[Federal Register Volume 78, Number 5 (Tuesday, January 8, 2013)]
[Notices]
[Pages 1296-1298]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-00162]


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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 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 
March 11, 2013. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Supplemental Statement Regarding Farming Activities of Person 
Living Outside the U.S.A.--0960-0103. When a beneficiary or claimant 
reports farm work from outside the United States, SSA documents this 
work on Form SSA-7163A-F4. Specifically, SSA uses the form to determine 
if we should apply foreign work deductions to the recipient's title II 
benefits. We collect the information either annually or every other 
year, depending on the respondent's country of residence. Respondents 
are Social Security recipients engaged in farming activities outside 
the United States.
    Type of Request: Revision 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-7163A-F4................................           1,000                1               60            1,000
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    2. International Direct Deposit--31 CFR 210--0960-0686. SSA's 
International Direct Deposit (IDD) Program allows beneficiaries living 
abroad to receive their payments via direct deposit to an account at a 
financial institution outside the United States. SSA uses Form SSA-
1199-(Country) to enroll title II beneficiaries residing abroad in IDD, 
and to obtain the direct deposit information for foreign accounts. 
Routing account number information varies slightly for each foreign 
country, so we use a variation of the Treasury Department's Form SF-
1199A per country. The respondents are Social Security beneficiaries 
residing abroad who want SSA to deposit their benefits payments 
directly to a foreign financial institution.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 1297]]



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                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1199-(Country)..........................           5,000                1                5              417
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    3. Certificate of Incapacity--5 CFR 890.302(d)--0960-0739. Rules 
governing the Federal Employee Health Benefits (FEHB) plan require a 
physician to verify the disability of Federal employees' children ages 
26 and over for such children to retain health benefits under their 
employed parents' plans. The physician must verify that the adult 
child's disability: (1) Pre-dates the child's 26th birthday; (2) is 
very serious; and (3) will continue for at least one year. Physicians 
use Form SSA-604, Certificate of Incapacity, to document this 
information. The respondents are physicians of SSA employees' children 
ages 26 or over who are seeking to retain health benefits under their 
parent's FEHB plan coverage.
    Type of Request: Revision 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-604.....................................              50                1               45               38
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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 February 7, 2013. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    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 on 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 Request for Replacement of Forms SSA-1099/SSA--1042S--
20 CFR 401.--0960-0583. Title II beneficiaries 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

[[Page 1298]]

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 (FO). The respondents are 
title II beneficiaries who wish to request a replacement SSA-1099 or 
SSA-1042S via the Internet or telephone.
    Type of Request: Revision 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)
----------------------------------------------------------------------------------------------------------------
Internet Requestors.........................         145,390                1               10           24,232
Automated Telephone Requestors..............         190,413                1                2            6,347
Live calls to the N8NN......................         566,667                1                3           28,333
Live calls to local FOs.....................         783,333                1                3           39,167
Other (program service centers).............          90,000                1                3            4,500
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    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: 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-3105....................................          80,000                1               15           20,000
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    Dated: January 3, 2013.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2013-00162 Filed 1-7-13; 8:45 am]
BILLING CODE 4191-02-P