[Federal Register Volume 80, Number 99 (Friday, May 22, 2015)]
[Notices]
[Pages 29787-29789]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-12454]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2015-0030]
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, and
reinstatements of previously 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, OLCA, Attn: Reports
Clearance Director, 3100 West High Rise, 6401 Security Blvd.,
Baltimore, MD 21235, Fax: 410-966-2830, Email address:
[email protected]. Or you may submit your comments online
through www.regulations.gov, referencing Docket ID Number [SSA-2015-
0029].
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 July
21, 2015. Individuals can obtain copies of the collection instruments
by writing to the above email address.
1. Statement of Funds You Provided to Another and Statement of
Funds You Received--20 CFR 404.1520(b), 404.1571-404.1576, 404.1584-
404.1593 and 416.971-416.976--0960-0059. SSA uses Form SSA-821-BK to
collect recipient employment information to determine whether
recipients worked after becoming disabled and, if so, whether the work
is substantial gainful activity. SSA's field offices use Form SSA-821-
BK to obtain work information during the initial claims process, the
continuing disability review process, and for Supplemental Security
Income (SSI) claims involving work issues. SSA's processing centers and
the Office of Disability and International Operations use the form to
obtain post-adjudicative work issue from recipients. SSA reviews and
evaluates the data to determine if the applicant or recipient meets the
disability requirements of the law. The respondents are applicants and
recipients of Title II Social Security and SSI disability payments.
Type of Request: Reinstatement with change of a previous OMB-
approved information collection.
[[Page 29788]]
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-821-BK.................................. 300,000 1 30 150,000
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2. Coverage of Employees of State and Local Governments--20 CFR
404, Subpart M--0960-0425. The Code of Federal Regulations at 20 CFR
404, Subpart M, prescribes the rules for States submitting reports of
deposits and recordkeeping to SSA. States (and interstate
instrumentalities) are required to provide wage and deposit
contribution information for pre-1987 periods. Not all states have
completely satisfied their pending wage report and contribution
liability with SSA for pre-1987 tax years. These regulations are needed
until all pending items with all states are closed out, and to provide
for collection of this information in the future, if necessary. The
respondents are State and local governments or interstate
instrumentalities.
Type of Request: Reinstatement without change of a previously
approved collection.
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Average burden Estimated
Regulation section Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
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404.1204 (a) & (b).............................. 52 1 30 26
404.1215........................................ 52 1 60 52
404.1216 (a) & (b).............................. 52 1 60 52
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Total....................................... 156 .............. .............. 130
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3. Credit Card Payment Form--0960-0648. SSA uses Form SSA-1414 to
process: (1) Credit card payments from former employees and vendors
with outstanding debts to the agency; (2) advance payments for
reimbursable agreements; and (3) credit card payments for all Freedom
of Information Act (FOIA) requests requiring payment. The respondents
are former employees and vendors who have outstanding debts to the
agency, entities who have reimbursable agreements with SSA, and
individuals who request information through FOIA.
Type of Request: Reinstatement without change of a previous 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)
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SSA-1414.................................... 6,000 1 2 200
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4. Social Security Administration Health IT Partner Program
Assessment--Participating Facilities and Available Content Form--20 CFR
404.1614, 416.1014, 24 CFR 495.300-495.370--0960-0798. 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 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.
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 (hours) (hours)
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SSA-680..................................... 30 1 5 150
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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.
[[Page 29789]]
To be sure we consider your comments, we must receive them no later
than June 22, 2015. Individuals can obtain copies of the OMB clearance
packages by writing to [email protected].
1. Application for Supplemental Security Income--20 CFR 416.305-
416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to determine
an applicant's eligibility for SSI and SSI payment amounts. SSA
employees also collect this information during interviews with members
of the public who wish to file for SSI. SSA uses the information for
two purposes: (1) Formally deny SSI for non-medical reasons when
information the applicant provides results in ineligibility; or (2)
establish a disability claim, but defer the complete development of
non-medical issues until SSA approves the disability. The respondents
are applicants for SSI.
Type of Request: Revision of an OMB-approved information
collection.
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Estimated
Number of Frequency of Average burden total annual
Modality of completion respondents response per response burden
(minutes) (hours)
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MSSICS/Signature Proxy.......................... 1,195,521 1 20 398,507
Non-MSSICS (Paper).............................. 140,145 1 20 46,715
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Totals...................................... 1,335,666 .............. .............. 445,222
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2. Statement of Reclamation Action--31 CFR 210--0960-0734.
Regulations governing the Federal Government Participation in the
Automated Clearing House (1) allow SSA to send Social Security payments
to Canada, and (2) mandate the reclamation of funds paid erroneously to
a Canadian bank or financial institution after the death of a Social
Security beneficiary. SSA uses Form SSA-1713, Notice of Reclamation
Action, to determine if, how, and when the Canadian bank or financial
institution is going to return erroneous payments after the death of a
Social Security beneficiary who elected to have payments sent to
Canada. Form SSA-1712 (or SSA-1712 CN), Notice of Reclamation-Canada
Payment Made in the United States, is the cover sheet SSA prepares to
request return of the payment. The respondents are Canadian banks and
financial institutions who erroneously received Social Security
payments.
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)
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SSA-1713.................................... 15 1 5 1
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Dated: May 19, 2015.
Faye I. Lipsky,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-12454 Filed 5-21-15; 8:45 am]
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