94-4862. Agency Forms Submitted to the Office of Management and Budget for Clearance

[Federal Register Volume 59, Number 43 (Friday, March 4, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-4862]


[[Page Unknown]]

[Federal Register: March 4, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

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 have been submitted to the 
Office of Management and Budget (OMB) for clearance in compliance with 
Public Law 96-511, The Paperwork Reduction Act. The following clearance 
packages have been submitted to OMB since the last list was published 
in the Federal Register on Friday, February 4, 1994.
    (Call Reports Clearance Officer on [phone] for copies of 
package.)
    1. Application for Special Age 72-or-Over Monthly Benefits-- 0960-
0096. The information on form SSA-19 is used by the Social Security 
Administration to determine if an applicant is entitled to special age 
72 payments. The respondents are applicants for these payments.

Number of Respondents: 250
Frequency of Response: 1
Average Burden Per Response: 20 minutes
Estimated Annual Burden: 83 hours

    2. Final Regulation Concerning Payments for Vocational 
Rehabilitation Services (OR-333F) and State Vocational Rehabilitation 
Agency Claim (SSA-199)--0960-0310. The information collected by means 
of this regulation and form will be used by the Social Security 
Administration to determine if State vocational rehabilitation agencies 
are providing appropriate services, including referrals when necessary, 
and whether their claims for those services should be paid.

Number of Respondents: 90
Frequency of Response: On occasion
Average Burden Per Response: Varies: low=23 minutes, high=4 hours
Estimated Annual Burden: 8,588 hours

    3. Claimant's Medications--0960-0289. The information on form HA-
4632 is used by the Social Security Administration to compile a current 
list of medications used by a claimant. The list is provided to an 
Administrative Law Judge (ALJ) who is considering the disability 
aspects of the claim. The affected public consists of claimants for 
disability benefits who have requested a hearing before an ALJ.

Number of Respondents: 223,742
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 55,936 hours

    4. Representative Payee Report--0960-0068. The information on forms 
SSA-623 and 6230 is used by the Social Security Administration to 
determine if a person receiving Social Security benefits on behalf of 
someone else is using those benefits properly. The affected public is 
comprised of representative payees.

Number of Respondents: 4,329,360
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 1,082,340

    5. Statement for Determining Continuing Eligibility for 
Supplemental Security Income Payments--0960-0416. The information on 
form SSA-8203 is used by the Social Security Administration to conduct 
high risk redetermination of Supplemental Security Income (SSI) 
recipients' eligibility and payment amount. The respondents are 
recipients of SSI who are selected for a redetermination.

Number of Respondents: 580,000
Frequency of Response: 1
Average Burden Per Response: 17 minutes
Estimated Annual Burden: 164,333 hours

    OMB Desk Officer: Laura Oliven
    Written comments and recommendations regarding these information 
collections should be sent directly to the appropriate OMB Desk Officer 
designated above at the following address: OMB Reports Management 
Branch, New Executive Office Building, room 3208, Washington, DC 20503.

    Dated: February 28, 1994.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 94-4862 Filed 3-3-94; 8:45 am]
BILLING CODE 4190-29-U