[Federal Register Volume 77, Number 131 (Monday, July 9, 2012)]
[Notices]
[Pages 40401-40402]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-16635]


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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 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions 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 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 
Director, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 410-966-2830, Email address: [email protected].

    The information collections below are pending at SSA. SSA will 
submit the information collections 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 September 7, 2012. Individuals can obtain copies of 
the collection instruments by writing to the above email address.
    1. Requests for Self-Employment Information, Employee Information, 
Employer Information--20 CFR 422.120--0960-0508. When SSA cannot 
identify Form W-2 wage data for an individual, we place the data in an 
earnings suspense file and contact the individuals (and in certain 
instances the employer) to obtain the correct information. If the 
respondent furnishes the name and SSN information that agrees with 
SSA's records, or provides information that resolves the discrepancy, 
SSA adds the reported earnings to the respondent's Social Security 
record. We use Forms SSA-L2765, SSA-L3365, and SSA-L4002 for this 
purpose. The respondents are self-employed individuals and employees 
whose name and SSN information do not agree with their employer's and 
SSA's records.
    Type of Request: Revision of an OMB approved information 
collection.

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                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total annual
                Collection method                   respondents      response      per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L2765.......................................          12,321               1              10           2,054
SSA-L3365.......................................         179,749               1              10          29,958
SSA-L4002.......................................         121,679               1              10          20,280
                                                 ---------------------------------------------------------------
    Totals......................................         313,749  ..............  ..............          52,292
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    2. Function Report Adult--Third Party--20 CFR 404.1512 & 416.912--
0960-0635. Individuals receiving or applying for Social Security 
Disability Insurance (SSDI) or Supplemental Security Income (SSI) 
provide SSA with medical evidence and other proof SSA requires to prove 
their disability. SSA, and Disability Determination Services (DDS) on 
our behalf, collect this information using Form SSA-3380-BK. We use the 
information to document how claimants' disabilities affect their 
ability to function, and to determine eligibility for SSI and SSDI 
claims. The respondents are third parties familiar with the functional 
limitations (or lack thereof) of claimants who apply for SSI and SSDI 
benefits.
    Type of Request: Revision of an OMB approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total annual
                Collection method                   respondents      response      per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-338-BK (Individuals)........................         500,000               1              61         508,333
SSA-338-BK (Private Sector).....................         500,000               1              61         508,333
                                                 ---------------------------------------------------------------

[[Page 40402]]

 
    Totals......................................       1,000,000  ..............  ..............       1,016,666
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    3. Function Report Adult--20 CFR 404.1512 & 416.912--0960-0681. 
Individuals receiving or applying for SSDI or SSI must provide medical 
evidence and other proof SSA requires to prove their disability. SSA, 
and DDSs on our behalf, collect the information using Form SSA-3373. We 
use this information to document how claimants' disabilities affect 
their ability to function, and to determine eligibility for SSI and 
SSDI claims. The respondents are title II and title XVI applicants (or 
current recipients undergoing redeterminations) for disability 
payments.
    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-3373....................................       4,221,656                1               61        4,292,016
----------------------------------------------------------------------------------------------------------------


    Dated: July 3, 2012.
Faye Lipsky,
Reports Clearance Director, Office of Regulations and Reports 
Clearance, Social Security Administration.
[FR Doc. 2012-16635 Filed 7-6-12; 8:45 am]
BILLING CODE 4191-02-P