[Federal Register Volume 81, Number 205 (Monday, October 24, 2016)]
[Notices]
[Pages 73189-73191]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-25625]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2016-0051]


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.
    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]

[[Page 73190]]

(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-2016-0051].
    I. The information collection below is pending at SSA. SSA will 
submit it 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 
December 23, 2016. Individuals can obtain copies of the collection 
instrument by writing to the above email address.
    Requests for Self-Employment Information, Employee Information, 
Employer Information--20 CFR 422.120--0960-0508. When SSA cannot 
identify Form W-2 wage data for an individual, we place the data in an 
earnings suspense file and contact the individual (and in certain 
instances the employer) to obtain the correct information. If the 
respondent furnishes the name and Social Security Number (SSN) 
information which agrees with SSA's records, or provides information 
resolving the discrepancy, SSA adds the reported earnings to the 
respondent's Social Security record. We use Forms SSA-L2765, SSA-L3365, 
and SSA-L4002 for this purpose. The respondents are self-employed 
individuals and employees whose name and SSN information do not agree 
with their employer's and SSA's records.
    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)
----------------------------------------------------------------------------------------------------------------
SSA-L2765.......................................          12,321               1              10           2,054
SSA-L3365.......................................         179,749               1              10          29,958
SSA-L4002.......................................         121,679               1              10          20,280
                                                 ---------------------------------------------------------------
    Totals......................................         313,749  ..............  ..............          52,292
----------------------------------------------------------------------------------------------------------------

    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 November 23, 2016. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    1. Application for Child's Insurance Benefits--20 CFR 404.350-
404.368, 404.603, & 416.350--0960-0010. Title II of the Social Security 
Act (Act) provides for the payment of monthly benefits to children of 
an insured retired, disabled, or deceased worker. Section 202(d) of the 
Act discloses the conditions and requirements the applicant must meet 
when filing an application. SSA uses the information on Form SSA-4-BK 
to determine entitlement for children of living and deceased workers to 
monthly Social Security payments. Respondents are guardians completing 
the form on behalf of the children of living or deceased workers, or 
the children of living or deceased workers.
    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)
----------------------------------------------------------------------------------------------------------------
Life claims (paper).............................          15,207               1              12           3,041
Life Claims (MCS/Signature Proxy)...............         465,428               1              11          85,328
Death Claims (paper)............................           6,290               1              12           1,258
Death Claims (MCS/Signature Proxy)..............         193,131               1              11          35,407
                                                 ---------------------------------------------------------------
    Totals......................................         680,056  ..............  ..............         125,034
----------------------------------------------------------------------------------------------------------------

    2. Private Printing and Modification of Prescribed Application and 
Other Forms--20 CFR 422.527--0960-0663. 20 CFR 422.527 of the Code of 
Federal Regulations requires a person, institution, or organization 
(third-party entities) to obtain approval from SSA prior to 
reproducing, duplicating, or privately printing any application or 
other form the agency owns. To obtain SSA's approval, entities must 
make their requests in writing using their company letterhead, 
providing the required information set forth in the regulation. SSA 
uses the information to: (1) Ensure requests comply with the law and 
regulations, and (2) process requests from third-party entities who 
want to reproduce, duplicate, or privately print any SSA application or 
other SSA form. SSA employees review the requests and provide approval 
via email or mail to the third-party entities. The respondents are 
third-party entities who submit a request to SSA to reproduce, 
duplicate, or privately print an SSA-owned form.
    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)
----------------------------------------------------------------------------------------------------------------
20 CFR 422.527..................................              10              15              10              25
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[[Page 73191]]

    Dated: October 19, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-25625 Filed 10-21-16; 8:45 am]
 BILLING CODE 4191-02-P