[Federal Register Volume 64, Number 168 (Tuesday, August 31, 1999)]
[Notices]
[Pages 47558-47559]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-22623]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
In compliance with Public Law 104-13, the Paperwork Reduction Act
of 1995, SSA is providing notice of its information collections that
require submission to the Office of Management and Budget (OMB). SSA is
soliciting comments on the accuracy of the agency's burden estimate;
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.
I. The information collections listed below will be submitted to
OMB within 60 days from the date of this notice. Therefore, comments
and recommendations regarding the information collections would be most
useful if received by the Agency within 60 days from the date of this
publication. Comments should be directed to the SSA Reports Clearance
Officer at the address listed at the end of this publication. You can
obtain a copy of the collection instruments by calling the SSA Reports
Clearance Officer on (410) 965-4145, or by writing to him at the
address listed at the end of this publication.
1. Statement of Living Arrangements, In-Kind Support and
Maintenance-0960-0174. Form SSA-8006 provides a nationally-uniform
vehicle for collecting information from SSI applicants and recipients
about whether they receive income from in-kind support and maintenance.
Responses are used to determine eligibility for SSI benefits payable.
The respondents are individuals applying for SSI or whose eligibility
is being reevaluated.
Number of Respondents: 438,400.
Frequency of Response: 1.
Average Burden Per Response: 7 minutes.
Estimated Annual Burden: 51,147 hours.
2. Quickstart Enrollment Form-0960-0564. The information collected
on this form is needed by SSA to facilitate electronic transmission of
data for direct deposit of funds to a payee's account. The respondents
are Social Security and SSI recipients requesting direct deposit to
their financial institutions.
Number of Respondents: 3,950,000.
Frequency of Response: 1.
Average Burden Per Response: 3 minutes.
Estimated Annual Burden: 197,500 hours.
3. Supplemental Security Income Claim Information Notice-0960-0324.
The information collected on Form SSA-L8050-U3 will be used by SSA to
ensure that all sources of potential income which can be used to
provide for an individual's own support and maintenance are utilized.
The respondents are applicants for SSI and recipients who are
potentially eligible for benefits from other public or private
programs.
Number of Respondents: 7,500.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 1,250 hours.
4. Marital Relationship Questionnaire-0960-0460. The information
collected on Form SSA-4178 is needed by SSA to determine whether
unrelated individuals of the opposite sex who are living together, and
present themselves to the public as husband and wife, should be paid as
a couple or two eligible individuals. The information is used to
determine whether correct payment is being made to SSI couples and
individuals. The respondents are applicants for and recipients of SSI
who are living together in a questionable relationship.
Number of Respondents: 5,100.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 425 hours.
5. Letter to Employer Requesting Information About Wages Earned by
Beneficiary--0960-0034. The information on Form SSA-L725 is used by SSA
to establish the exact amount of wages earned by a beneficiary and to
determine the amount of benefit payment, should one be due. The
respondents are employers of the beneficiaries.
Number of Respondents: 150,000.
Frequency of Response: 1.
Average Burden Per Response: 40 minutes.
Estimated Annual Burden: 100,000 hours.
II. The information collections listed below have been submitted to
OMB for clearance. Written comments and recommendations on the
information collections would be most useful if received within 30 days
from the date of this publication. Comments should be directed to the
SSA Reports Clearance Officer and the OMB Desk Officer at the addresses
listed at the end of this publication. You can obtain copies of the OMB
clearance packages by calling the SSA Reports Clearance Officer on
(410) 965-4145, or by writing to him.
1. Application for Widow's or Widower's Insurance Benefits--0960-
0004. SSA uses the information collected on Form SSA-10-BK to determine
whether the applicant meets the statutory and regulatory conditions for
entitlement to widow(er)'s benefits. The respondents are applicants for
widow(er)'s benefits.
Number of Respondents: 288,580.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 72,145 hours.
2. Request for Waiver of Overpayment Recovery Or Change in
Repayment Notice--0960-0037. Form SSA-632 collects information on the
circumstances surrounding overpayment of Social Security Benefits to
recipients. SSA uses the information to determine whether recovery of
an overpayment amount can be waived or must be repaid and, if repaid,
how recovery will be made. The respondents are recipients of Social
Security, Medicare, Black Lung or Supplemental Security Income
overpayments.
Number of Respondents: 500,000.
Frequency of Response: 1.
Average Burden Per Response: 120 minutes.
Estimated Annual Burden: 1,000,000 hours.
3. Application for Supplemental Security Income--0960-0444. The
information collected on Form SSA-8001 is used by SSA to determine
whether applicants for SSI benefits meet all statutory and regulatory
requirements for eligibility and, if so, the amount of benefits
payable. The respondents are applicants for SSI benefits.
Number of Respondents: 1,011,046.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
[[Page 47559]]
Estimated Annual Burden: 252,762 hours.
4. Disability Evaluation Study--0960-NEW. The Social Security
Administration is sponsoring the Disability Evaluation Study (DES), a
national disability study of the civilian non-institutionalized
population of working-age adults aged 18-69. The DES will provide a key
source of data for disability program and policy goals of critical
interest to SSA, Congress, and others. SSA will collect information
from individuals, aged 18 to 69 years, and their medical providers. SSA
will use the information to:
Estimate and project the size of the potential pool of
eligible persons, that is, severely impaired working age individuals
who, but for work or other reasons, meet SSA's definition of
disability;
Determine what enables individuals with severe impairments
to work;
Construct self-reported disability measures to be included
on national surveys to monitor future program changes and changes in
the pool of eligible persons;
Examine relationships between disability and retirement
for older workers;
Evaluate ways to improve the current disability decision
process, such as use of additional objective performance measures.
Following is a listing of the information that will be collected
and the burden imposed on the public:
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Average Estimated
Number of Frequency burden annual
Title of collection respondents of response hours per burden
response hours
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Pilot Study:
Focus groups, cognitive laboratory studies, and pretest. 100 1 2.00 200
In-person canvassing for area probability sample........ 11,795 1 0.08 944
Initial Screening....................................... 11,882 1 0.50 5,941
Follow-up Screening, Comprehensive Survey Interview, 1,800 1 1.50 2,700
Forms for obtaining informed consent, release of
medical records, and release of SSA records............
Medical Examination..................................... 1,000 1 2.00 2,000
Provide Medical Records................................. 2,000 1 0.50 1,000
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Total (Pilot)......................................... 28,577 ........... ........... 12,785
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Main Study:
In-person canvassing for area probability sample........ 55,405 1 0.08 4,432
Initial Screening....................................... 56,031 1 0.50 28,016
Follow-up Screening, Comprehensive Survey Interview, 10,000 1 1.50 15,000
Forms for obtaining informed consent, release of
medical records, and release of SSA records............
Medical Examination..................................... 5,500 1 2.00 11,000
Provide Medical Records................................. 11,000 1 0.50 5,500
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Total (Main).......................................... 137,936 ........... ........... 63,948
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Total (Overall)....................................... 166,513 ........... ........... 76,733
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(SSA Address): Social Security Administration, DCFAM, Attn:
Frederick W. Brickenkamp, 6401 Security Blvd., 1-A-21 Operations Bldg.,
Baltimore, MD 21235.
(OMB Address): Office of Management and Budget, OIRA, Attn: Lori
Schack, New Executive Office Building, Room 10230, 725 17th St., NW,
Washington, DC 20503.
Dated: August 25, 1999.
Frederick W. Brickenkamp,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 99-22623 Filed 8-30-99; 8:45 am]
BILLING CODE 4190-29-P
