94-8327. Agency Forms Submitted to the Office of Management and Budget for Clearance
[Federal Register Volume 59, Number 68 (Friday, April 8, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-8327]
[[Page Unknown]]
[Federal Register: April 8, 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
Pub. L. 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, March 25, 1994.
(Call Reports Clearance Officer on (410) 965-4142 for copies of
package)
1. Supplement to Claim of Person Outside the United States--0960-
0051. The information on form SSA-21 is used by the Social Security
Administration to determine continuing entitlement, proper benefit
amount, and withholding tax liability of aliens who lived, live, or are
planning to live, outside the U.S. for more than 6 months. The
respondents are such aliens.
Number of Respondents: 35,000
Frequency of Response: On occasion
Average Burden Per Response: 5 minutes
Estimated Annual Burden: 2,917 hours
2. Request for Withdrawal of Application--0960-0015. The
information on form SSA-521 is used by the Social Security
Administration to effectuate and record an applicant's withdrawal of
his or her claim for benefits. The respondents are applicants who
choose to withdraw their claims for benefits.
Number of Respondents: 100,000
Frequency of Response: 1
Average Burden Per Response: 5 minutes
Estimated Annual Burden: 8,333 hours
3. Claim for Amounts Due in the Case of a Deceased Beneficiary--
0960-0101. The information on form SSA-1724 is used by the Social
Security Administration to determine which applicant should receive any
underpayment that is due a deceased beneficiary. The respondents are
applicants for such underpayments.
Number of Respondents: 300,000
Frequency of Response: 1
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 50,000 hours
4. Claimant's Statement about Loan of Food or Shelter; Statement
about Food or Shelter Provided to Another--0960-NEW. The information on
forms SSA-5062 and SSA-L5063 will be used by the Social Security
Administration to determine whether food or shelter provided to a
recipient of Supplemental Security Income (SSI) payments should be
counted as income. The respondents are SSI recipients who receive food
or shelter and individuals who provide it to them.
Number of Respondents: 131,080
Frequency of Response: On occasion
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 21,847 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.
Date: April 4, 1994.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 94-8327 Filed 4-7-94; 8:45 am]
BILLING CODE 4190-29-P
Document Information
- Published:
- 04/08/1994
- Department:
- Social Security Administration
- Entry Type:
- Uncategorized Document
- Document Number:
- 94-8327
- Dates:
- April 4, 1994. Charlotte Whitenight, Reports Clearance Officer, Social Security Administration. [FR Doc. 94-8327 Filed 4-7-94; 8:45 am] BILLING CODE 4190-29-P
- Pages:
- 0-0 (1 pages)
- Docket Numbers:
- Federal Register: April 8, 1994