[Federal Register Volume 77, Number 136 (Monday, July 16, 2012)]
[Notices]
[Pages 41874-41877]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-17244]


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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 of OMB-approved information collections and one new 
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 burden 
on respondents,

[[Page 41875]]

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].

    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 30 days from the date of this 
publication. To be sure we consider your comments, we must receive them 
no later than August 15, 2012. Individuals can obtain copies of the OMB 
clearance packages by writing to [email protected].
    1. Health IT Partner Program Assessment--Partnering Facilities and 
Available Content Form--24 CFR 495.300-495.370--0960-NEW. The Health 
Information Technology for Economic and Clinical Health (HITECH) Act 
promotes the adoption and meaningful use of health information 
technology (IT), particularly in the context of working with government 
agencies. Similarly, section 3004 of the Public Health Service Act 
requires health care providers or health insurance issuers with 
government contracts to implement, acquire, or upgrade their health IT 
systems and products to meet adopted standards and implementation 
specifications.
    To support expansion of SSA's health IT initiative as defined under 
HITECH, SSA developed Form SSA-680, the Health IT Partner Program 
Assessment--Participating Facilities and Available Content Form. The 
SSA-680 allows healthcare providers to provide the information SSA 
needs to determine their ability to exchange health information with us 
electronically. We intend to evaluate potential partners (i.e., 
healthcare providers and organizations) on (1) the accessibility of 
health information they possess, and (2) the content value of their 
electronic health records' systems for our disability adjudication 
processes. SSA reviews the completeness of organizations' SSA-680 
responses as one part of our careful analysis of their readiness to 
enter into a health IT partnership with us. The respondents are 
healthcare providers and organizations exchanging information with the 
agency.

    Note: This is a correction notice. SSA published this 
information collection notice with a different form title on January 
31, 2012 at 77 FR 4854. We are publishing this notice with the 
revised, corrected form title here.

    Type of Request: This is a new information collection request.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
            Collection instrument                Number of       Frequency of     per response    annual burden
                                                 responses         response         (hours)          (hours)
----------------------------------------------------------------------------------------------------------------
SSA-680.....................................              30                1                5              150
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    2. Statement of Self-Employment Income--20 CFR 404.101, 404.110, 
404.1096(a)-(d)--0960-0046. To qualify for insured status and thus 
collect Social Security benefits, self-employed individuals must 
demonstrate they earned the minimum amount of self-employment income 
(SEI) in a current year. SSA uses Form SSA-766, Statement of Self-
Employment Income, to collect the information we need to determine if 
the individual will have at least the minimum amount of SEI needed for 
one or more quarters of coverage in the current year. Based on the 
information we obtain, we may credit additional quarters of coverage to 
give the individual insured status thus expediting benefit payments. 
Respondents are self-employed individuals who may be eligible for 
Social Security benefits.
    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-766.....................................           2,500                1                5              208
----------------------------------------------------------------------------------------------------------------

    3. Certification by Religious Group-20 CFR 404.1075-0960-0093. SSA 
is responsible for determining whether religious groups meet the 
qualifications exempting certain members and sects from payment of 
Self-Employment Contribution Act taxes under the Internal Revenue Code, 
section 1402(g). SSA sends Form SSA-1458, Certification by Religious 
Group, to a group's authorized spokesperson to complete and verify 
organizational members meet or continue to meet the criteria for 
exemption. The respondents are spokespersons for religious groups or 
sects.
    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-1458....................................             180                1               15               45
----------------------------------------------------------------------------------------------------------------


[[Page 41876]]

    4. Claim for Amounts Due in the Case of a Deceased Beneficiary--20 
CFR 404.503(b)-0960-0101. SSA requests applicants complete Form SSA-
1724 when there is insufficient information in the file to identify the 
person(s) entitled to the underpayment, or the person's address. SSA 
collects the information when a surviving widow(er) is not already 
entitled to a monthly benefit on the same earnings record, or is not 
filing for a lump-sum death payment as a former spouse. SSA uses the 
information Form SSA-1724 provides to ensure proper payment of an 
underpayment due a deceased beneficiary. The respondents are applicants 
for underpayments owed to deceased beneficiaries.
    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-1724....................................         250,000                1               10           41,667
----------------------------------------------------------------------------------------------------------------

    5. Certificate of Election for Reduced Spouse's Benefits--20 CFR 
404.421-0960-0398. Reduced benefits are not payable to an already 
entitled spouse, at least age 62 but under full retirement age, who no 
longer has a child in their care unless the spouse elects to receive 
reduced benefits. If spouses decide to elect reduced benefits, they 
complete Form SSA-25. SSA uses the information to pay qualified spouses 
who elect to receive reduced benefits. Respondents are entitled spouses 
seeking reduced benefits.
    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-25......................................          30,000                1                2            1,000
----------------------------------------------------------------------------------------------------------------

    6. Surveys in Accordance with E.O. 12862 for the Social Security 
Administration--0960-0526. Under the auspices of Executive Order 12862, 
Setting Customer Service Standards, SSA conducts multiple customer 
satisfaction surveys each year. These voluntary customer satisfaction 
assessments include paper, Internet, and telephone surveys; mailed 
questionnaires; and customer comment cards. The purpose of these 
questionnaires is to assess customer satisfaction with the timeliness, 
appropriateness, access, and overall quality of existing SSA services 
and proposed modifications or new versions of services. The respondents 
are recipients of SSA services (including most members of the public), 
professionals, and individuals who work on behalf of SSA beneficiaries.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                 Number of                                        Burden (burden
                                                respondents                                          for all
                                              (burden for all    Frequency of       Range of        activities
                                                 activities        response      response times    within that
                                                within that                        (minutes)      year; reported
                                                   year)                                            in hours)
----------------------------------------------------------------------------------------------------------------
Year 1 (September 2012-August 2013).........       4,481,566                1             3-90          290,741
Year 2 (September 2013-August 2014).........       1,559,566                1             3-90          144,991
Year 3 (September 2014-September 2015)......       1,484,566                1             3-90          141,741
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    Totals..................................       7,525,698   ...............  ...............         577,473
----------------------------------------------------------------------------------------------------------------

    7. Request for Business Entity Taxpayer Information--0960-0731. Law 
firms or other business entities must complete Form SSA-1694, Request 
for Business Entity Taxpayer Information, if they wish to serve as 
appointed representatives and receive direct payment of fees from SSA. 
SSA uses the information to issue a Form 1099-MISC. SSA also uses the 
information to allow business entities to designate individuals to 
serve as entity administrators authorized to perform certain 
administrative duties on their behalf, such as providing bank account 
information, maintaining entity information, and updating individual 
affiliations. Respondents are law firms or other business entities 
which have attorneys or other qualified individuals as partners or 
employees who represent claimants before SSA.
    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-1694....................................           2,000                1               10              334
----------------------------------------------------------------------------------------------------------------



[[Page 41877]]

    Dated: July 11, 2012.
Faye Lipsky,
Reports Clearance Director, Office of Regulations and Reports 
Clearance, Social Security Administration.
[FR Doc. 2012-17244 Filed 7-13-12; 8:45 am]
BILLING CODE 4191-02-P