[Federal Register Volume 60, Number 194 (Friday, October 6, 1995)]
[Notices]
[Pages 52445-52447]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-24880]
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SOCIAL SECURITY ADMINISTRATION
Agency Forms Submitted to the Office of Management and Budget for
Clearance
Normally on Fridays, the Social Security Administration publishes a
list of information collection packages that will require submission to
the Office of Management and Budget (OMB) for clearance in compliance
with P.L. 96-511, as amended (P.L. 104-13 effective October 1, 1995),
The Paperwork Reduction Act. Since the last list was published in the
Federal Register on September 22, 1995, the following information
collections have been proposed or will require extension of the current
OMB approvals.
(Call the Reports Clearance Officer on (410) 965-4142 for a copy of the
form(s)
[[Page 52446]]
or package(s), or write to her at the address listed after the
information collections.)
SSA Reports Clearance Officer: Charlotte S. Whitenight.
1. Request To Be Selected As Payee--0960-0014. The information
collected on form SSA-11-BK is used by the Social Security
Administration to help determine the proper payee for a person who
cannot receive his or her own Social Security benefits. The respondents
will be individuals who apply to receive Social Security benefits on
behalf of someone else.
Number of Respondents: 605,000
Frequency of Response: 1
Average Burden Per Response: 10.5 minutes
Estimated Annual Burden: 105,875 hours
2. Disability Update Report--0960-0511. The information on form
SSA-455 is used by the Social Security Administration to determine if a
full medical continuing disability review (CDR) should be conducted.
The respondents will be Social Security disability insurance
beneficiaries who are scheduled to receive a CDR.
Number of Respondents: 431,200
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 107,800 hours
3. Statement Regarding Marriage--0960-0017. The information
collected via form SSA-753 is used by the Social Security
Administration to make determinations regarding entitlement to spouse's
benefits when a common law marriage is alleged. The respondents are
third parties who can supply evidence concerning the existence of a
common law marriage.
Number of Respondents: 40,000
Frequency of Response: 1
Average Burden Per Response: 9 minutes
Estimated Annual Burden: 6,000 hours
4. State Contribution Return--0960-0041. The information on form
SSA-3961 is used by the Social Security Administration to identify and
account for all contributions due and paid by the states (or interstate
instrumentalities) under Section 218 of the Social Security Act. The
respondents are state agencies.
Number of Respondents: 117
Frequency of Response: on occasion
Average Burden Per Response: 3 minutes
Estimated Annual Burden: 500 hours
5. Statement of Death by Funeral Director--0960-0142. The
information collected on the SSA-721 is used by the Social Security
Administration to verify the death of an individual insured under the
Social Security Act and to determine if there is a survivor eligible
for a lump sum death payment. The respondents will be funeral directors
with knowledge of the death of a person insured for Social Security
benefits.
Number of Respondents: 900,000
Frequency of Response: 1
Average Burden Per Response: 3.5 minutes
Estimated Annual Burden: 52,500 hours
6. Annual Report of Earnings (long and short forms)--0960-0057. The
information on forms SSA-777 and SSA-7770 is used by the Social
Security Administration to determine the amount of yearly earnings of
beneficiaries so that the proper benefit amounts are paid to them. The
respondents will be beneficiaries under age 70 who have earned over the
exempt amount for the year and still received benefits.
Number of Respondents: (SSA-777)-200,000; (SSA-7770)-1,000,000
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SSA-777 SSA-7770
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Frequency of Response........... 1................... 1
Average Burden Per Response..... 17 minutes.......... 8 minutes.
Estimated Annual Burden......... (1)190,000 hours
(total for both
forms).
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7. Public Information Campaigns and News Releases-0960-0544. The
purpose of the public information campaigns and new releases is to
better inform the public about the programs and activities of the
Social Security Administration (SSA). The information is used by SSA to
determine media interest in airing and printing the public information
materials and news releases and to determine which materials are used,
how often, its effectiveness, and the need for more local
announcements. The respondents are newspapers and public broadcasting
systems such as television, cable, and radio stations.
Number of Respondents: TV--500, Newspaper-500, Radio--1,500, Cable--148
Frequency of Response: Public Service Announcements--4, News Releases--
Educational Tapes--2
Average Burden Per Response: 1 minute (solicitation card), 2 minutes
(business reply card)
Estimated Annual Burden: 298 hours
8. Work Reintegration Study--0960-0543. The information on the two
forms used in this study will aid the Social Security Administration in
determining what steps it can take to help beneficiaries who are
disabled due to a back condition to return to work.
Number of Respondents: 1,500
Frequency of Response: 1
Average Burden Per Response: 1 hour
Estimated Annual Burden: 1,500 hours
Social Security Administration
Written comments and recommendations regarding these information
collections should be sent within 60 days from the date of this
publication, directly to the SSA Reports Clearance Officer at the
following address: Social Security Administration, DCFAM, Attn:
Charlotte S. Whitenight, 6401 Security Blvd., 1-B-22 Operations Bldg.,
Baltimore, MD 21235.
In addition to your comments on the accuracy of the agency's burden
estimate, we are soliciting comments on 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.
The following information collections, which were published in the
Federal Register on August 4, 1995, have been submitted to OMB:
1. Notice Regarding Substitution of Party Upon Death of Claimant--
Reconsideration of Disability Cessation--OMB Control No. 0960-0351. The
information on form SSA-770 is used by the Social Security
Administration to obtain information from substitute parties regarding
their intention to pursue the appeals process on behalf of an
individual who died. The respondents are such parties.
Number of Respondents: 1,200
Frequency of Response: 1
Average Burden Per Response: 5 minutes
Estimated Annual Burden: 100 hours
[[Page 52447]]
2. Disability Determination and Transmittal--OMB Control No. 0960-
0437. The information on form SSA-831 will be used by the State
disability determination services to document whether an individual who
applies for disability benefits is eligible for those benefits based on
his or her alleged disability. It is also used by SSA for program
management and evaluation. The respondents are state agency employees
who make disability determinations for SSA.
Number of Respondents: 3,525,600
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 881,400
3. Cessation or Continuance of Disability or Blindness
Determination and Transmittal--Title XVI--OMB Control No. 0960-0443.
The information on form SSA-832 is used by State disability
determination services to document determinations as to whether an
individual's disability benefits should be terminated or continued on
the basis of his/her impairment. The respondents are state disability
determination services adjudicating Title XVI disability claims.
Number of Respondents: 53,700
Frequency of Response: 1
Average Burden Per Response: 30 minutes
Estimated Annual Burden: 26,850 hours
4. Cessation or Continuance of Disability or Blindness
Determination and Transmittal--Title II--OMB Control No. 0960-0442. The
information on form SSA-833 is used by State disability determination
services to prepare determinations of whether individuals receiving
Title II disability or blindness benefits continue to be unable to
engage in substantial gainful work by reason of their impairments and
are still eligible for benefit payments. It is also used to collect
data for program evaluation and program management.
Number of Respondents: 268,700
Frequency of Response: 1
Average Burden Per Response: 30 minutes
Estimated Annual Burden: 134,350 hours
Social Security Administration
Written comments and recommendations regarding these information
collections should be sent within 30 days of the date of this
publication. Comments may be directed to OMB and SSA at the following
addresses:
(OMB)
Office of Management and Budget, OIRA, Attn: Laura Oliven, New
Executive Office Building, Room 10230,Washington, D.C. 20503
(SSA)
Social Security Administration, DCFAM, Attn: Charlotte S.
Whitenight, 6401 Security Blvd, 1-A-21 Operations Bldg., Baltimore, MD
21235
Dated: October 2, 1995.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 95-24880 Filed 10-5-95; 8:45 am]
BILLING CODE 4190-29-P
