[Federal Register Volume 60, Number 170 (Friday, September 1, 1995)]
[Notices]
[Pages 45764-45765]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-21615]
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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 will require submission to
the Office of Management and Budget (OMB) for clearance in compliance
with Public Law 96-511, as amended (P.L. 104-13 effective October 1,
1995), The Paperwork Reduction Act. Since the last list was published
in the Federal Register on August 4, 1995, the following information
collections have been proposed or will require extension of the current
OMB approvals.
(Call the Reports Clearance Officer on (410) 965-4142 for a copy of
the form(s) or package(s), or write to her at the address listed after
the information collections.)
SSA Reports Clearance Officer: Charlotte S. Whitenight.
1. Statement by School Official About Student's Attendance and
Statement to U.S. Social Security Administration by School Outside the
U.S. About Student's Attendance--0960-0090. The information on forms
SSA-1371 and SSA-1371FC is used by the Social Security Administration
to determine a student's alleged full time attendance at an educational
institution in cases where such attendance is needed for continued
entitlement to benefits. The respondents are the school officials who
provide the information on these forms.
Number of Respondents: 5,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 833 hours.
2. Report of Continuing Disability Interview--0960-0072. The
information on form SSA-454 is used by the Social Security
Administration to determine whether a person who receives Social
Security Disability benefits is still unable to work because of his/her
disability. It will be used to make a determination as to whether the
Disability benefits should continue or terminate. The affected public
will consist of approximately 300,000 Social Security Disability
benefit recipients.
Number of Respondents: 300,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 150,000 hours.
3. Medical Report (Individual With Childhood Impairment)--0960-
0102. The information on form SSA-3827 is used by the Social Security
Administration to determine if an individual with a childhood
impairment medically qualifies for benefits or payments under the
provisions of the Social Security Act. Without this data, SSA would not
by able to properly evaluate the medical aspects of an individual's
claim or application. The respondents will be attending physicians/
medical sources.
Number of Respondents: 12,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 6,000 hours.
4. Agreement to Sell Property--0960-0127. The information on form
SSA-8060 is used by the Social Security Administration when individuals
or couples who are otherwise eligible for Supplemental Security Income
(SSI) benefits, but whose resources exceed the allowable limit, may
receive conditional payments if they agree to dispose of their excess
nonliquid resources and make repayment. The respondents will be
applicants for and recipients of SSI benefits.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 3,333 hours.
5. Application for Survivors Benefits--0960-0062. The information
on form SSA-24 is used by the Social Security Administration to
determine if an individual who is filing for benefits from the
Department of Veterans Affairs (DVA) may also be entitled by SSA. The
respondents are claimants for VA benefits.
Number of Respondents: 3,200.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 800 hours.
6. Modified Benefit Formula Questionnaire--0960-0395. The
information on form SSA-150 is used by the Social Security
Administration to determine the correct formula to be used in computing
the Social Security benefit of someone who also receives a benefit from
employment not covered by Social Security. The respondents will be
people who are entitled to both types of benefits.
Number of Respondents: 90,000.
Frequency of Response: 1.
Average Burden Per Response: 8 minutes.
Estimated Annual Burden: 12,000 hours.
7. Modified Benefit Formula Questionnaire, Employer--0960-0477. The
information on form SSA-50 is used by the Social Security
Administration to verify the claimant's allegation that he or she
received a pension based on union-covered employment after 1956. It
also shows whether or not the individual became eligible for that
pension before 1985. The respondents will be persons who are first
eligible for both Social Security benefits and a pension from
noncovered employment after 1985.
Number of Respondents: 30,000.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 10,000 hours.
8. Report of Student Beneficiary About to Attain Age 19--0960-0274.
The information on form SSA-1390 is used by the Social Security
Administration to determine whether a student beneficiary is entitled
to benefits for the month of attainment of age 19 and subsequent
months. The respondents will be student beneficiaries about to attain
age 19.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 4,167 hours.
9. Reconsideration Disability Report--0960-0144. The information on
form SSA-3441 is used by the Social Security Administration to
determine if the claimant's medical or vocational situation changed
after the initial disability determination. This form also elicits
additional sources of medical and vocational evidence which were not
considered in the initial determination.
[[Page 45765]]
The respondents are disability beneficiaries who request a
reconsideration.
Number of Respondents: 400,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 200,000 hours.
Written comments and recommendations regarding these information
collections should be sent within 60 days from the date of this
publication, directly to the SSA Reports Clearance Officer at the
following address: Social Security Administration, DCFAM, Attn:
Charlotte S. Whitenight, 6401 Security Blvd., 1-A-21 Operations Bldg.,
Baltimore, MD 21235.
In addition to your comments on the accuracy of the agency's burden
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.
Dated: August 25, 1995.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 95-21615 Filed 8-31-95; 8:45 am]
BILLING CODE 4190-29-P
