[Federal Register: September 5, 2003 (Volume 68, Number 172)]
[Notices]
[Page 52807-52809]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr05se03-92]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages that will require clearance by the
Office of Management and Budget (OMB) in compliance with Public Law
104-13 effective October 1, 1995, The Paperwork Reduction Act of 1995.
The information collection packages that may be included in this notice
are for new information collections, revisions to OMB-approved
information collections and extensions (no change) of OMB-approved
information collections.
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. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed
[[Page 52808]]
and/or faxed to the individuals at the addresses and fax numbers listed
below:
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA,
New Executive Office Building, Room 10235, 725 17th St., NW.,
Washington, DC 20503, Fax: 202-395-6974;
(SSA)
Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, 1338 Annex, 6401 Security Blvd., Baltimore, MD 21235, Fax:
410-965-6400.
I. The information collections listed below are pending at SSA and
will be submitted to OMB within 60 days from the date of this notice.
Therefore, your comments should be submitted to SSA within 60 days from
the date of this publication. You can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
0454 or by writing to the address listed above.
1. Application for Lump Sum Death Payment--0960-0013--20 CFR
404.390-404.392--960-0013. The information collected on form SSA-8 by
the Social Security Administration is required to authorize payment of
a lump-sum death benefit to a widow, widower, or children as defined in
Section 202(i) of the Social Security Act. The respondents are widows,
widowers or children who apply for a lump-sum death payment.
Type of Request: Extension of an OMB-approved information
collection.
Number of respondents: 43,850.
Frequency of response: 1.
Average burden per response: 10 minutes.
Estimated annual burden: 7,308 hrs.
2. Student Statement Regarding School Attendance--20 CFR
404.351-.352, 404.367-.368--0960-0105. The information collected on
Form SSA-1372 is needed to determine whether children of an insured
worker are eligible for benefits as a student. The respondents are
student claimants for Social Security benefits and their respective
schools.
Type of Request: Extension of an OMB-approved information
collection.
Number of respondents: 200,000.
Number of Response: 1.
Average burden per response: 10 minutes.
Estimated Annual Burden: 33,333 hours.
3. Annual Earning Test--Direct Mail Follow-up Program Notices--20
CFR 404.452-.455-0960-0369. Social Security beneficiaries who are under
full retirement age (FRA) are required to report their current year
earnings estimate and the following year earnings estimate to ensure
correct payment of Social Security benefits. Beneficiaries use one of
the midyear mailer forms (SSA-L9778, L9779, and L9781) for this report.
Beneficiaries who attain FRA are not subject to the annual earnings
test. In the year of FRA, beneficiaries approaching retirement complete
forms SSA-L9784 and L9785 which request earnings estimates for the
period prior to the month of FRA. Respondents are beneficiaries who
must update their current year estimate of earnings, give SSA an
estimate of earnings for the following year, and an earnings estimate
(in the year of FRA) for the period prior to the month of FRA.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 225,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 37,500 hours.
4. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. SSA uses the information collected on Form SSA-7160 to determine
whether the Social Security number-holder is self-employed or an
employee. The respondents are applicants for Social Security Benefits
and/or employers.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 47,500.
Frequency of Response: 1.
Average Burden Per Response: 25 minutes.
Estimated Annual Burden: 19,792 hours.
II. The information collections listed below have been submitted to
OMB for clearance. Your comments on the information collections would
be most useful if received by OMB and SSA within 30 days from the date
of this publication. You can obtain a copy of the OMB clearance
packages by calling the SSA Reports Clearance Officer at 410-965-0454,
or by writing to the address listed above.
1. Uniform Administrative Requirements for Grants and Agreements
with Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations--20 CFR 435--0960-0616. These rules cover the basic
administrative reporting and recordkeeping requirements for applicable
recipients of grants and agreements. Because very specific requirements
must be met, it is necessary that SSA collect significant information
from the applicants and grantees to determine if they meet, or continue
to meet, the conditions specified. The respondents are institutions of
higher education, hospitals, and other non-profit organizations.
Type of Request: Extension of an OMB-approved information
collection. SSA currently has a total of 17 grant recipients that are
subject to the requirements of the proposed rule. The hourly burden as
estimated for each of the reporting (Rpt) and recordkeeping (Rec-kp)
requirements is explained below and reflected in the following table:
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Average Estimated
CFR section No. Type Number of Frequency of burden hours annual burden
respondents response per response hours
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435.21.................. Rec-kp............ 1 N/A............... 40 40
435.23.................. Rec-kp............ 94 Quarterly (4)..... 1 376
435.25.................. Rpt............... 14 Biannually (2).... 4 112
435.33.................. Rpt............... 1 Annually (1)...... 1 1
435.44.................. Rpt............... 1 Annually (1)...... 2 2
435.51.................. Rpt............... 150 Quarterly (4)..... 12 7200
435.53.................. Rec-kp............ 150 Annually (1)...... 8 1200
435.81.................. Rpt............... 1 Annually (1)...... 16 16
435.82.................. Rpt............... 1 Annually (1)...... 8 8
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Total estimated annual burden: 8,955 hours.
1. Collection of SSI Overpayments from Special Benefits for Certain
WWII Veterans; 20 CFR, Subpart E, 416.570 & .572--0960-0653. The
information
[[Page 52809]]
collection requirement in 20 CFR 416.570 allows for an individual to
request to withhold a title XVI overpayment from Title II/VIII
benefits. The information collection requirement in 20 CFR 416.572
allows for an individual to elect a higher or lower rate of withholding
for recovery of an SSI overpayment. The information collected will be
used to determine the proper rate of withholding of benefits to recover
program overpayments. The respondents are Title II or Title VIII
beneficiaries who were overpaid title XVI benefits and who request a
higher rate of recovery than specified in 20 CFR 416.571.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 2,500.
Frequency of Response: 1.
Average Burden Per Response: 1 hour.
Estimated Annual Burden: 2,500 hours.
2. Medical or Psychological Consultant's Review of Childhood
Disability Evaluation Form--20 CFR, Subpart J, 416.1040, .1043, .1045--
0960-NEW. Form SSA-536 is used by SSA medical or psychological
consultants to document their review and assessment of the Childhood
Disability Evaluation Form, SSA-538, prepared by State DDS employees. A
childhood disability evaluation is required in each SSI childhood
disability case. Therefore, the consultants must prepare an assessment
form SSA-536 for each childhood disability case that is reviewed. The
respondents are 256 SSA medical and psychological consultants.
Type of Request: Approval of an existing information collection.
Number of Responses: 17,000.
Frequency of Response: 1.
Average Burden Per Response: 12 minutes.
Estimated Annual Burden: 3,400 hours.
3. Requests for Self-Employment Information, Employee Information,
Employer Information--20 CFR, Subpart A, 422.120--0960-0508. SSA uses
Forms SSA-L2765, SSA-L3365 and SSA-L4002 to request correct information
when an employer, employee or self-employed person reports an
individual's earnings without a Social Security Number (SSN) or with an
incorrect name or SSN. The respondents are employers, employees or
self-employed individuals who are requested to furnish additional
identifying information.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 3,000,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 500,000 hours.
4. Function Report--Adult--20 CFR 404.1512 and 416.912--0960-NEW.
Form SSA-3373 records information about the disability applicant's
impairment-related limitations and ability to function. It documents
the types of information specified in SSA regulations and provides
disability interviewers with a convenient means to record information
about how the claimant's condition affects his or her ability to
function. This information, together with medical evidence, forms the
evidentiary basis upon which the initial disability process is founded.
The respondents are title II and XVI benefits applicants.
Type of Request: New information collection.
Number of Respondents: 4,005,367.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 2,002,684.
5. Application for Search of Census Records for Proof of Age--20
CFR 404.716--0960-0097. The information collected on Form SSA-1535-U3
is required to provide the Census Bureau with sufficient identification
information, which will allow an accurate search of census records to
establish proof of age for an individual applying for Social Security
benefits. It is used for individuals who must establish age as a factor
for entitlement. The respondents are individuals applying for Social
Security benefits who need to document their date of birth.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 18,000.
Number of Response: 1.
Average Burden per Response: 12 minutes.
Estimated Average Burden: 3,600.
6. Representative Payee Report--Special Veterans Benefits Form--
0960-0621. SSA needs the information collected on form SSA-2001 to
determine whether payments certified to the representative payee have
been used properly and whether the representative payee demonstrates
concern for the beneficiary's best interest. The form will be completed
annually by representative payees receiving Special Veterans Benefit
payments on behalf of beneficiaries who are outside of the United
States. It will also be required when SSA has reason to believe a
representative payee could be misusing the payments. The respondents
are representative payees for beneficiaries who are receiving Special
Veterans Benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 100.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 17 hours.
Dated: August 28, 2003.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 03-22579 Filed 9-4-03; 8:45 am]
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