[Federal Register Volume 77, Number 218 (Friday, November 9, 2012)]
[Notices]
[Pages 67435-67438]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-27358]


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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

[[Page 67436]]

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 to 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].

    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 
January 8, 2013. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Child Relationship Statement--20 CFR 404.355 & 404.731--0960-
0116. To help determine a child's entitlement to Social Security 
benefits, SSA uses criteria under section 216(h)(3) of the Social 
Security Act (Act), deemed child provision. SSA may deem a child to an 
insured individual if: (1) The insured individual presents SSA with 
satisfactory evidence of parenthood and was living with or contributing 
to the child's support at certain specified times; or (2) the insured 
individual (a) acknowledged the child in writing; (b) was court decreed 
as the child's parent; or (c) was court ordered to support the child. 
To obtain this information, SSA uses Form SSA-2519, Child Relationship 
Statement. Respondents are people with knowledge of the relationship 
between certain individuals filing for Social Security benefits and 
their alleged biological children.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                Average  burden  Estimated total
           Modality of collection                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2519....................................          50,000                1               15           12,500
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    2. Pain Report-Child--20 CFR 404.1512 and 416.912--0960-0540. 
Before SSA can make a disability determination for a child, we require 
evidence from Supplemental Security Income (SSI) applicants or 
claimants to prove their disability. Form SSA-3371-BK provides 
disability interviewers, and SSI applicants or claimants in self-help 
situations, with a convenient way to record information claimants' pain 
or other symptoms. The State disability determination services 
adjudicators and administrative law judges then use the information 
from Form SSA-3371-BK to assess the effects of symptoms on function for 
purposes of determining disability under the Act. The respondents are 
applicants for, or claimants of, SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                Average  burden  Estimated total
           Modality of collection                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3371....................................         250,000                1               15           62,500
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    3. Internet and Automated Telephone Request for Replacement Forms 
SSA-1099/SSA-1042S--20 CFR 401.45--0960-0583. Title II recipients use 
Forms SSA-1099 and SSA-1042S, Social Security Benefit Statement, to 
determine if their Social Security benefits are taxable and the amount 
they need to report to the Internal Revenue Service. In cases where the 
original forms are unavailable (e.g., lost, stolen, mutilated), an 
individual may use SSA's Internet request form or automated telephone 
application to request a replacement SSA-1099 and SSA-1042S. SSA uses 
the information from the Internet and automated telephone requests to 
verify the identity of the requestor and to provide replacement copies 
of the forms. The Internet and automated telephone options reduce 
requests to the National 800 Number Network (N8NN) and visits to local 
Social Security field offices. The respondents are title II recipients 
who wish to request a replacement SSA-1099 or SSA-1042S via the 
Internet and telephone.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Internet Requests...............................         145,390               1              10          24,232
Automated Telephone Requests....................         190,413               1               2           6,347
N8NN............................................         566,667               1               3          28,333
Calls to local field offices....................         783,333               1               3          39,167
Other (program service centers).................          90,000               1               3           4,500

[[Page 67437]]

 
    Totals......................................       1,775,803  ..............  ..............         102,579
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    4. Important Information About Your Appeal, Waiver Rights, and 
Repayment Options--20 CFR 404.502-521--0960-0779. When SSA accidentally 
overpays beneficiaries, the agency informs them of the following 
rights: (1) The right to reconsideration of the overpayment 
determination; (2) the right to request a waiver of recovery and the 
automatic scheduling of a personal conference if SSA cannot approve a 
request for waiver; and (3) the availability of a different rate of 
withholding when SSA proposes the full withholding rate. SSA uses Form 
SSA-3105, Important Information About Your Appeal, Waiver Rights, and 
Repayment Options, to explain these rights to overpaid individuals, and 
allow them to notify SSA of their decision(s) regarding these rights. 
The respondents are overpaid claimants requesting a waiver of recovery 
for the overpayment, reconsideration of the fact of the overpayment, or 
a lesser rate of withholding of the overpayment.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3105....................................          80,000                1               15           20,000
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    II. SSA submitted the information collection below to OMB for 
clearance. Your comments regarding the information collection 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 December 10, 2012. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    Vocational Rehabilitation Provider Claim--20 CFR 404.2108(b), 
404.2117(c)(1)&(2), 404.2101(a)&(b), 404.2121(a), 416.2208(b), 
416.2217(c)(1)&(2), 416.2201(a)&(b), 416.2221(a), 34 CFR 361--0960-
0310.
    State vocational rehabilitation (VR) agencies submit Form SSA-199 
to SSA to obtain reimbursement of costs incurred for providing VR 
services. SSA requires state VR agencies to submit reimbursement claims 
for the following categories:
    (1) Claiming reimbursement for VR services provided; (2) certifying 
adherence to cost containment policies and procedures; and (3) 
preparing causality statements.
    The respondents mail the paper copy of the SSA-199 to SSA for 
consideration and approval of the claim for reimbursement of cost 
incurred for SSA beneficiaries. For claims certifying adherence to cost 
containment policies and procedures, or for preparing causality 
statements, State VR agencies submit written requests as stipulated in 
SSA's regulations within the Code of Federal Regulations. In most 
cases, SSA requires adherence to cost containment policies and 
procedures as well as causality statements prior to determining whether 
to reimburse the State VR agencies. SSA uses the information on the 
SSA-199, along with the written documentation, to determine whether or 
not, and how much, to pay the State VR agencies under SSA's VR program. 
Respondents are State VR agencies who offer vocational and employment 
services to Social Security and SSI recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
     Modality of collection          Number of     Frequency of      Number of     per response    total annual
                                    respondents      response        responses       (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
a. Claiming Reimbursement on SSA-             80             160        (12,800)              23           4,907
 199--20 CFR 404.2108(b) &
 416.2208(b)....................
b. Certifying Adherence to Cost               80               1            (80)              60              80
 Containment Policy and
 Procedures--20 CFR
 404.2117(c)(1)&(2),
 416.2217(c)(1)&(2) & 34 CFR 361
c. Preparing Causality                        80             2.5           (200)             100             333
 Statements--20 CFR 404.2121(a),
 404.2101(a), 416.2201(a), &
 416.2221(a)....................
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    Totals......................              80  ..............        (13,080)  ..............           5,320
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[[Page 67438]]

    Dated: November 5, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2012-27358 Filed 11-8-12; 8:45 am]
BILLING CODE 4191-02-P