for SSI and the 
amount payable. This form is not used for all claims and post 
eligibility determinations; rather, it is used only when it is 
necessary to document in-kind support and maintenance and only in cases 
where the householder's corroboration is needed. Respondents are SSI 
applicants and/or recipients.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 400,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 100,000 hours.

    Dated: January 10, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E7-555 Filed 1-16-07; 8:45 am]
BILLING CODE 4191-02-P