[Federal Register Volume 77, Number 53 (Monday, March 19, 2012)]
[Notices]
[Pages 16113-16115]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-6499]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: 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 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions and information collections in use without an OMB 
number.
    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 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 SSA Reports Clearance Officer at the following 
addresses or fax numbers.

(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, 
Fax: 202-395-6974, Email address: [email protected].
(SSA), Social Security Administration, DCRDP, Attn: Reports Clearance 
Officer, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 410-965-6400, Email address: [email protected].

    SSA submitted the information collections below to OMB for 
clearance. Your comments regarding 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 April 18, 2012. Individuals can obtain copies of the 
OMB clearance packages by calling the SSA Reports Clearance Officer at 
410-965-8783 or by writing to the above email address.
    1. Notice to Show Cause for Failure to Appear--20 CFR 404.938, 
416.1438, 404.957(a)(ii)-0960-NEW. When claimants who requested a 
hearing before an administrative law judge (ALJ) fail to appear at 
their scheduled hearing, the ALJ may reschedule the hearing if the 
claimants establish good cause for missing the hearings. The claimants 
can provide a reason for not appearing at their scheduled hearings 
using Form HA-L90. If the ALJ determines the claimants established good 
cause for failure to appear at the hearing, the ALJ will schedule a 
supplemental hearing; if not, the ALJ makes a claims eligibility 
determination based on the claimants' evidence of record. Respondents 
are claimants seeking to show cause for failure to appear at a 
scheduled hearing before an ALJ.
    Type of Request: Existing collection in use without an OMB number.

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                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
              Collection instrument                  responses       response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
HA-L90 PDF/Paper................................           7,000               1              10           1,167
Electronic Records Express......................          28,000               1              10           4,667
                                                 ---------------------------------------------------------------
    Total.......................................          35,000  ..............  ..............           5,834
----------------------------------------------------------------------------------------------------------------

    2. Request for Documents or Information--20 CFR 404.703-0960-NEW. 
SSA asks individuals applying for Social Security benefits for 
additional information when the information they provided is incomplete 
or insufficient for us to determine their eligibility for benefits. SSA 
uses the SSA-2118-U2, Request for Documents or Information, to request 
the additional documents or information we need to process individuals' 
claims for benefits. Respondents are claimants for title II Social 
Security Old Age, Survivors, and Disability Insurance benefits.
    Type of Request: Existing collection in use without an OMB number.

[[Page 16114]]



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                                                                                Average  burden  Estimated total
            Collection instrument                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2118-U2.................................           7,500                1                5              625
----------------------------------------------------------------------------------------------------------------

    3. Statement of Living Arrangements, In-Kind Support and 
Maintenance--20 CFR 416.1130-416.1148--0960-0174. SSA determines 
Supplemental Security Income (SSI) payment amounts based on applicants' 
and recipients' needs. We measure individuals' needs, in part, by the 
amount of income they receive, including in-kind support and 
maintenance in the form of food and shelter provided by other persons. 
SSA uses information from Form SSA-8006-F4 to determine if in-kind 
support and maintenance exists for SSI applicants and recipients. This 
information also assists SSA in determining the income value of in-kind 
support and maintenance SSI applicants and recipients receive. The 
respondents are individuals who apply for SSI payments, or who complete 
an SSI eligibility redeterminination.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
            Collection instrument                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8006-F4.................................         173,380                1                7           20,228
----------------------------------------------------------------------------------------------------------------

    4. Statement of Funds You Provided to Another and Statement of 
Funds You Received--20 CFR 416.1103(f)--0960-0481. SSA uses Forms SSA-
2854 and SSA-2855 to gather information to verify if a loan is bona 
fide for SSI recipients. The SSA-2854 asks the lender for details on 
the transaction, and Form SSA-2855 asks the borrower the same basic 
questions independently. Agency personnel then compare the two 
statements, gather evidence if needed, and make a decision on the 
validity of the bona fide status of the loan.
    For SSI purposes, we consider a loan bona fide if it meets these 
requirements:
     Must be between a borrower and lender with the 
understanding that the borrower has an obligation to repay the money;
     Must be in effect at the time the cash goes to the 
borrower, that is, the agreement cannot come after the cash is paid; 
and
     Must be enforceable under State law; often there are 
additional requirements from the State.
    SSA collects this information at the time of initial application 
for SSI or at any point when an individual alleges being party to an 
informal loan while receiving SSI. SSA collects information on the 
informal loan through both interviews and mailed forms. The agency's 
field personnel conduct the interviews and mail the form(s) for 
completion, as needed. The respondents are SSI recipients and 
applicants, and individuals who lend money to them.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
                      Form                          respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2854........................................          20,000               1              10           3,333
SSA-2855........................................          20,000               1              10           3,333
                                                 ---------------------------------------------------------------
    Totals......................................          40,000  ..............  ..............           6,666
----------------------------------------------------------------------------------------------------------------

    5. Certification of Low Birth Weight for SSI Eligibility of Funds 
You Provided to Another and Statement of Funds You Received--20 CFR 
416.931, 416.926a(m), and 416.924--0960-0720. Hospitals and claimants 
use Form SSA-3380 to provide medical information to local field offices 
(FO) and the Disability Determination Services (DDS) on behalf of 
infants with low birth weight. FOs use the form as a protective filing 
statement and the medical information to make presumptive disability 
findings, which allow expedited payment to eligible claimants. DDSs use 
the medical information to determine disability and continuing 
disability. The respondents are hospitals and claimants who have 
information identifying low birth weight babies and their medical 
conditions.
    This is a correction notice. SSA published this information 
collection as an extension on January 3, 2012 at 77 FR 147. Since we 
are revising the Privacy Act Statement, this is actually a revision of 
an OMB-approved information collection.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
            Collection instrument                Number of       Frequency of     of  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3380....................................          24,000                1               15            6,000
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[[Page 16115]]

    Dated: March 14, 2012.
Faye Lipsky,
Reports Clearance Director, Office of Regulations and Reports 
Clearance, Social Security Administration.
[FR Doc. 2012-6499 Filed 3-16-12; 8:45 am]
BILLING CODE 4191-02-P