[Federal Register Volume 81, Number 11 (Tuesday, January 19, 2016)]
[Notices]
[Pages 2938-2939]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-00855]



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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2016-0001]


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 an extension 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-2016-0001].
    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 21, 2016. 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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7163A-F4................................           1,000                1               60            1,000
----------------------------------------------------------------------------------------------------------------

    2. Employer Verification of Earnings After Death--20 CFR 404.821 
and 404.822--0960-0472. When SSA records show a wage earner is deceased 
and we receive wage reports from an employer for the wage earner for a 
year subsequent to the year of death, SSA mails the employer Form SSA-
L4112 (Employer Verification of Earnings After Death). SSA uses the 
information Form SSA-L4112 provides to verify wage information 
previously received from the employer is correct for the employee and 
the year in question. The respondents are employers who report wages 
for employees who have died.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L4112...................................          50,000                1               10            8,333
----------------------------------------------------------------------------------------------------------------

    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 these children to retain health benefits under their 
employed parents' plans. The physician must verify 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, the Certificate of Incapacity, to document and certify 
this information, and the Social Security Administration uses the 
information provided to determine the eligibility for these children, 
ages 26 and over, for coverage under a parent's FEHB plan. The 
respondents are physicians of SSA employees' children ages 26 or over 
who are seeking to retain health benefits under their parent's FEHB 
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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-604.....................................              50                1               45               38
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    4. Certificate of Election for Reduced Widow(er)s and Surviving 
Divorced Spouse's Benefits--20 CFR 404.335--0960-0759. Section 202(q) 
of the Act provides SSA the authority to reduce benefits under certain 
conditions when elected by a Title II beneficiary. However, reduced 
benefits are not payable to an already entitled spouse (or divorced 
spouse) who:

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     Is at least age 62 and under full retirement age in the 
month of the number holder's death; and
     Is receiving both reduced spouse's (or divorced spouse's) 
benefits and either retirement or disability benefits in the month 
before the month of the number holder's death.
    To elect reduced widow(er) benefits, a recipient completes Form 
SSA-4111. SSA uses the information collected to pay a qualified dually 
entitled widow(er) (or surviving divorced spouse) who elects to receive 
a reduced widow(er) benefit. The respondents are qualified dually 
entitled widow(er)s (or surviving divorced spouse) who elect to receive 
a reduced widow(er) benefit.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4111....................................          30,000                1                2            1,000
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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 18, 2016. 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, 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. The 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 completion                Number of       Frequency of    per  response    annual burden
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2519....................................          50,000                1               15           12,500
----------------------------------------------------------------------------------------------------------------

    2. Request for Reinstatement (Title XVI)--20 CFR 416.999-416.999d--
0960-0744. SSA uses Form SSA-372 to (1) inform previously entitled 
beneficiaries of the expedited reinstatement (EXR) requirements of 
Supplemental Security Income (SSI) payments under Title XVI of the 
Social Security Act (Act), and (2) document their requests for EXR. We 
require this application for reinstatement of benefits for respondents 
to obtain SSI disability payments for EXR. When an SSA claims 
representative learns of individuals whose medical conditions no longer 
permit them to perform substantial gainful activity as defined in the 
Act, the claims representative gives or mails the form to the 
previously entitled individuals if they request EXR over the phone. SSA 
employees collect this information whenever an individual files for EXR 
benefits. The respondents are applicants for EXR of SSI disability 
payments.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                Average  burden  Estimated total
             Regulation section                  Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-372.....................................           2,000                1                2               67
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    Dated: January 13, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-00855 Filed 1-15-16; 8:45 am]
 BILLING CODE 4191-02-P