[Federal Register Volume 72, Number 151 (Tuesday, August 7, 2007)]
[Notices]
[Pages 44211-44212]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-15153]


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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, 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: [email protected]
(SSA), Social Security Administration, DCBFM, 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. Authorization for SSA to Disclose Tax Information for Your 
Appeal of Your Medicare Part B Income-Related Monthly Adjustment 
Premium Amount--20 CFR 418.1350--NEW. Medicare Part B beneficiaries who 
wish to appeal SSA's reconsideration of their Income-Related Monthly 
Adjustment Amount (IRMAA) must ensure that the relevant Internal 
Revenue Service (IRS) income tax data is made available to the Health 
and Human Services Administrative Law Judge (ALJ) who will consider 
their appeal. Currently, SSA is using IRS Form-8821 to obtain 
beneficiary authorization to disclose the IRS beneficiary tax data to 
the ALJ. With IRS's permission, SSA has developed its own form for this 
purpose, the SSA-54. The respondents are Medicare Part B recipients who 
want to appeal SSA's reconsideration of their IRMAA amount.
    Type of Request: New information collection.
    Number of Respondents: 6,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 1,500 hours.
    2. Request for Corrections of Earnings Record--20 CFR 404.820 & 20 
CFR 422.125--0960-0029. The information collected by Form SSA-7008 is 
needed when an individual alleges his/her earnings record is 
inaccurate. The information is used to check against the record 
maintained by SSA and, as necessary, initiate development to resolve 
the issue. The respondents are individuals who request correction of 
earnings posted to their Social Security earnings record.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 375,000.
    Estimated Annual Burden: 62,500 hours.

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                                                                                     Estimated
                                                     Number of     Frequency of     burden  per      Estimated
                                                    respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Paper Version...................................          37,500               1              10          6,250.
In-person or telephone interview................         337,500               1              10         56,250.
                                                 ---------------------------------------------------------------
    Total.......................................         375,000  ..............  ..............         62,500.
----------------------------------------------------------------------------------------------------------------

    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. Electronic Records Express Third-Party Registration Form--0960-
NEW. ERE (Electronic Records Express) is an online system which enables 
medical providers and various third parties to submit disability 
claimant information

[[Page 44212]]

electronically to SSA as part of the disability application process. 
Third parties who wish to use this system must complete a unique 
registration process so the Agency can ensure they are authorized to 
access a claimant's electronic disability folder. This request is for 
the Third-Party Registration Form. The respondents are third-party 
representatives of disability applicants or recipients who want to use 
ERE to electronically access beneficiary folders and submit information 
to SSA.
    Type of Request: New information collection.
    Number of Respondents: 75,784.
    Frequency of Response: 1.
    Average Burden per Response: 3 minutes.
    Estimated Annual Burden: 3,789 hours.
    2. Representative Payee Evaluation Report--20 CFR 404.2065 & 
416.665--0960-0069. Sections 205(j) and 1631(a)(2) of the Social 
Security Act provide that a representative payee may be appointed to 
receive benefits on behalf of an individual entitled to Title II and/or 
Title XVI benefits when that individual is unable to manage or direct 
the management of those funds him/herself. The representative payee is 
required to report to SSA at least once per year on how those funds 
received have been used or conserved. When a representative payee fails 
to adequately report to SSA as required, SSA will conduct a face-to-
face interview with the payee to complete an SSA-624, Representative 
Payee Evaluation Report, in order to determine the continued 
suitability of the representative payee to serve as a payee. The 
respondents are individuals and organizations who act as representative 
payees for Title II and Title XVI benefits who fail to comply with 
SSA's statutory annual reporting requirement.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 252,000.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 126,000 hours.
    3. Request for Change in Time/Place of Disability Hearing--20 CFR 
404.914(c)(2) and 416.1414(c)(2)--0960-0348. The information on Form 
SSA-769 is used by SSA and the State Disability Determination Services 
to provide claimants with a structured format to exercise their right 
to request a change in time or place of a scheduled disability hearing. 
The information will be used as a basis for granting or denying 
requests for changes and for rescheduling disability hearings. 
Respondents are claimants who wish to request a change in the time and/
or place of their hearing.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 7,483.
    Frequency of Response: 1.
    Average Burden per Response: 8 minutes.
    Estimated Annual Burden: 998 hours.
    4. Agency/Employer Government Pension Offset Questionnaire--20 CFR 
404.408(a)--0960-0470. The information collected by form SSA-4163 will 
provide SSA with accurate information from the agency paying the 
pension, for purposes of applying the pension-offset provision. The 
form will be used only when (1) The claimant does not have the 
information and (2) the pension-paying agency has not cooperated with 
the claimant. Respondents are Federal and State Government agencies 
which have information needed by SSA to determine if the GPO applies 
and the amount of offset.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden per Response: 3 minutes.
    Estimated Annual Burden: 50 hours.

    Dated: July 31, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E7-15153 Filed 8-3-07; 8:45 am]
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