[Federal Register Volume 77, Number 189 (Friday, September 28, 2012)]
[Notices]
[Pages 59690-59692]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-23869]


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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 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;

[[Page 59691]]

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].
    I. The information collections below are pending at SSA. SSA will 
submit them 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 
November 27, 2012. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. 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: (1) Access to their SSA 
records; (2) disclosure of SSA records; (3) correct or amend their SSA 
records; (4) consent to release of their records; (5) request records 
under the Freedom of Information Act (FOIA); (6) and waive or reduce 
fees normally charged for release of FOIA records. SSA often collects 
the necessary information for these requests through a written letter, 
with the exception of the consent for release of records for which 
there is the Form SSA-3288. The 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        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                  responses       response        response         burden
                                                                                     (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 of 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
----------------------------------------------------------------------------------------------------------------

    2. Claimant Statement about Loan of Food or Shelter; Statement 
about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. SSA uses Forms SSA-5062 and SSA-L5063 in the administration 
of the Supplemental Security Income (SSI) program. SSA bases an SSI 
claimant or recipient's eligibility on need. We measure need by the 
amount of income an individual receives. Income includes other persons 
providing in-kind support and maintenance in the form of food and 
shelter to SSI applicants or recipients. SSA uses Forms SSA-5062 and 
SSA-L5063 to obtain statements about food and/or shelter provided to 
SSI claimants or recipients. SSA uses this information to determine 
whether food or shelter are bona fide loans or should be counted as 
income for SSI purposes. This determination may affect a claimant or 
recipient's eligibility for SSI and the amount of SSI payments. The 
respondents are claimants and recipients for SSI payments, and 
individuals who provide loans of food or shelter to them.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of      burden of     total annual
             Modality of completion                  responses       response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-5062 Paper form.............................          34,900               1              10           5,817
SSA-L5063 Paper form............................          34,900               1              10           5,817
SSA-5062 Modernized SSI Claims System (MSSICS)..          34,900               1              10           5,817
SSA-L5063 MSSICS................................          34,900               1              10           5,817
                                                 ---------------------------------------------------------------
    Total.......................................         139,600  ..............  ..............          23,268
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    II. 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 October 29, 2012. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    1. Statement of Employer--20 CFR 404.801-404.803--0960-0030. When 
workers report they were paid wages but cannot provide proof of those 
earnings, and the wages do not appear in SSA's records of earnings, SSA 
uses form SSA-7011-F4 to document the alleged wages. Specifically, the 
agency uses the form to resolve discrepancies in the individual's 
Social Security earnings record and to process claims for Social 
Security benefits. We only send Form SSA-7011-F4 to employers if we are 
unable to locate the earnings information in our own records. The 
respondents are employers who can verify wage allegations made by wage 
earners.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 59692]]



----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                  responses       response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7011-F4.....................................         462,000               1              20         154,000
----------------------------------------------------------------------------------------------------------------

    2. Request for Deceased Individual's Social Security Record--20 CFR 
402.130--0960-0665. When a member of the public requests an 
individual's Social Security record, SSA needs the name and address of 
the requestor as well as a description of the requested record to 
process the request. SSA uses the information the respondent provides 
on Form SSA-711, or via an Internet request through SSA's electronic 
Freedom of Information Act (eFOIA) Web site, to (1) verify the wage 
earner is deceased and (2) access the correct Social Security record. 
Respondents are members of the public requesting deceased individuals' 
Social Security records.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                  responses       response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Internet Request through eFOIA..................          49,800               1               7           5,810
SSA-711 (paper).................................             200               1               7              23
                                                 ---------------------------------------------------------------
Total...........................................          50,000  ..............  ..............           5,833
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    Dated: September 25, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2012-23869 Filed 9-27-12; 8:45 am]
BILLING CODE 4191-02-P