[Federal Register Volume 64, Number 209 (Friday, October 29, 1999)]
[Notices]
[Pages 58464-58466]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-28434]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
In compliance with Public Law 104-13, the Paperwork Reduction Act
of 1995, SSA is providing notice of its information collections that
require submission to the Office of Management and Budget (OMB). 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 on ways to minimize burden on
respondents, including the use of automated collection techniques or
other forms of information technology.
I. The information collections listed below will be submitted to
OMB within 60 days from the date of this notice. Therefore, comments
and recommendations regarding the information collections would be most
useful if received by the Agency within 60 days from the date of this
publication. Comments should be directed to the SSA Reports Clearance
Officer at the address listed at the end
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of this publication. You can obtain a copy of the collection
instruments by calling the SSA Reports Clearance Officer on (410) 965-
4145, or by writing to him at the address listed at the end of this
publication.
1. Partnership Questionnaire--0960-0025. Form SSA-7104 is used to
establish several aspects of eligibility for benefits, including
accuracy of reported partnership earnings, the veracity of a
retirement, and lag earnings where they are needed for insured status.
The respondents are applicants for old age and disability benefits.
Number of Respondents: 12,350.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 6,175 hours.
2. Report of New Information in Disability Cases--0960-0071. The
information collected on Form SSA-612 is used to update the disability
records of respondents, based on changes reported. The respondents are
applicants for and recipients of Title II Disability Benefits.
Number of Respondents: 27,000.
Frequency of Response: 1.
Average Burden Per Response: 6 minutes.
Estimated Annual Burden: 2,700 hours.
3. Claimant's Recent Medical Treatment--0960-0292. The information
collected on Form HA-4631 is used to provide an updated medical history
for a disability claimant who requests a hearing and to afford
claimants their statutory right to a hearing and decision under the
Social Security Act. The respondents are claimants requesting hearings
on entitlement to benefits based on disability under title II (Old-Age,
Survivors and Disability Insurance) and/or title XVI (Supplemental
Security Income) of the Social Security Act.
Number of Respondents: 309,490.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 51,582 hours.
4. Supplemental Security Income (SSI)--Quality Review Case
Analysis--0960-0133. Form SSA-8508-BK is used with a sample of SSI
recipients in a personal interview and covers all elements of SSI
eligibility. The information obtained is used to assess the
effectiveness of SSI policies and procedures and to establish payment
accuracy rates. The respondents are SSI Recipients.
Number of Respondents: 15,000.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 15,000 hours.
5. Psychiatric Review Technique--0960-0413. The information
collected on Form SSA-2506 is needed by the Social Security
Administration to facilitate in the adjudication of claims involving
mental impairments. The information is used to identify the need for
additional evidence for the determination of impairment severity; to
consider aspects of mental impairment relevant to the individual's
ability to work; and to organize and present the findings in a clear,
concise manner. The respondents are State Disability Determination
Services administering titles II and XVI disability programs.
Number of Respondents: 1,005,804.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 251,451 hours.
6. Instructions for Completion of Federal Assistance Application
Form SSA-96 for SSA Research and Demonstration Grant Programs--0960-
0184. The information collected on Form SSA-96 is needed by the SSA to
evaluate and select grant proposals for funding. The respondents are
applicants for Federal assistance, including State and Local
governments, educational institutions and other nonprofit and for-
profit organizations.
Number of Respondents: 150.
Frequency of Response: 1.
Average Burden Per Response: 14 hours.
Estimated Annual Burden: 2,100 hours.
II. The information collections listed below have been submitted to
OMB for clearance. Written comments and recommendations on the
information collections would be most useful if received within 30 days
from the date of this publication. Comments should be directed to the
SSA Reports Clearance Officer and the OMB Desk Officer at the addresses
listed at the end of this publication. You can obtain a copy of the OMB
clearance packages by calling the SSA Reports Clearance Officer on
(410) 965-4145, or by writing to him.
1. Statement of Living Arrangements, In-Kind Support and
Maintenance--0960-0174. Form SSA-8006 provides a nationally-uniform
vehicle for collecting information from SSI applicants and recipients
about whether they receive income from in-kind support and maintenance.
Responses are used to determine eligibility for SSI benefits payable.
The respondents are individuals applying for SSI or whose eligibility
is being reevaluated.
Number of Respondents: 438,400.
Frequency of Response: 1.
Average Burden Per Response: 7 minutes.
Estimated Annual Burden: 51,147 hours.
2. Quickstart Enrollment Form--0960-0564. The information collected
on this form is needed by SSA to facilitate electronic transmission of
data for direct deposit of funds to a payee's account. The respondents
are Social Security and SSI recipients requesting direct deposit to
their financial institutions.
Number of Respondents: 3,950,000.
Frequency of Response: 1.
Average Burden Per Response: 3 minutes.
Estimated Annual Burden: 197,500 hours.
3. Supplemental Security Income Claim Information Notice--0960-
0324. The information collected on Form SSA-L8050-U3 will be used by
SSA to ensure that all sources of potential income which can be used to
provide for an individual's own support and maintenance are utilized.
The respondents are applicants for SSI and recipients who are
potentially eligible for benefits from other public or private
programs.
Number of Respondents: 7,500.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 1,250 hours.
4. Marital Relationship Questionnaire--0960-0460. The information
collected on Form SSA-4178 is needed by SSA to determine whether
unrelated individuals of the opposite sex who are living together, and
present themselves to the public as husband and wife, should be paid as
a couple or two eligible individuals. The information is used to
determine whether correct payment is being made to SSI couples and
individuals. The respondents are applicants for and recipients of SSI
who are living together in a questionable relationship.
Number of Respondents: 5,100.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 425 hours.
5. Letter to Employer Requesting Information About Wages Earned by
Beneficiary--0960-0034. The information on Form SSA-L725 is used by SSA
to establish the exact amount of wages earned by a beneficiary and to
determine the amount of benefit payment, should one be due. The
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respondents are employers of the beneficiaries.
Number of Respondents: 150,000.
Frequency of Response: 1.
Average Burden Per Response: 40 minutes.
Estimated Annual Burden: 100,000 hours.
(SSA Address)
Social Security Administration, DCFAM, Attn: Frederick W.
Brickenkamp, 1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore,
MD 21235
(OMB Address)
Office of Management and Budget, OIRA, Attn: Lori Schack, New
Executive Office Building, Room 10230, 725 17th St., NW, Washington, DC
20503.
Dated: October 22, 1999.
Frederick W. Brickenkamp,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 99-28434 Filed 10-28-99; 8:45 am]
BILLING CODE 4191-02-U
