[Federal Register Volume 73, Number 208 (Monday, October 27, 2008)]
[Notices]
[Pages 63761-63762]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-25531]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law (Pub. L.) 
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. 
This notice includes a revision to an OMB-approved information 
collection.
    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 ways to minimize the 
burden on respondents, including the use of automated collection 
techniques or other forms of information technology. Mail, e-mail, or 
fax your comments and recommendations on the information collection(s) 
to the OMB Desk Officer and the SSA Reports Clearance Officer to the 
addresses or fax numbers listed below.

(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, 
Fax: 202-395-6974m, e-mail address: [email protected].
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 collection below is pending at SSA. SSA will 
submit it to OMB within 60 days from the date of this notice. 
Therefore, your comments would be most helpful if you submit them to 
SSA within 60 days from the date of this publication. Individuals can 
obtain copies of the collection instrument by calling the SSA Reports 
Clearance Officer at 410-965-0454 or by writing to the e-mail address 
listed above.
    1. Application for Mother's or Father's Insurance Benefits--20 CFR 
404.339-404.342, 20 CFR 404.601-404.603--0960-0003. The Social Security 
Act provides for the payment of monthly benefits to the widow or 
widower of an insured individual if the surviving spouse is caring for 
the deceased worker's child who is entitled to Social Security 
benefits. SSA uses the information collected on Form SSA-5-F6 to 
entitle an individual to mother's or father's insurance benefits. The 
respondents are individuals applying for mother's or father's insurance 
benefits under the Old Age, Survivors, and Disability Insurance (OASDI) 
program.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 53,700.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Average Burden: 12,992 hours.
    2. Statement of Marital Relationship (By one of the parties)--20 
CFR 404. 726--0960-0038. Where no formal marriage documentation exists, 
SSA uses information collected on Form SSA-754-F4 to determine whether 
an individual applying for spousal benefits meets the criteria of 
common-law marriage under State law. The respondents are applicants for 
spouse's Social Security or Supplemental Security Income (SSI) 
benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 15,000 hours.
    3. Public Information Campaign--0960-0544. Periodically, SSA sends 
various public information materials, including public service 
announcements, news releases, and educational tapes, to public 
broadcasting systems so they can inform the public about various 
programs and activities conducted by SSA. SSA will frequently send 
follow-up business reply cards for these public information materials 
to obtain suggestions for improving them. The respondents are media 
sources (e.g., broadcast television and radio media sources) who have 
received public information campaign materials.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 6,000.
    Frequency of Response: 2.
    Average Burden Per Response: 1 minute.
    Estimated Annual Burden: 200 hours.
    4. Medical Source Statement of Ability To Do Work Related 
Activities (Physical and Mental)--20 CFR 404.1512-404.1513, 404.912-
404.913, 404.1517, 416.917--0960-0662. SSA uses the Forms HA-1151 and 
HA-1152

[[Page 63762]]

to collect data that is required to determine the residual functional 
capacity (RFC) of individuals who are appealing denied claims for 
benefits based on disability. The RFC of an individual must be 
determined in cases where SSA cannot make a determination on a claim 
for benefits based on current work activity or on medical facts alone. 
The respondents are medical sources paid by SSA to provide reports 
either based on existing medical evidence or on consultative 
examinations conducted for the purposes of the report.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 10,000.
    Frequency of Response: 20.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 50,000 hours.
    II. SSA has submitted the information collections listed below 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 above listed address.
    1. Marriage Certification--20 CFR 404.725--0960-0009. SSA uses Form 
SSA-3 to collect information to determine if the spouse claimant has 
the necessary relationship to the number holder (i.e., the worker) to 
qualify for OASDI benefits. The respondents are applicants for spouse's 
OASDI benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 180,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 15,000 hours.
    2. Claimant's Work Background--20 CFR 404.1565(b), 20 CFR 
416.965(b)--0960-0300. Form HA-4633 collects information SSA needs to 
assess an individual's degree of disability within the meaning of the 
Social Security Act (the Act). SSA uses the information in cases where 
an individual requests a hearing before an administrative law judge 
(ALJ) on the issue of disability. The completed HA-4633 provides an 
updated summary of the individual's relevant work history. The ALJ 
requires this information in assessing the claimant's degree of 
disability within the meaning of the Act. The respondents are members 
of the public who have filed for disability benefits under Title II 
and/or Title XVI and have requested a hearing before an ALJ.

    Note: SSA listed this information collection as an extension of 
an OMB-approved information collection in the 60-Day Federal 
Register Notice published on September 17, 2008; it is a revision of 
an OMB-approved information collection.

    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 151,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 37,750 hours.
    3. Letter to Landlord Requesting Rental Information--20 CFR 
416.1130 (b)--0960-0454. SSA collects information on Form SSA-L5061 to 
identify rental subsidy arrangements involving applicants for, and 
recipients of, SSI payments. SSA uses the information to determine an 
income value for these subsidies, eligibility for payments, and the 
correct amount payable. The respondents are landlords of SSI claimants.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 49,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 8,167 hours.

    Dated: October 21, 2008.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration
 [FR Doc. E8-25531 Filed 10-24-08; 8:45 am]
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