[Federal Register Volume 72, Number 60 (Thursday, March 29, 2007)]
[Notices]
[Pages 14845-14847]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-5728]


=======================================================================
-----------------------------------------------------------------------

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, 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, faxed or e-mailed 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, E-mail address: OIRA--Submission@omb.eop.gov.
(SSA): Social Security Administration, DCFAM, Attn: Reports Clearance 
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, 
Fax: 410-965-6400, E-mail address: [email protected].

    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. Certificate of Responsibility for Welfare and Care of Child Not 
in Applicant's Custody--20 CFR 404.330, 404.339-341 and 404.348-
404.349--0960-0019. SSA uses the information to determine if a non-
custodial parent who is filing for Spouse's or Mother's and Father's 
benefits based on having a child in care meets the in-care 
requirements. Respondents are applicants for Spouse and/or Mother's and 
Father's benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 14,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 2,333 hours.
    2. Request for Waiver of Overpayment Recovery or Change in 
Repayment Notice--20 CFR 404.502-.513, 404.515 and 20 CFR 416.550-.570, 
416.572--0960-0037. The SSA-632-BK is used by a beneficiary/claimant to 
request a waiver of recovery of an overpayment by explaining why they 
feel they are without fault in causing the overpayment and to provide 
financial circumstances so that SSA can determine whether recovery 
would cause financial hardship. It is also used to request a different 
rate of recovery. In those cases the financial information must be 
provided for SSA to determine how much the overpaid person can afford 
to repay each month. Respondents are overpaid beneficiaries or 
claimants who are requesting a waiver of recovery for overpayment or a 
lesser rate of withholding.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 500,000.
    Estimated Annual Burden: 875,000 hours.

----------------------------------------------------------------------------------------------------------------
                                       Number of     Frequency of    Average  burden per
    Reason for completing form        respondents      response            response         Total annual burden
----------------------------------------------------------------------------------------------------------------
Request Waiver....................         400,000               1  2 hours..............  800,000
Request Change....................         100,000               1  45 minutes...........  75,000
                                   -----------------------------------------------------------------------------
    Totals........................         500,000  ..............  .....................  875,000
----------------------------------------------------------------------------------------------------------------

    3. Supplemental Statement Regarding Farming Activities of Person 
Living Outside the U.S.A.--0960-0103. Form SSA-7163A is used whenever a 
beneficiary or claimant reports work on a farm outside the United 
States (U.S.). It is designed to obtain sufficient information to 
determine whether or not foreign work deductions are applicable to the 
claimant's benefits. Respondents are beneficiaries or claimants for 
Social Security benefits who are engaged in farming activity outside 
the U.S.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden per Response: 1 hour.
    Estimated Annual Burden: 1,000 hours.
    4. Disability Report--Appeal--20 CFR 404.1512, 416.912, 404.916(c), 
416.1416(c), 405 Subpart C, 422.140--0960-0144. The SSA-3441-BK is used

[[Page 14846]]

to secure updated medical and other information since the claimant's 
last disability determination from claimants who are appealing an 
unfavorable disability determination. This information may be used for 
reconsideration or request for federal reviewing official review of 
initial disability determinations and continuing disability reviews as 
well as a request for a hearing. This information assists the State 
Disability Determination Services, federal reviewing officials, and 
administrative law judges in preparing for appeals and hearings and in 
issuing a decision. Respondents are individuals who appeal denial of 
Social Security disability income and Supplemental Security Income 
(SSI) benefits, cessation of benefits, or who are requesting a hearing.
    Type of Request: Revision of an OMB-approved information 
collection.
    Estimated Annual Burden: 1,296,190 hours.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
          Collection method               Number of     Frequency of      Average burden  per      annual burden
                                         respondents      response              response               hours
----------------------------------------------------------------------------------------------------------------
SSA-3441 (Paper Form)................          21,282               1  45 minutes...............          15,962
Electronic Disability Collect System        1,284,019               1  45 minutes...............         963,014
 (EDCS).
I3441 (Internet Form)................         158,607               1  120 minutes..............         317,214
                                      --------------------------------------------------------------------------
    Totals...........................       1,463,908  ..............  .........................       1,296,190
----------------------------------------------------------------------------------------------------------------

    5. Request for Earnings and Benefit Estimate Statement--20 CFR 
404.810--0960-0466. SSA uses the information the requestor provides on 
Form SSA-7004 to identify his or her Social Security earnings record, 
extract posted earnings information, calculate potential benefit 
estimates, produce the resulting Social Security Statement and mail it 
to the requestor. Respondents are Social Security number holders 
requesting information about their Social Security earnings records and 
estimates of their potential benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 545,000.
    Frequency of Response: 1.
    Average Burden per Response: 5 minutes.
    Estimated Average Burden: 45,417 hours.
    6. Employer Verification of Earnings After Death--20 CFR 404.821 
and 404.822--0960-0472. The information collected on Form SSA-L4112 is 
used by SSA to determine whether wages reported by an employer are 
correct and should be credited to the employee's Social Security number 
when SSA records indicate that the wage earner is deceased. The 
respondents are employers who report wages for a deceased employee.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 8,333 hours.
    7. Earnings Record Information--20 CFR 404.801-404.803 and 404.821-
404.822--0960-0505. The information collected by form SSA-L3231-C1 is 
used to ensure that the proper person is credited for working when 
earnings are reported for a minor under age seven years. The 
respondents are businesses reporting earnings for children under age 7.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 20,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 3,333 hours.
    8. Appointment of Representative--20 CFR 404.1707, 404.1720, 
404.1725, 410.684 and 416.1507--0960-0527. A person claiming a right or 
benefit under the Social Security Act must notify SSA in writing if he 
or she appoints an individual to represent him or her in dealing with 
SSA. The information collected by SSA on form SSAS-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, and it also allows the claimant to give permission to their 
appointed representative to designate a person to copy claims files. 
Respondents are applicants who notify SSA that they have appointed a 
person to represent them in their dealings with SSA when claiming a 
right to benefits and representatives of claimants for Social Security 
benefits.
    Type of Request: Revision of an approved OMB information 
collection.
    Number of Respondents: 551,520.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 91,920 hours.
    9. Community Work Incentive Coordinator Application--0960--NEW. 
Section 1149 of the Social Security Act established the ``Work 
Incentives Outreach Program.'' The program was reauthorized by Section 
407 of the Social Security Protection Act of 2004. To be eligible to 
work as a specialist under the new improved program, individuals must 
possess a bachelors degree or have equivalent qualifications derived 
from training and work experience. Through the services of a private 
contractor, SSA will collect the requested information to determine if 
an individual is qualified to provide services. Respondents are 
individuals who apply to become qualified as Community Work Incentive 
Coordinators.
    Type of Request: Request for a new information collection.
    Number of Respondents: 500.
    Frequency of Response: 1.
    Average Burden per Response: 60 minutes.
    Estimated Annual Burden: 500 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. Farm Self-Employment Questionnaire--20 CFR 404.1095--0960-0061. 
Section 211(a) of the Social Security Act requires the existence of a 
trade or business as a prerequisite for determining whether an 
individual or partnership may have ``net earnings from self-
employment.'' Form SSA-7156 elicits the information necessary to 
determine the existence of an agricultural trade or business and 
subsequent covered earnings for Social Security entitlement purposes. 
The respondents are applicants for Social Security benefits, whose 
entitlement depends on whether the worker has covered earnings from 
self-employment as a farmer.

[[Page 14847]]

    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 47,500.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 7,917 hours.
    2. Authorization To Disclose Information to the Social Security 
Administration--20 CFR Subpart O, 404.1512 and Subpart I, 416.912--
0960-0623. SSA must obtain sufficient medical evidence to make 
eligibility determinations for the SSDI benefits and Supplemental 
Security Income (SSI) payments. For SSA to obtain medical evidence, an 
applicant must authorize his or her medical source(s) to release the 
information to SSA. The applicant may use form SSA-827 to provide 
consent for release of information. Generally, the State DDS completes 
the form(s) based on information provided by the applicant, and sends 
the form(s) to the designated medical source(s). The respondents are 
applicants for SSDI and SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 3,853,928.
    Frequency of Response: 1 (Average forms per case 4).
    Average Burden per Response: *13 minutes.
    Total Annual Responses: 15,415,712.
    Estimated Annual Burden: 835,018 hours.

    *Please Note: Respondents to the SSA-827 collection complete a 
total four forms. SSA estimates that it takes a claimant 10 minutes 
to read both sides and sign the initial SSA-827. However, once a 
claimant reads the first form, it takes considerably less time to 
date and sign the subsequent forms because the forms do not have to 
be read again. SSA estimates the signing and dating of the three 
additional forms at one minute per form, resulting in three 
additional minutes. Therefore, the total time it takes to complete 
all four SSA-827's is 13 minutes.

    3. Prisoner Matching Agreements--20 CFR 404.468 and 20 CFR 416.211 
--0960-NEW.

Collection Background

    Section 202(x) of the Social Security Act (the Act) and regulations 
at 20 CFR 404.468 preclude a person from receiving a benefit under 
title II for any month during which such individual is confined in a 
jail, prison, or other penal institution or correctional facility 
pursuant to his conviction of a criminal offense or because he/she is 
not-guilty by reason of insanity. Accordingly, Section 1611(e) of the 
Social Security Act and regulations at 20 CFR 416.211, provide that no 
person shall be an eligible individual or eligible spouse for title XVI 
with respect to any month if throughout such month he is an inmate of a 
public institution.

Prisoner Matching Collection Activity

    To enforce these provisions of the Act, SSA has entered into 
agreements with the Federal Bureau of Prisons, along with State and 
local correctional facilities and certain mental health institutions, 
to submit monthly prisoner reports to SSA. SSA matches these reports 
against our files to identify incarcerated individuals receiving Social 
Security and Supplemental Security Income (SSI) payments and take 
action to suspend their payments. SSA uses the reports of confinement 
as the basis for stopping payments under titles II & XVI. The 
respondents to the collection are State and local correctional 
facilities, the Federal Bureau of Prisons and certain mental health 
institutions that have entered into prisoner matching agreements with 
SSA.
    Type of Request: Collection in use without OMB Control Number.
    Number of Respondents: 3,000.
    Frequency of Response: 12.
    Average Burden per Response: 60 minutes.
    Estimated Annual Burden: 36,000 hours.
    4. Fugitive Felon Matching Agreements--20 CFR 404.471 and 
416.1339--0960-NEW.

Collection Background

    Sections 202(x) and 1611(e)(4) of the Social Security Act provides 
that a person may not receive a benefit under title II and will not be 
eligible under title XVI for any month he or she is avoiding 
prosecution for a felony, is avoiding confinement or conviction of a 
felony, or is violating a condition of probation or parole. In 
jurisdictions that do not define crimes as felonies this nonpayment/
ineligibility applies to any crime that is punishable by death or 
imprisonment for more than one year, regardless of the actual sentence 
imposed.

Fugitive Felon Matching Collection Activity

    To enforce these provisions of the Act, SSA has entered agreements 
with the FBI's National Crime Information Center (NCIC), the U.S. 
Marshall Service, 21 individual States, Washington DC, and four 
metropolitan law enforcement agencies under which these law enforcement 
agencies submit outstanding felony and parole/probation violator 
warrants to SSA. SSA uses the reports of outstanding warrants as the 
basis for stopping payments under titles II & XVI. The respondents to 
the collection are the Federal, State and local law enforcement 
agencies that have entered into Fugitive Felon matching agreements with 
SSA.
    Type of Request: Collection in use without OMB Control Number.
    Number of Respondents: 28.
    Frequency of Response: * 7.
    Average Burden per Response: 60 minutes.
    Estimated Annual Burden: 196 hours.

    *Please Note: Seven responses per respondent is the average 
frequency of reporting. The actual response rate per respondent 
varies based on the individual need to report.


    Dated: March 23, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
 [FR Doc. E7-5728 Filed 3-28-07; 8:45 am]
BILLING CODE 4191-02-P