[Federal Register Volume 63, Number 103 (Friday, May 29, 1998)]
[Notices]
[Pages 29464-29465]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-14263]
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SOCIAL SECURITY ADMINISTRATION
Information Collection Activities: 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 PL. 104-13 effective October 1, 1995, The Paperwork
Reduction Act of 1995. The information collection(s) listed below have
been submitted to OMB:
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. 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
4. 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
5. 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
6. 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
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.
[[Page 29465]]
(SSA)
Social Security Administration, DCFAM, Attn: Frederick W.
Brickenkamp, 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) 965-4145 or write to him at
the address listed above.
Dated: May 21, 1998.
Frederick W. Brickenkamp,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 98-14263 Filed 5-28-98; 8:45 am]
BILLING CODE 4190-29-P
