95-11369. Agency Forms Submitted to the Office of Management and Budget for Clearance

[Federal Register Volume 60, Number 92 (Friday, May 12, 1995)]
[Notices]
[Pages 25757-25758]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-11369]



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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 have been submitted to the 
Office of Management and Budget (OMB) for clearance in compliance with 
P.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 April 21, 1995.

(Call Reports Clearance Officer on [phone] for copies of 
package.)
    1. Disability Hearing Officer's Report of Disability Hearing--0960-
0507. The information on form SSA-1204 is used [[Page 25758]] by the 
Disability Hearings Officers to conduct and document disability 
hearings. The respondents are disability hearings officers in the State 
Disability Determination Staffs.

Number of Respondents: 3,250
Frequency of Response: 1
Average Burden Per Response: 60 minutes
Estimated Annual Burden: 3,250 hours

    2. Disability Hearing Officer's Decision--0960-0441. The 
information on form SSA-1207 is used as an official document to record 
the Disability Hearing Officer's decision. The respondents are 
Disability Hearing Officers in the State Disability Determination 
Services.

Number of Respondents: 14,110
Frequency of Response: 1
Average Burden Per Response: 45 minutes
Estimated Annual Burden : 10,582 hours

    3. Application for Benefits Under the Italy-U.S. International 
Social Security Agreement--0960-0445. The information on form SSA-2528 
is used by the Social Security Administration to determine if a 
resident of Italy is eligible for Social Security benefits under the 
Italy-U.S. Social Security agreement. The respondents are Italian 
residents who file for U.S. benefits with the Italian Social Security 
Agency.

Number of Respondents: 200
Frequency of Response: 1
Average Burden Per Response: 20 minutes
Estimated Annual Burden: 67 hours

    4. Disability Hearing Officer's Report of Disability Hearing--0960-
0440. The information on form SSA-1205 is used by Disability Hearings 
Officers to conduct disability hearings. The form serves as a guide in 
conducting the hearings and ensures that all pertinent issues are 
considered. It also provides a record of the hearing. The respondents 
are Disability Hearings Officers in the State Disability Determinations 
staff.

Number of Respondents: 10,860
Frequency of Response: 1
Average Burden Per Response: 60 minutes
Estimated Annual Burden: 10,860 hours

    5. Chinese Custom Marriage Statement and Statement Regarding 
Chinese Custom Marriage--0960-0086. The information on forms SSA-1344 
and SSA-1345 is used by the Social Security Administration to determine 
if an alleged spouse of the number holder is legally married for the 
purpose of paying social security benefits. The respondents are 
individuals applying for benefits based upon a Chinese custom marriage 
or individuals who attended the marriage.

Number of Respondents: 200
Frequency of Response: 1
Average Burden Per Response: 14 minutes
Estimated Annual Burden: 47 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: Office of Management and 
Budget, OIRA, New Executive Office Building, Room 10230, Washington, 
D.C. 20503.

    Dated: May 1, 1995.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 95-11369 Filed 5-11-95; 8:45 am]
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