[Federal Register Volume 80, Number 172 (Friday, September 4, 2015)]
[Notices]
[Pages 53608-53611]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-21967]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2015-0052]


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 Extensions 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-
0052].
    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 
November 3, 2015. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. The Ticket to Work and Self-Sufficiency Program--20 CFR 411--
0960-0644. SSA's Ticket to Work (TTW) Program transitions Social 
Security Disability Insurance (SSDI) and Supplemental Security Income 
(SSI) recipients toward independence by allowing them to receive Social 
Security payments while maintaining employment under the auspices of 
the program. SSA uses service providers, called Employment Networks 
(ENs), to supervise participant progress through the stages of TTW 
Program participation, such as job searches and interviews, progress 
reviews, and changes in ticket status. ENs can be private for-profit 
and nonprofit organizations, as well as state vocational rehabilitation 
agencies (VRs). SSA and the ENs utilize the TTW program manager to 
operate the TTW Program and exchange information about participants. 
For example, the ENs use the program manager to provide updates on 
tasks such as selecting a payment system or requesting payments for 
helping the beneficiary achieve certain work goals. Since the ENs are 
not PRA-exempt, the multiple information collections within the TTW 
program manager require OMB approval, and we clear them under this 
information collection request (ICR). Most of the categories of 
information in this ICR are necessary for SSA to: (1) Comply with the 
Ticket to Work legislation; and (2) provide proper oversight of the 
program. SSA collects this information through several modalities, 
including forms, electronic exchanges, and written documentation. The 
respondents are the ENs or state VRs, as well as SSDI

[[Page 53609]]

beneficiaries, and blind or disabled SSI recipients working under the 
auspices of the TTW Program.
    Type of Collection: 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)
----------------------------------------------------------------------------------------------------------------
a) 20 CFR 411.140(d)(2)--Interactive              6,428                  1                2.5                268
 Voice Recognition Telephone........
a) 20 CFR 411.140(d)(2)--Portal.....             25,713                  1               1.25                536
a) 20 CFR 411.140(d)(3)--Virtual Job                500                  1                 10                 83
 Fair Registration-Employment
 Networks...........................
a) 20 CFR 411.140(d)(3); 411.325(a);                948                  1                 15                237
 411.150(b)(3)--SSA-1365............
a) 20 CFR 411.140(d)(3); 411.325(a);              3,792                  1                 11                695
 411.150(b)(3)--SSA-1365 Portal.....
a) 20 CFR 411.140(d)(3); 411.325(a);              1,956                  1                 60              1,956
 411.150(b)(3)--SSA-1370............
a) 20 CFR 411.140(d)(3); 411.325(a);              5,868                  1                 10                978
 411.150(b)(3)--SSA-1370 Portal.....
a) 20 CFR 411.166; 411.170(b)--                  40,324                  1                  5              3,360
 Electronic File Submission.........
b) 20 CFR 411.145; 411.325..........              2,494                  1                 15                624
b) 20 CFR 411.145; 411.325--Portal..              7,481                  1                 11              1,372
b) 20 CFR 411.535(a)(1)(iii)--Data                8,505                  1                  5                709
 Sharing/Portal.....................
c) 20 CFR 411.192(b) & (c)..........                  6                  1                 30                  3
c) 20 CFR 411.200(b)--SSA-1375......            112,362                  1                 15             28,091
c) 20 CFR 411.200(b)--Portal........             64,824                  1                  5              5,402
c) 20 CFR 411.210(b)................                 41                  1                 30                 21
c) 20 CFR 411.200(b) Wise Webinar                24,000                  1                  3              1,200
 Registration Page..................
c) 20 CFR 411.200(b) Virtual Job                  9,000                  1                 10              1,500
 Fair Registration..................
d) 20 CFR 411.365; 411.505; 411.515.                  6                  1                 10                  1
e) 20 CFR 411.325(d); 411.415.......                 1*                  1                480                  8
f) 20 CFR 411.575--SSA-1389; SSA-                 2,805                  1                 40              1,870
 1391; SSA-1393; SSA-1396; SSA-1398;
 SSA-1399...........................
f) 20 CFR 411.575--Portal...........             42,075                  1                 22             15,427
f) 20 CFR 411.575--Automatic                     11,220                  1                  0                  0
 Payments...........................
f) 20 CFR 411.560--SSA-1401.........                100                  1                 20                 33
g) 20 CFR 411.325(f)................              1,371                  1                 45              1,028
h) 20 CFR 411.435; 411.615; 411.625.                  2                  1                120                  4
i) 20 CFR 411.320--SSA-1394.........                 52                  1                 10                  9
i) 20 CFR 411.320--SSA-1394 Portal..                158                  1                  5                 13
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    Totals..........................            372,032  .................  .................             65,428
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* (None received in 2012, 2013, 2014)

    2. Representative Payment Policies and Administrative Procedures 
for Imposing Penalties for False or Misleading Statements or 
Withholding of Information--0960-0740. This information collection 
request comprises several regulation sections that provide additional 
safeguards for Social Security beneficiaries' whose representative 
payees receive their payment. SSA requires representative payees to 
notify them of any event or change in circumstances that would affect 
receipt of benefits or performance of payee duties. SSA uses the 
information to determine continued eligibility for benefits, the amount 
of benefits due and if the payee is suitable to continue servicing as 
payee. The respondents are representative payees who receive and use 
benefits on behalf of Social Security beneficiaries.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                                                              Average burden    Estimated total
 Modality of completion (regulation       Number of         Frequency of       per response      annual burden
              citation)                  respondents          response          (minutes)           (hours)
----------------------------------------------------------------------------------------------------------------
404.2035(d)--Paper/Mail.............             28,600                  1                  5              2,383
404.2035(d)--Office interview/                  543,400                  1                  5             45,283
 Intranet...........................
404.2035(f)--Paper/Mail.............                286                  1                  5                 24
404.2035(f)--Office interview/                    5,434                  1                  5                453
 Intranet...........................
416.635(d)--Paper/Mail..............             15,600                  1                  5              1,300
416.635(d)--Office interview/                   286,400                  1                  5             23,867
 Intranet...........................
416.635(f)--Paper/Mail..............                156                  1                  5                 13
416.635(f)--Office interview/                     2,964                  1                  5                247
 Intranet...........................
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    Totals..........................            882,840  .................  .................             73,570
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[[Page 53610]]

    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 October 5, 2015. Individuals can obtain copies of the OMB 
clearance packages by writing to [email protected].
    1. Statement of Employer--20 CFR 404.801-404.803--0960-0030. When 
workers report they were paid wages but cannot provide proof of those 
earnings, and the wages do not appear in SSA's records of earnings, SSA 
uses Form SSA-7011-F4 to document the alleged wages. Specifically, the 
agency uses the form to resolve discrepancies in the individual's 
Social Security earnings record and to process claims for Social 
Security benefits. We only send Form SSA-7011-F4 to employers if we are 
unable able to locate the earnings information within our own records. 
The respondents are employers who can verify wage allegations made by 
wage earners.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                          Average burden per    Estimated total
     Modality of completion            Number of         Frequency of          response          annual burden
                                      respondents          response            (minutes)            (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7011-F4.....................                500                   1                  20                 167
----------------------------------------------------------------------------------------------------------------

    2. Substitution of Party Upon Death of Claimant--20 CFR 
404.957(c)(4) and 416.1457(c)(4)--0960-0288. An administrative law 
judge (ALJ) may dismiss a request for a hearing on a pending claim of a 
deceased individual for Social Security benefits or SSI payments. 
Individuals who believe the dismissal may adversely affect them may 
complete Form HA-539, which allows them to request to become a 
substitute party for the deceased claimant. The ALJs and the hearing 
office support staff use this information from the HA-539 to: (1) 
Maintain a written record of request; (2) establish the relationship of 
the requester to the deceased claimant; (3) determine the substituted 
individual's wishes regarding an oral hearing or decision on the 
record; and (4) admit the data into the claimant's official record as 
an exhibit. The respondents are individuals requesting to be a 
substitute party for a deceased claimant.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                          Average burden per    Estimated total
     Modality of completion            Number of         Frequency of          response          annual burden
                                      respondents          response            (minutes)            (hours)
----------------------------------------------------------------------------------------------------------------
HA-539..........................              4,000                   1                   5                 333
----------------------------------------------------------------------------------------------------------------

    3. Claimant Statement about Loan of Food or Shelter; Statement 
about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. SSA bases an SSI claimant or recipient's eligibility on 
need, as measured by the amount of income an individual receives. Per 
our calculations, income includes other people providing in-kind 
support and maintenance in the form of food and shelter to SSI 
applicants or recipients. SSA uses Forms SSA-5062 and SSA-L5063 to 
obtain statements about food or shelter provided to SSI claimants or 
recipients. SSA uses this information to determine whether food or 
shelters are bona fide loans or income for SSI purposes. This 
determination may affect claimants' or recipients' eligibility for SSI 
as well as the amounts of their SSI payments. The respondents are 
claimants and recipients for SSI payments, and individuals who provide 
loans of food or shelter to them.
    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-5062 Paper form.................             34,752                  1                 10              5,792
SSA-L5063 Paper form................             34,752                  1                 10              5,792
SSA-5062 Modernized SSI Claims                   34,752                  1                 10              5,792
 System (MSSICS)....................
SSA-L5063 MSSICS....................             34,752                  1                 10              5,792
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    Total...........................            139,008  .................  .................              3,168
----------------------------------------------------------------------------------------------------------------

    4. Representative Payee Report of Benefits and Dedicated Account--
20 CFR 416.546, 416.635, 416.640, 416.665--0960-0576. SSA requires 
representative payees (RPs) to submit a written report accounting for 
the use of money paid to Social Security or SSI recipients, and to 
establish and maintain a dedicated account for these payments. SSA uses 
Form SSA-6233 to: (1) Ensure the RPs use the payments for the 
recipient's current maintenance and personal needs; and (2) confirm the 
expenditures of funds from the dedicated account remain in compliance 
with the law. Respondents are RPs for SSI and Social Security 
recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 53611]]



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                                                                          Average burden per    Estimated total
     Modality of completion            Number of         Frequency of          response          annual burden
                                      respondents          response            (minutes)            (hours)
----------------------------------------------------------------------------------------------------------------
SSA-6233........................             30,000                   1                  20              10,000
----------------------------------------------------------------------------------------------------------------

    5. Application for Circuit Court Law--20 CFR 404.985 & 416.1458--
0960-0581. Persons claiming an acquiescence ruling (AR) would change 
SSA's prior determination or decision must submit a written 
readjudication request with specific information. SSA reviews the 
information in the requests to determine if the issues stated in the AR 
pertain to the claimant's case, and if the claimant is entitled to 
readjudication. If readjudication is appropriate, SSA considers the 
issues the AR covers. Any new determination or decision is subject to 
administrative or judicial review as specified in the regulations. 
Respondents are claimants for Social Security benefits and SSI payments 
who request readjudication. This information collection request is for 
the information claimants must provide to request readjudication.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                          Average burden per    Estimated total
     Modality of completion            Number of         Frequency of          response          annual burden
                                      respondents          response            (minutes)            (hours)
----------------------------------------------------------------------------------------------------------------
AR-based Readjudication.........             10,000                   1                  17               2,833
Requests........................
----------------------------------------------------------------------------------------------------------------

    6. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. Inmates of Federal, State, or local prisons may need a 
Social Security card as verification of their Social Security number 
for school or work programs, or as proof of employment eligibility upon 
release from incarceration. Before SSA can issue a replacement Social 
Security card, applicants must show SSA proof of their identity. People 
who are in prison for an extended period typically do not have current 
identity documents. Therefore, under formal written agreement with the 
correctional institution, SSA allows prison officials to verify the 
identity of certain incarcerated U.S. citizens who need replacement 
Social Security cards. Information prison officials provide comes from 
the official prison files, sent on correctional facility letterhead. 
SSA uses this information to establish the applicant's identity in the 
replacement Social Security card process. The respondents are prison 
officials who certify the identity of prisoners applying for 
replacement Social Security cards.
    Type of Request: Extension of an OMB-approved Information 
Collection.

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                                                                                                                  Average burden per    Estimated total
               Modality of completion                      Number of         Frequency of         (Number of           response          annual burden
                                                          respondents          response           responses)           (minutes)            (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Verification of Prisoner Identity Statements........              1,000                 200           (200,000)                   3              10,000
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    Dated: September 1, 2015.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-21967 Filed 9-3-15; 8:45 am]
 BILLING CODE 4191-02-PDEPARTMENT OF STATE