[Federal Register: May 29, 1998 (Volume 63, Number 103)] [Notices] [Page 29464-29465] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr29my98-95] ======================================================================= ----------------------------------------------------------------------- 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. ------------------------------------------------------------------------ SSA-L711 SSA-L712 ------------------------------------------------------------------------ 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. ------------------------------------------------------------------------ 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