[Federal Register Volume 77, Number 247 (Wednesday, December 26, 2012)]
[Notices]
[Pages 76160-76163]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-30949]


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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 to and an extension of OMB-approved information 
collections.
    SSA is soliciting comments on the accuracy of the agency's burden

[[Page 76161]]

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 
February 22, 2013. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Application for Benefits Under the Italy-U.S. International 
Social Security Agreement--20 CFR 404.1925--0960-0445. As per the 
November 1, 1978 agreement between the United States and Italian Social 
Security agencies, residents of Italy filing an application for U.S. 
Social Security benefits directly with one of the Italian Social 
Security agencies must complete Form SSA-2528. SSA uses the SSA-2528 to 
establish age, relationship, citizenship, marriage, death, military 
service, or to evaluate a family bible or other family record when 
determining eligibility for benefits. The Italian Social Security 
agencies assist applicants in completing Form SSA-2528, and then 
forward the application to SSA for processing. The respondents are 
individuals living in Italy who wish to file for U.S. Social Security 
benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2528....................................             300                1               20              100
----------------------------------------------------------------------------------------------------------------

    2. Internet Direct Deposit Application--31 CFR 210--0960-0634. SSA 
requires all applicants and recipients of Social Security Old Age, 
Survivors, and Disability Insurance (OASDI) benefits, or Supplemental 
Security Income (SSI) payments to receive these benefits and payments 
via direct deposit at a financial institution. SSA receives Direct 
Deposit/Electronic Funds Transfer (DD/EFT) enrollment information from 
OASDI beneficiaries and SSI recipients to facilitate DD/EFT of their 
funds with their chosen financial institution. We also use this 
information when an enrolled individual wishes to change their DD/EFT 
information. For the convenience of the respondents, we collect this 
information through several modalities, including an Internet 
application, in-office or telephone interviews, and our automated 
telephone system. In addition to using the direct deposit information 
to enable DD/EFT of funds to the recipients' chosen financial 
institution, we also use the information through our Direct Deposit 
Fraud Indicator to ensure the correct recipient receives the funds. 
Respondents are OASDI beneficiaries and SSI recipients requesting that 
we enroll them in the Direct Deposit program or change their direct 
deposit banking information.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Internet DD.....................................         188,129               1              10          31,355
Non-Electronic Services (FO, 800-ePath,       6,455,815               1              12       1,291,163
 MSSICS,SPS,MACADE,POS,RP)......................
Automated 800 Response System..........         237,065               1               8          31,609
Direct Deposit Fraud Indicator..................          10,000               1               2             333
                                                 ---------------------------------------------------------------
    Totals......................................       6,891,009  ..............  ..............       1,354,460
----------------------------------------------------------------------------------------------------------------

    3. Certification of Contents of Document(s) or Record(s)--20 CFR 
404.715--0960-0689. SSA established procedures for individuals to 
provide the evidence necessary to establish their rights to Social 
Security benefits. Examples of such evidence categories include age, 
relationship, citizenship, marriage, death, and military service. Form 
SSA-704 allows SSA employees, State record custodians, and other 
custodians of evidentiary documents to certify and record information 
from original documents and records under their custodial ownership to 
establish these types of evidence. SSA uses Form SSA-704 in situations 
where individuals cannot produce the original evidentiary documentation 
required to establish benefits eligibility. The respondents are State 
record custodians and other custodians of evidentiary documents.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 76162]]



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                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-704.....................................           4,800                1               10              800
----------------------------------------------------------------------------------------------------------------

    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 January 23, 2013. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    1. Certificate of Support--20 CFR 404.370, 404.750, 404.408a--0960-
0001. A parent of a deceased, fully insured worker may be entitled to 
Social Security OASDI benefits based on the earnings record of the 
deceased worker under certain conditions. One of the conditions is the 
parent must have received at least one-half support from the deceased 
worker. The one-half support requirement also applies to a spousal 
applicant in determining whether OASDI benefits are subject to 
Government Pension Offset (GPO). SSA uses the information from Form 
SSA-760-F4 to determine if the parent of a deceased worker or a spouse 
applicant meets the one-half support requirement. Respondents are (1) 
parents of deceased workers and (2) spouses who may meet the GPO 
exception.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-760-F4..................................          18,000                1               15            4,500
----------------------------------------------------------------------------------------------------------------

    2. Physician's/Medical Officer's Statement of Patient's Capability 
to Manage Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA 
appoints a representative payee in cases where we determine 
beneficiaries are not capable of managing their own benefits. In those 
instances, we require medical evidence to determine the beneficiaries' 
capability of managing or directing their benefit payments. SSA 
collects medical evidence on Form SSA-787 to (1) determine 
beneficiaries' capability or inability to handle their own benefits, 
and (2) assist in determining the beneficiaries' need for a 
representative payee. The respondents are the beneficiaries' 
physicians, or medical officers of the institution in which the 
beneficiaries reside.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-787.....................................         120,000                1               10           20,000
----------------------------------------------------------------------------------------------------------------

    3. Pre-1957 Military Service Federal Benefit Questionnaire--20 CFR 
404.1301-404.1371--0960-0120. SSA may grant gratuitous military wage 
credits for active military or naval service (under certain conditions) 
during the period September 16, 1940 through December 31, 1956, if no 
other Federal agency (other than the Veterans Administration) credited 
the service for benefit eligibility or computation purposes. We use 
Form SSA-2512 to collect specific information about other Federal, 
military, or civilian benefits the wage earner may receive when the 
applicant indicates both pre-1957 military service and the receipt of a 
Federal benefit. SSA uses the data in the claims adjudication process 
to grant gratuitous military wage credits when applicable, and to 
solicit sufficient information to determine eligibility. Respondents 
are applicants for Social Security benefits on a record where the wage 
earner claims pre-1957 military service.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2512....................................           5,000                1               10              833
----------------------------------------------------------------------------------------------------------------

    4. Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution and Request for Records--
20 CFR 416.200, 416.203--0960-0293. SSA collects and verifies financial 
information from individuals applying for SSI to determine if the 
applicant meets the SSI resource eligibility requirements. SSA contacts 
claimants' financial institutions to verify the existence, ownership, 
and value of the account owned when the claimants provide incomplete, 
unavailable, or seemingly altered records. Financial

[[Page 76163]]

institutions require individuals to sign Form SSA-461-U2 to authorize 
them to disclose records to SSA. The respondents are SSI applicants, 
recipients, and their deemors.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4641 (paper)................................          44,100               1               6           4,410
e4641 (electronic)..............................       6,955,900               1               2         231,863
    Totals......................................       7,000,000  ..............  ..............         236,273
----------------------------------------------------------------------------------------------------------------

    5. Statement of Household Expenses and Contributions--20 CFR 
416.1130-416.1148--0960-0456. SSA bases eligibility for SSI on the 
needs of the recipient. In part, we assess need by determining the 
amount of income a recipient receives. This income includes in-kind 
support and maintenance in the form of food and shelter provided by 
others. SSA uses Form SSA-8011-F3 to determine whether the claimant or 
recipient receives in-kind support and maintenance. This is necessary 
to determine (1) the claimant or recipient's eligibility for SSI and 
(2) the SSI payment amount. SSA only uses this form in cases where SSA 
needs the householder's (head of household) corroboration of in-kind 
support and maintenance. Respondents are householders of homes in which 
an SSI applicant or recipient resides.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8011-F3.................................         428,100                1               15          107,025
----------------------------------------------------------------------------------------------------------------

    6. Notification of a Social Security Number (SSN) to An Employer 
for Wage Reporting--20 CFR 422.103(a)--0960-0778. Individuals applying 
for employment must provide an SSN or indicate they have applied for 
one.
    However, when an individual applies for an initial SSN, there is a 
delay between the assignment of the number and the delivery of the SSN 
card. At an individual's request, SSA uses Form SSA-132 to send the 
individual's SSN to an employer. Mailing this information to the 
employer (1) ensures the employer has the correct SSN for the 
individual; (2) allows SSA to receive correct earnings information for 
wage reporting purposes; and (3) reduces the delay in the initial SSN 
assignment and delivery of the SSN information directly to the 
employer. It also enables SSA to verify the employer as a safeguard for 
the applicant's personally identifiable information. The majority of 
individuals who take advantage of this option are in the United States 
with exchange visitor and student visas; however, we allow any 
applicant for an SSN to use the SSA-132. The respondents are 
individuals applying for an initial SSN who ask SSA to mail 
confirmation of their application or the SSN to their employers.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-132.....................................         249,000                1                2            8,300
----------------------------------------------------------------------------------------------------------------


    Dated: December 19, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2012-30949 Filed 12-21-12; 8:45 am]
BILLING CODE 4191-02-P