[Federal Register Volume 74, Number 234 (Tuesday, December 8, 2009)]
[Notices]
[Pages 64801-64803]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-29119]


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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 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 revisions to and extensions 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 ways to minimize the 
burden on respondents, including the use of automated collection 
techniques or other forms of information technology. Mail, email, or 
fax your comments and recommendations on the information collection(s) 
to the OMB Desk Officer and the SSA Director for Reports Clearance to 
the addresses or fax numbers shown 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: Director, 
Center for Reports Clearance, 1333 Annex Building, 6401 Security Blvd., 
Baltimore, MD 21235, Fax: 410-965-0454, 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. To be 
sure we consider your comments, we must receive them no later than 
February 8, 2010. Individuals can obtain copies of the collection 
instrument by calling the SSA Director for Reports Clearance at 410-
965-0454 or by writing to the above e-mail address.
    1. Farm Self-Employment Questionnaire--20 CFR 404.1082(c) & 
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. During a personal interview, the requesting Social Security 
field office uses Form SSA-7165 to elicit 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.
    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. Site Review Questionnaire for Volume and Fee-for-Service Payees 
and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665, 
416.701, and 416.708--0960-0633. SSA uses the SSA-637, Site Review 
Questionnaire for Volume and Fee-for-Service Payees, to obtain 
information from the payee about how the organization operates and 
carries out its representative payee responsibilities, including how it 
manages beneficiary funds. We then use the SSA-639, Beneficiary 
Interview Form, to obtain information from the beneficiaries to help 
corroborate the payee's statements. Due to the sensitivity of the 
information, SSA employees always complete the forms based on the 
answers respondents give during the interview. The respondents are 
individuals, State and local governments, non-profit and for-profit 
organizations that serve as representative payees and the beneficiaries 
they serve.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                           Number of     Frequency of      Average burden per      Total annual
              Form number                 respondents      response        response (minutes)     burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-637...............................           2,001               1  2 hours.................           4,002
SSA-639...............................           9,341               1  10 minutes..............           1,557
Totals................................          11,342  ..............  ........................           5,559
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    3. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. This regulation stipulates when a valid agreement is in 
place, prison officials verify the identity of certain incarcerated 
U.S. citizens who need replacement Social Security cards. Information 
the prison officials provide will come from the official prison files, 
sent on prison letterhead. SSA uses this information to establish the 
applicant's identity in the replacement Social Security card process. 
The respondents are prison officials who certify the identity of 
prisoners applying for replacement Social Security cards.
    Type of Request: Extension of an OMB-approved information 
collection.

[[Page 64802]]

    Number of Respondents: 1,000.
    Frequency of Response: 200.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 10,000 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 OMB and SSA receive them within 30 days from the date 
of this publication. To be sure we consider your comments, we must 
receive them no later than January 7, 2010. You can obtain a copy of 
the OMB clearance packages by calling the SSA Director for Reports 
Clearance at 410-965-0454 or by writing to the above e-mail address.
    1. Application for Widow's or Widower's Insurance Benefits--20 CFR 
404.335-404.338, 404.603--0960-0004. SSA uses the information it 
collects on the SSA-10-BK to determine whether the applicant meets the 
statutory and regulatory conditions for entitlement to widow's or 
widower's Social Security Title II benefits. The respondents are 
applicants for widow's or widower's insurance benefits.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 341,560.

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                                                   Number of
               Collection method                  respondents       Estimated completion time      Burden hours
----------------------------------------------------------------------------------------------------------------
MCS...........................................         162,241  15 minutes......................          40,560
MCS/Signature Proxy...........................         162,241  14 minutes......................          37,856
Paper.........................................          17,078  15 minutes......................           4,270
                                               -----------------------------------------------------------------
    Totals:...................................         341,560  ................................          82,686
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    Estimated Annual Burden: 82,686 hours.
    2. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. SSA obtains information on Form SSA-7160-F4 to determine a 
worker's employment status; i.e., whether, under the definition of an 
employee found in Section 210(j)(2) of the Act and 20 CFR 404.1007 of 
the Code of Federal Regulations, a worker is an employee under the 
``usual common law rules'' applicable in determining the existence of 
an employer-employee relationship. We use the information to develop 
the employment relationship and to determine whether a beneficiary is 
self-employed or an employee. The respondents are individuals 
questioning their status as employees and their alleged employers.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
                 Respondent type                     Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Individuals.....................................           8,000               1              25           3,333
Businesses......................................           7,200               1              25           3,000
State/Local Government..........................             800               1              25             333
                                                 ---------------------------------------------------------------
    Totals:.....................................          16,000  ..............  ..............           6,666
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    3. Substitution of Party upon Death of Claimant--20 CFR 
404.957(c)(4) and 416.1457(c)(4)--0960-0288. SSA collects information 
on Form HA-539 when a claimant for Social Security or Supplemental 
Security Income (SSI) payments dies while his or her request for a 
hearing is pending. The information SSA collects establishes a written 
record of the request of any individual who asks to be made a 
substitute party for a deceased claimant. It also facilitates a 
decision by SSA on who, if anyone, should become a substitute party for 
the deceased. The Administrative Law Judge and the hearing office 
support staff use this information to: (1) Establish the relationship 
of the requester to the deceased claimant; (2) determine the 
substituted individual's wishes regarding an oral hearing or decision 
on the record; and (3) admit the data into the claimant's official 
record as an exhibit. The respondents are individuals requesting to be 
made a substitute party for a deceased claimant.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 4,000.
    Frequency of Response: 1.
    Average Burden per Response: 5 minutes.
    Estimated Annual Burden: 333 hours.
    4. Response to Notice of Revised Determination--20 CFR 
404.913-.914, 404.992(b), 416.1413-.1414 and 416.1492(d)--0960-0347. 
When SSA determines that: (1) A claimant for initial disability 
benefits does not actually have a disability; or (2) the current 
recipient's disability ceased, the agency must notify the disability 
claimants/recipients of this decision. In response to this notice, the 
affected claimant and disability recipient has the following recourse: 
(1) May request a disability hearing to contest SSA's decision; and (2) 
may submit additional information or evidence for SSA to consider. 
Disability claimants, recipients, and their representatives use form 
SSA-765 to accomplish these two actions. The respondents are disability 
claimants, current disability recipients, or their representatives.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,925.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 963 hours.
    5. Statement of Household Expenses and Contributions--20 CFR 
416.1130-416.1148--0960-0456. SSA uses the information from Form SSA-
8011-F3, to determine whether the claimant or recipient receives in-
kind support and maintenance. This is necessary to determine the 
claimant's or recipient's eligibility for SSI and the payment amount. 
SSA does not use this form for all claims and post eligibility 
determinations. SSA uses this form only in cases where SSA needs the 
householder's (head of household) corroboration of in-kind support and 
maintenance. Respondents are householders where an SSI applicant or 
recipient resides.


[[Page 64803]]


    Note:  This is a correction notice. SSA published this 
information collection as an extension on October 06, 2009 at 74 FR 
51353. Since we are revising the Privacy Act Statement, this is now 
a revision of an OMB-approved information collection.

    Type of Request: Revision 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.
    6. Privacy and Disclosure of Official Records and Information; 
Availability of Information and Records to the Public--20 CFR 
401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185--0960-0566. 
Under the Privacy and Disclosure of Official Records and Information, 
SSA established methods for the public to: access their SSA records; 
disclose SSA records to others; correct/amend their SSA records; 
consent to release their records; request records under the Freedom of 
Information Act (FOIA); and request waiver/reduction of fees normally 
charged for release of FOIA records. SSA most often collects the 
required information for these requests through a written letter, with 
the exception of the consent for release of records for which there is 
Form SSA-3288. Respondents are individuals requesting access to, 
correction of, or disclosure of SSA records.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
                 Type of request                     Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Access to Records...............................          10,000               1              11           1,833
Designating a Representative for Disclosure of             3,000               1               2           6,000
 Records........................................
Amendment of Records............................             100               1              10              17
Consent for Release of Records..................       3,000,000               1               3         150,000
FOIA Requests for Records.......................          15,000               1               5           1,250
Waiver/Reduction of Fees........................             400               1               5              33
                                                 ---------------------------------------------------------------
    Totals......................................       3,028,500  ..............  ..............         159,133
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    7. Request for Reinstatement (Title II)--20 CFR 404.1592b--
404.1592f--0960-0742. Through Form SSA-371, SSA obtains a signed 
statement from individuals stating a request for Expedited 
Reinstatement (EXR) of their Title II disability benefits and proof the 
requestor meets the EXR requirements. SSA maintains the form in the 
disability folder of the applicant to demonstrate the individual's 
awareness of the EXR requirements and his or her choice to request EXR. 
Respondents are individuals requesting expedited reinstatement of their 
Title II disability benefits.

    Note:  This is a correction notice. SSA published this 
information collection as an extension on October 06, 2009 at 74 FR 
51353. Since we are revising the Privacy Act Statement, this is now 
a revision of an OMB-approved information collection.

    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 10,000.
    Frequency of Response: 1.
    Average Burden per Response: 2 minutes.
    Estimated Annual Burden: 333 hours.
    8. Request for Reinstatement (Title XVI)--20 CFR 416.999--
416.999d--0960-0744. Through the SSA-372, SSA obtains a signed 
statement from individuals stating a request for EXR of their Title XVI 
SSI payments and proof the requestor meets the EXR requirements. SSA 
maintains the form in the disability folder of the applicant to 
demonstrate the individual's awareness of the EXR requirements and his 
or her choice to request EXR. Respondents are individuals requesting 
expedited reinstatement of their Title XVI SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 2,000.
    Frequency of Response: 1.
    Average Burden per Response: 2 minutes.
    Estimated Annual Burden: 67 hours.

    Dated: December 2, 2009.
Elizabeth A. Davidson,
Director, Center for Reports Clearance, Social Security Administration.
[FR Doc. E9-29119 Filed 12-7-09; 8:45 am]
BILLING CODE 4191-02-P