[Federal Register Volume 63, Number 64 (Friday, April 3, 1998)]
[Notices]
[Pages 16606-16607]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-8755]
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SOCIAL SECURITY ADMINISTRATION
Information Collection Activities: Proposed Collection Requests
and Comment Requests
This notice lists information collection packages that will require
submission to the Office of Management and Budget (OMB), as well as
information collection packages submitted to OMB for clearance, in
compliance with Pub. L. 104-13 effective October 1, 1995, The Paperwork
Reduction Act of 1995.
I. The information collection(s) listed below require(s)
extension(s) of the current OMB approval(s) or are proposed new
collection(s):
1. Representative Payee Evaluation Report--0960-0069. The
information on Form SSA-624 is used by SSA to accurately account for
the use of Social Security benefits and Supplemental Security Income
(SSI) payments received by representative payees on behalf of an
individual. The respondents are individuals and organizations, who (as
representative payees) received Form SSA-623/6230 and failed to
respond, provided unacceptable responses which cannot be resolved or
reported a change in custody.
Number of Respondents: 250,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Average Burden: 125,000 hours.
2. Request for Address Information from Motor Vehicles Records; and
Request for Address Information from Employment Commissions Records--
0960-0341. The information on Forms SSA-L711 and L712 is used by SSA to
determine the current address for missing debtors. The respondents are
State agencies who have entered into agreements with SSA to provide the
requested information.
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SSA-L711 SSA-L712
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Number of Respondents........... 1,300............. 1,100.
Frequency of Response........... 1................. 1.
Average Burden Per Response..... 2 minutes......... 2 minutes.
Estimated Annual Burden......... 43 hours.......... 37 hours.
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3. Child-Care Dropout Questionnaire--0960-0474. The information on
Form SSA-4162 is used by SSA to determine whether zero earnings years
can be dropped out when computing a claimant's benefit. The respondents
are applicants for Disability Insurance benefits, who may qualify for a
higher primary insurance amount because of having a child in care for
certain years.
Number of Respondents: 2,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Average Burden: 167 hours.
4. Medical History and Disability Report, Disabled Child--0960-
0577. The information collected on Form SSA-3820 is needed for the
determination of disability by the State Disability Determination
Services. The SSA-3820 will be used to obtain various types of
information about a child's condition, his/her treating sources and/or
other medical sources of evidence. The respondents are applicants for
disability benefits.
Number of Respondents: 523,000.
Frequency of Response: 1.
Average Burden Per Response: 40 minutes.
Estimated Annual Burden: 348,667 hours.
5. Disability Report--0960-0579. The information collected on Form
SSA-3368 is needed for the determination of disability by the State
Disability Determination Services. The information will be used to
develop medical evidence and to assess the alleged disability. The
respondents are applicants for disability benefits.
Number of Respondents: 2,438,500.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 1,219,250 hours.
6. Work History Report--0960-0578. The information collected on
Form SSA-3369 is needed for the determination of disability by the
State Disability Determination Services. The respondents are applicants
for disability benefits. The information will be used to document an
individual's past work history.
Number of Respondents: 1,000,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 500,000 hours.
Written comments and recommendations regarding the information
collection(s) should be sent on or before June 2, 1998, directly to the
SSA Reports Clearance Officer at the following address: Social Security
Administration, DCFAM, Attn: Nicholas E. Tagliareni, 6401 Security
Blvd., 1-A-21 Operations Bldg., Baltimore, MD 21235.
In addition to your comments on the accuracy of the agency's burden
[[Page 16607]]
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.
II. The information collection(s) listed below have been submitted
to OMB:
1. Request to have Supplemental Security Income Overpayment
Withheld from My Social Security Benefits--0960-0549. The information
on Form SSA-730-U2 is used by SSA to verify that a beneficiary has
freely, voluntarily and knowingly requested that an SSI overpayment be
recovered from his or her Old-Age, Survivors and Disability Insurance
benefits. The respondents are overpaid SSI beneficiaries who agree to
have the overpayments withheld from their Social Security benefits.
Number of Respondents: 10,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 833 hours.
2. Farm Self-Employment Questionnaire--0960-0061. The information
on Form SSA-7156 is used by SSA to determine whether an agricultural
trade or business exists and to verify possible covered earnings for
Social Security entitlement purposes. The respondents are claimants for
benefits who allege covered earnings from agricultural self-employment.
Number of Respondents: 47,500.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 7,917 hours.
3. Supplemental Statement Regarding Farming Activities of Person
Living Outside the U.S.A.--0960-0103. SSA uses Form SSA-7163A to
collect needed information whenever a Social Security beneficiary or
claimant reports work on a farm outside the U.S. The data are used for
the purpose of making a determination of work deduction. The
respondents are Social Security beneficiaries or claimants who are
engaged in farming activities outside the U.S.
Number of Respondents: 1,000.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 1,000 hours.
4. Earnings Record Information--0960-0505. The information on Form
SSA-L3231-C1 is used by SSA to ensure that the proper person is
credited with earnings reported for a minor under age 7. The
respondents are businesses reporting earnings for children under age 7.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 3,333 hours.
5. Employer Verification of Earnings After Death--0960-0472. The
information on Form SSA-L4112 is used by SSA to determine whether wages
reported by an employer are correct, when SSA records indicate that the
wage earner is deceased. The respondents are employers who report wages
for a deceased employee.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 8,333 hours.
6. Payee Interview, SSA-835; Beneficiary Interview, SSA-836;
Custodian Interview, SSA-837--OMB No. 0960-NEW. SSA is proposing a
three-tier review process of the representative payee program. As part
of this review process, SSA is proposing to conduct interviews with a
sample of beneficiaries and recipients and their representative payees.
The information will be used to assess the effectiveness of the
representative payee program. The respondents are beneficiaries of
title II benefits, recipients of title XVI benefits, and representative
payees for both title II and title XVI beneficiaries and recipients.
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SSA-835 SSA-836 SSA-837
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Number of Respondents............ 2,000 1,000 380
Frequency of Response............ 1 1 1
Average Burden Per Response
(Minutes)....................... 30 20 10
Estimated Annual Burden (Hours).. 1,000 333 63
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Written comments and recommendations regarding the information
collection(s) should be directed within 30 days to the OMB Desk Officer
and SSA Reports Clearance Officer at the following addresses:
(OMB)
Office of Management and Budget, OIRA, Attn: Laura Oliven, New
Executive Office Building, Room 10230, 725 17th St., NW, Washington,
D.C. 20503.
(SSA)
Social Security Administration, DCFAM, Attn: Nicholas E. Tagliareni, 1-
A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 21235.
To receive a copy of any of the forms or clearance packages, call
the SSA Reports Clearance Officer on (410) 965-4125 or write to him at
the address listed above.
Dated: March 30, 1998.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 98-8755 Filed 4-2-98; 8:45 am]
BILLING CODE 4190-29-P
