[Federal Register Volume 80, Number 221 (Tuesday, November 17, 2015)]
[Notices]
[Pages 71908-71911]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-29269]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2015-0067]


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-

[[Page 71909]]

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-2015-0067].
    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 
January 19, 2016. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Certificate of Responsibility for Welfare and Care of Child Not 
in Applicant's Custody--20 CFR 404.330, 404.339-404.341 and 404.348-
404.349--0960-0019. Under the provisions of the Social Security Act 
(Act), non-custodial parents who are filing for spouse, mother, or 
father Social Security benefits based on having the child of a number 
holder or worker in their care, must meet the in-care requirements the 
Act discusses. The in-care provision requires claimants to have an 
entitled child under age 16 or disabled in their care. SSA uses Form 
SSA-781, Certificate of Responsibility for Welfare and Care of Child in 
Applicant's Custody, to determine if claimants meet the requirement. 
The respondents are applicants for spouse, mother's or father's Social 
Security benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                Average  burden     Estimated
           Modality of  completion               Number of      Frequency  of    per  response     total annual
                                                respondents        response        (minutes)     burden  (hours)
----------------------------------------------------------------------------------------------------------------
SSA-781.....................................          14,000                1               10            2,333
----------------------------------------------------------------------------------------------------------------

    2. Request for Change in Time/Place of Disability Hearing--20 CFR 
404.914(c)(2) and 416.1414(c)(2)--0960-0348. At the request of the 
claimants or their representative, SSA schedules evidentiary hearings 
at the reconsideration level for claimants of Title II benefits or 
Title XVI payments when we deny their claims for disability. When 
claimants or their representatives find they are unable to attend the 
scheduled hearing, they complete Form SSA-769 to request a change in 
time or place of the hearing. SSA uses the information as a basis for 
granting or denying requests for changes and for rescheduling 
disability hearings. Respondents are claimants or their representatives 
who wish to request a change in the time or place of their hearing.
    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-769-U4..................................           7,483                1                8              998
----------------------------------------------------------------------------------------------------------------

    3. Notice Regarding Substitution of Party Upon Death of Claimant--
Reconsideration of Disability Cessation--20 CFR 404.907-404.921 and 
416.1407-416.1421--0960-0351. When a claimant dies before we make a 
determination on that person's request for reconsideration of a 
disability cessation, SSA seeks a qualified substitute party to pursue 
the appeal. If SSA locates a qualified substitute party, the agency 
uses Form SSA-770 to collect information about whether to pursue or 
withdraw the reconsideration request. We use this information as the 
basis for the decision to continue or discontinue with the appeals 
process. Respondents are substitute applicants who are pursuing a 
reconsideration request for a deceased claimant.
    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-770.....................................           1,200                1                5              100
----------------------------------------------------------------------------------------------------------------

    4. Beneficiary Interview and Auditor's Observations Form--0960-
0630. SSA's Office of the Inspector General collects information from 
Form SSA-322, the Beneficiary Interview and Auditor's Observation form, 
to interview beneficiaries or their payees to determine whether they 
are complying with their duties and responsibilities. The respondents 
are randomly selected Supplemental Security Income (SSI) recipients and 
Social Security beneficiaries who have representative payees.
    Type of Request: Revision of previously approved collection.

[[Page 71910]]



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                                                                                Average  burden     Estimated
           Modality of  completion               Number of      Frequency  of    per  response     total annual
                                                respondents        response        (minutes)     burden  (hours)
----------------------------------------------------------------------------------------------------------------
SSA-322.....................................           1,000                1               15              250
----------------------------------------------------------------------------------------------------------------

    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 December 17, 2015. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    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 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 
one of SSA's electronic applications, e4641 or the Access to Financial 
Institutions (AFI) screens, 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)................................         252,500               1               6          25,250
e4641 and AFI (electronic)......................      15,747,500               1               2         524,917
                                                 ---------------------------------------------------------------
    Totals......................................      16,000,000  ..............  ..............         550,167
----------------------------------------------------------------------------------------------------------------

    2. Surveys in Accordance with E.O. 12862 for the Social Security 
Administration--0960-0526. Under the auspices of Executive Order 12862, 
Setting Customer Service Standards, SSA conducts multiple customer 
satisfaction surveys each year. These voluntary customer satisfaction 
assessments include paper, Internet, and telephone surveys; mailed 
questionnaires; and customer comment cards. The purpose of these 
questionnaires is to assess customer satisfaction with the timeliness, 
appropriateness, access, and overall quality of existing SSA services 
and proposed modifications or new versions of services. The respondents 
are recipients of SSA services (including most members of the public), 
professionals, and individuals who work on behalf of SSA beneficiaries.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency  of    burden per     total annual
                                                    respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Year 1..........................................       9,164,640               1            3-30       1,346,904
Year 2..........................................       9,170,140               1            3-30       1,347,404
Year 3..........................................       9,175,640               1            3-30       1,348,504
                                                 ---------------------------------------------------------------
    Totals......................................      27,510,420  ..............  ..............       4,042,812
----------------------------------------------------------------------------------------------------------------

    3. 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 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 beneficiaries and blind or 
disabled SSI recipients working under the auspices of the TTW Program.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 71911]]



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                                                                                      Average        Estimated
                                                     Number of     Frequency  of    burden per     total annual
             Modality of  completion                respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
a) 20 CFR 411.140(d)(2)--Interactive Voice                 6,428               1             2.5             268
 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 Fair                    500               1              10              83
 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)--Electronic File            40,324               1               5           3,360
 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 Sharing/                8,505               1               5             709
 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 Registration            24,000               1               3           1,200
 Page...........................................
c) 20 CFR 411.200(b) Virtual Job Fair                      9,000               1              10           1,500
 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-1391; SSA-1393;           2,805               1              40           1,870
 SSA-1396; SSA-1398; SSA-1399...................
f) 20 CFR 411.575--Portal.......................          42,075               1              22          15,427
f) 20 CFR 411.575--Automatic Payments...........          11,220               1               0               0
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
                                                 ---------------------------------------------------------------
    Totals......................................         372,032  ..............  ..............          65,428
----------------------------------------------------------------------------------------------------------------
* (None received in 2012, 2013, 2014)

    4. 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 Collection: Extension of an OMB-approved information 
collection.

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


    Dated: November 11, 2015.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-29269 Filed 11-16-15; 8:45 am]
 BILLING CODE 4191-02-P