[Federal Register Volume 83, Number 218 (Friday, November 9, 2018)]
[Notices]
[Pages 56133-56136]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-24517]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2018-0058]


Agency Information Collection Activities: Proposed 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].
(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-2018-0058].
    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 8, 2019. 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. SSA uses Form SSA-781 to determine if non-custodial 
parents who file for spouse, mother's, father's, or surviving divorced 
mother's or father's benefits based on having a child in their care, 
meet the in-care requirements. The in-care provision requires claimants 
to have an entitled child under age 16 or disabled in their care. The 
respondents are applicants for spouse; mother's, father's, or surviving 
divorced mother's or father's Social Security benefits.
    Type of Request: Request for a new information collection.

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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     of response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-781.....................................          14,000                1               10            2,333
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    2. Farm Self-Employment Questionnaire--20 CFR 404.1082(c) & 
404.1095--0960-0061. SSA collects the information on Form SSA-7156 on a 
voluntary and as-needed basis to determine the existence of an 
agriculture trade or business which may affect the monthly benefit, or 
insured status, of the applicant. SSA requires the existence of a trade 
or business before determining if an individual or partnership has net 
earnings from self-employment. When an applicant indicates self-
employment as a farmer, SSA uses the SSA-7165 to obtain the information 
we need to determine the existence of an agricultural trade or 
business, and subsequent covered earnings for Social Security 
entitlement purposes. As part of the application process, we conduct a 
personal interview, either face-to-face or via telephone, and document 
the interview using Form SSA-7165. We also allow applicants to complete 
a fillable version of the form available on our website, which they can 
complete, print, and sign. The respondents are applicants for Social 
Security benefits whose entitlement depends on whether the

[[Page 56134]]

worker received covered earnings from self-employment as a farmer.
    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     of response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7156....................................          47,500                1               10            7,917
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    3. 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 (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     of response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2519....................................          50,000                1               15           12,500
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    4. Pre-1957 Military Service Federal Benefit Questionnaire--20 CFR 
404.1301-404.1371--0960-0120. SSA may grant gratuitous military wage 
credits for active military or naval service (under certain conditions) 
during the period of September 16, 1940 through December 31, 1956, if 
no other Federal agency (other than the Veterans Administration) 
credited the service for benefit eligibility or computation purposes. 
We use Form SSA-2512 to collect specific information about other 
Federal, military, or civilian benefits the wage earner may receive 
when the applicant indicates both pre-1957 military service and the 
receipt of a Federal benefit. SSA uses the data in the claims 
adjudication process to grant gratuitous military wage credits when 
applicable, and to solicit sufficient information to determine 
eligibility. Respondents are applicants for Social Security benefits on 
a record where the wage earner claims pre-1957 military service.
    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     of response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2512....................................           5,000                1               10              833
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    5. Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution--20 CFR 416.200, 416.203, 
404.508, & 416.553--0960-0293. SSA collects and verifies financial 
information from individuals applying for Title II and Title XVI waiver 
determinations, as well as those who apply for, or currently receive 
(in the case of redetermination), Supplemental Security Income (SSI) 
payments. We require the financial information from these applicants 
to: (1) Determine the eligibility of the applicant or recipient for SSI 
benefits; or (2) determine if a request to waive a Social Security 
overpayment defeats the purpose of the Act. If the Title II and Title 
XVI waiver applicants, or 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 need individuals to sign Form SSA-4641-
F4, or work with SSA staff to complete one of SSA's electronic 
applications, e4641 or the Access to Financial Institutions (AFI) 
screens, to authorize the individual's financial institution to 
disclose records to SSA. The respondents are Title II and Title XVI 
recipients applying for waivers, or SSI applicants, recipients, and 
their deemors to determine SSI eligibility.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of     of response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4641 (paper)................................         140,000               1               6          14,000
e4641 and AFI (Internet)........................      15,860,000               1               2         528,667
                                                 ---------------------------------------------------------------
    Totals......................................      16,000,000  ..............  ..............         542,667
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[[Page 56135]]

    6. Vocational Rehabilitation Provider Claim--20 CFR 404.2108(b), 
404.2117(c)(1)&(2), 404.2101(b)&(c), 404.2121(a), 416.2208(b), 
416.2217(c)(1)&(2), 416.2201(b)&(c), 416.2221(a)--0960-0310. State 
vocational rehabilitation (VR) agencies submit Form SSA-199 to SSA to 
obtain reimbursement of costs incurred for providing VR services. SSA 
requires state VR agencies to submit reimbursement claims for the 
following categories: (1) Claiming reimbursement for VR services 
provided; (2) certifying adherence to cost containment policies and 
procedures; and (3) preparing causality statements. The respondents 
provide the information requested through a web-based Secure Ticket 
Portal, in lieu of submitting forms. This Portal allows VRs to retrieve 
reports, and enter and submit information electronically, minimizing 
the use of the paper form to SSA for consideration and approval of the 
claim for reimbursement of costs incurred for SSA beneficiaries. SSA 
uses the information on the SSA-199, along with the written 
documentation, to determine whether, and how much, to pay State VR 
agencies under SSA's VR program. Respondents are State VR agencies 
offering vocational and employment services to Social Security and SSI 
recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
     Modality of completion          Number of     Frequency of      Number of      of response    total annual
                                    respondents      response        responses       (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-199 CFR 404.2108 & 416.2208.              80             160          12,800              23           4,907
CFR 404.2117 & 416.2217 Written               80               1              80              60              80
 requests.......................
CFR 404.2121 & 416.2221 Written               80             2.5             200             100             333
 requests.......................
                                 -------------------------------------------------------------------------------
    Total.......................              80  ..............          13,080  ..............           5,320
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    7. 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 representatives, 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.

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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     of response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-769.....................................           7,483                1                8              998
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    8. Application for Supplemental Security Income--20 CFR 416.305-
416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to determine 
an applicant's eligibility for SSI and SSI payment amounts. SSA 
employees also collect this information during interviews with members 
of the public who wish to file for SSI. SSA uses the information for 
two purposes: (1) To formally deny SSI for nonmedical reasons when 
information the applicant provides results in ineligibility; or (2) to 
establish a disability claim, but defer the complete development of 
non-medical issues until SSA approves the disability. The respondents 
are applicants for SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of     of response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSI Claims System...............................         802,368               1              20         267,456
iClaim/SSI Claims System........................         168,661               1              20          56,220
SSA-8001-BK (Paper Version).....................           2,588               1              20             863
                                                 ---------------------------------------------------------------
    Totals......................................         973,617  ..............  ..............         324,539
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    9. Wage Reports and Pension Information--20 CFR 422.122(b)--0960-
0547. Pension plan administrators annually file plan information with 
the Internal Revenue Service, which then forwards the information to 
SSA. SSA maintains and organizes this information by plan number; plan 
participant's name; and Social Security number. Section 1131(a) of the 
Act entitles pension plan participants to request this information from 
SSA. The Wage Reports and Pension Information regulation, 20 CFR 
422.122(b) of the Code of Federal Regulations, requires requestors 
submit a written request with identifying information to SSA, before 
SSA disseminates this information. The respondents are requestors of 
pension plan information.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 56136]]



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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     of response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
Requests for pension plan information.......             580                1               30              290
----------------------------------------------------------------------------------------------------------------

    10. International Direct Deposit--31 CFR 210--0960-0686. SSA's 
International Direct Deposit (IDD) Program allows beneficiaries living 
abroad to receive their payments via direct deposit to an account at a 
financial institution outside the United States. SSA uses Form SSA-
1199-(Country) to enroll Title II beneficiaries residing abroad in IDD, 
and to obtain the direct deposit information for foreign accounts. 
Routing account number information varies slightly for each foreign 
country, so we use a variation of the Treasury Department's Form SF-
1199A for each country. The respondents are Social Security 
beneficiaries residing abroad who want SSA to deposit their Title II 
benefit payments directly to a foreign financial institution.
    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     of response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1199-(Country)..........................          13,750                1                5            1,146
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    11. 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: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of     of response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
404.2035(d)--Paper/Mail.........................          29,601               1               5           2,467
404.2035(d)--Office interview/Intranet..........         562,419               1               5          46,868
404.2035(f)--Paper/Mail.........................             296               1               5              25
404.2035(f)--Office interview/Intranet..........           5,624               1               5             469
416.635(d)--Paper/Mail..........................          16,146               1               5           1,346
416.635(d)--Office interview/Intranet...........         296,424               1               5          24,702
416.635(f)--Paper/Mail..........................             162               1               5              14
416.635(f)--Office interview/Intranet...........           3,067               1               5             256
                                                 ---------------------------------------------------------------
    Totals......................................         913,739  ..............  ..............          76,147
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    Dated: November 5, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-24517 Filed 11-8-18; 8:45 am]
 BILLING CODE 4191-02-P