[Federal Register Volume 80, Number 141 (Thursday, July 23, 2015)]
[Notices]
[Pages 43828-43830]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-18040]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2015-0046]


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 and reinstatements of 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-2015-0046].
    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 
September 21, 2015. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution--20 CFR 416.200 and 
416.203--0960-0293. SSA collects and verifies financial information 
from individuals applying for Supplemental Security Income (SSI) 
payments to determine if the applicant meets the SSI resource 
eligibility requirements. If the SSI claimants provide incomplete, 
unavailable, or seemingly altered records, SSA contacts their financial 
institutions to verify the existence, ownership, and value of accounts 
owned. Financial institutions require individuals to sign Form SSA-
4641-F4, or complete the e4641 electronic application, 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.

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                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4641 (paper)................................         252,500               1               6          25,250
e4641 (electronic)..............................      15,747,500               1               2         524,917
                                                 ---------------------------------------------------------------
    Totals......................................      16,000,000  ..............  ..............         550,167
----------------------------------------------------------------------------------------------------------------

    2. Site Review Questionnaire for Volume and Fee-for-Service Payees 
and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665, 
416.701, and 416.708--0960-0633. SSA asks organizational representative 
payees to complete Form SSA-637, the Site Review Questionnaire for 
Volume and Fee-for-Service Payees, to provide information on how they 
carry out their responsibilities, including how they manage beneficiary 
funds. SSA then obtains information from the beneficiaries these 
organizations represent via Form SSA-639, Beneficiary Interview Form, 
to corroborate the payees' statements. Due to the sensitivity of the 
information, SSA employees always complete the forms based on the 
answers respondents give during the interview. The respondents are 
individuals, State and local governments, non-profit and for-profit 
organizations serving as representative payees, and the beneficiaries 
they serve.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 43829]]



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                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-637.........................................           1,999               1             120           3,998
SSA-639.........................................           8,293               1              10           1,382
                                                 ---------------------------------------------------------------
    Totals......................................          10,292  ..............  ..............           5,380
----------------------------------------------------------------------------------------------------------------

    3. 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 a Social Security number (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
           Modality of completion                Number of       Frequency of    per  response     total annual
                                                respondents        response        (minutes)     burden  (hours)
----------------------------------------------------------------------------------------------------------------
SSA-132.....................................         298,953                1                2            9,965
----------------------------------------------------------------------------------------------------------------

    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.

----------------------------------------------------------------------------------------------------------------
                                                                                 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
----------------------------------------------------------------------------------------------------------------

    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 August 24, 2015. Individuals can obtain copies of the OMB 
clearance packages by writing to [email protected].
    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 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 Title XVI SSI disability payments.
    Type of Request: Reinstatement with change of a previous OMB-
approved information collection.

[[Page 43830]]



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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-821-BK..................................         300,000                1               30          150,000
----------------------------------------------------------------------------------------------------------------

    2. 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.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1414........................................           6,000               1               2             200
----------------------------------------------------------------------------------------------------------------


    Date: July 19, 2015.
Faye I. Lipsky,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-18040 Filed 7-22-15; 8:45 am]
 BILLING CODE 4191-02-P