[Federal Register: January 6, 2006 (Volume 71, Number 4)]
[Notices]
[Page 961-963]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr06ja06-74]
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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, the Paperwork Reduction Act of 1995, effective October 1, 1995.
The information collection packages that may be included in this notice
are for new information collections, approval of existing 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 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,
Fax: 202-395-6974.
(SSA) Social Security Administration, DCFAM, Attn: Reports
Clearance Officer, 1333 Annex Building, 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. Work Activity Report--Employee--20 CFR 404.1520(b),
404.1571-.1576, 404.1584-.1593, and 416.971-.976--0960-0059. Form SSA-
821-BK collects information that provides evidence necessary to
determine initial or continuing eligibility for Supplemental Security
Income (SSI) or Social Security disability benefits. An individual's
entitlement to benefits ends if he/she demonstrates an ability to
perform substantial gainful activity (SGA). This form is used to
determine whether work an individual performs in employment is at the
SGA level. The respondents are Social Security disability applicants
and beneficiaries; and SSI applicants.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 300,000.
Frequency of Response: 1.
Average Burden per Response: 45 minutes.
[[Page 962]]
Estimated Annual Burden: 225,000 hours.
2. Homeless Outreach Project and Evaluation (HOPE)--0960-0704.
Background. Congress passed the McKinney Act of 1987 in recognition of
and in an effort to address situations and conditions facing people
without permanent shelter. The Act funded 15 emergency services and
nine individual titles to authorize the provision of specific programs
by Federal agencies. The Act also established the Interagency Council
on Homelessness (ICH) composed of leaders from 15 Federal agencies who
are in charge of coordinating efforts to assist people who are
homeless. During the past decade, SSA and other ICH agencies have
compiled important data about people who are homeless and have carried
out evaluations of services which have generated evidence about
``best'' or ``promising practices'' well suited to combating
homelessness.
In fiscal year 2003, President George W. Bush announced an
initiative to end chronic homelessness in 10 years. As a result, SSA
developed Project HOPE and in May 2004 awarded 34 Cooperative
Agreements to organizations which provide outreach, support services
and benefit application assistance to the chronically homeless and
other underserved populations. An additional 7 cooperative agreements
were awarded in November 2004 for a total of 41. The goal of Project
HOPE is to improve both the quantity and quality of applications for
disability benefits. Project HOPE gives focused support to Cooperative
(co-op) awardees via a training program and ongoing technical
assistance.
Evaluation of Project HOPE. SSA uses the project HOPE evaluation to
determine the effectiveness and the efficiency of the program. To
obtain the information needed for the evaluation, SSA has developed an
interactive Web site that is used by co-op awardees to input client and
program data, and by SSA to communicate project-wide announcements to
the awardees. The respondents are HOPE grantees/non-profit social
services organizations serving people who are homeless and disabled.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 41.
Frequency of Response: 12.
Average Burden Per Response: 65 minutes.
Estimated Annual Burden: 533 hours.
3. Report to United States Social Security Administration by Person
Receiving Benefits for a Child or for an Adult Unable to Handle Funds
and Report to United States Social Security Administration--0960-0049.
SSA needs the information on Form SSA-7161-OCR-SM to monitor the
performance of representative payees outside the U.S. and the
information on SSA-7162-OCR-SM to determine continuing entitlement to
Social Security benefits and correct benefit amounts for beneficiaries
outside the U.S. The respondents are individuals outside the U.S. who
are receiving benefits either for someone else, or on their own behalf
under title II of the Social Security Act.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Number of Frequency of burden per
Forms respondents response response (in Burden hours
minutes)
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SSA-7161-OCR-SM................................. 30,000 1 15 7,500
SSA-7162-OCR-SM................................. 227,000 1 5 18,917
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Totals...................................... 257,000 .............. .............. 26,417
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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. Report of New Information in Disability Cases--20 CFR 404.460,
404.468, 404.408, and 404.1588--0960-0071. The information collected on
the form SSA-612 is used to update the disability records of a
respondent based on reported changes contained in the form. These
changes may affect the respondent's Title II disability benefits. The
respondents are applicants for Title II disability benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 27,000.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 2,250 hours.
2. Statement of Marital Relationship (By one of the parties)--20
CFR 404.726--0960-0038. SSA uses the information collected on Form SSA-
754-F4 to determine whether the conditions for establishing a common-
law marriage under state law are met. The respondents are applicants
for spouse's benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 30,000.
Frequency of Response: 1.
Average Burden per Response: 30 minutes.
Estimated Annual Burden: 15,000 hours.
3. Employee Verification Service (EVS)--0960-0669. Background.
Under Internal Revenue Service regulations, employers are required to
provide wage and tax data to SSA using form W-2, Wage and Tax Statement
or its electronic equivalent. As part of this process, the employer
must furnish the employee's name and Social Security Number (SSN). This
information must match SSA's records in order for the employee's wage
and tax data to be properly posted to the earnings record. Information
that is incorrectly provided to the Agency must be corrected by the
employer using an amended reporting form, which is a labor-intensive
and time-consuming process for both SSA and the employer. Therefore, to
help ensure that employers provide accurate name and SSN information on
their wage reports, SSA offers the EVS service whereby employers can
verify, via magnetic tape, cartridge, diskette, paper, and telephone,
if the reported name and SSN of their employee matches SSA's records.
EVS Collection. SSA will use the information collected through the
EVS to verify that the employee name and SSN information, provided by
employers, matches SSA records. SSA will respond to the employer
informing them only of matches and mismatches of submitted information.
Respondents are employers who provide wage and tax data to SSA who
elect to use EVS
[[Page 963]]
to verify their employees' names and SSNs.
Type of Request: Extension of an OMB-Approved Information
Collection.
Number of Respondents: 50,000.
Frequency of Response: 12.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 100,000 hours.
4. Application for Parent's Insurance Benefits--20 CFR 404.370-
404.374, 20 CFR 404.601-404.603--0960-0012. Form SSA-7-F6 collects
information to entitle an individual to his parent's insurance
benefits. The respondents are individuals who wish to apply to receive
their parent's insurance benefits.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 1,400.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 350 hours.
5. Application for Supplemental Security Income--20 CFR 416.305-
416.335--0960-0444. The information collected on the SSA-8001-BK is
needed and used to determine eligibility for SSI, and the amount of SSI
benefits payable to the applicant. Respondents are applicants for SSI
benefits.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Number of Frequency of burden per
Title of collection respondents response response (in Burden hours
minutes)
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MISSICS......................................... 840,088 1 16 224,023
MISSICS/Signature Proxy......................... 280,029 1 15 70,007
Paper........................................... 25,982 1 19 8,228
Paper/Signature Proxy........................... 8,661 1 18 2,598
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Totals...................................... 1,154,760 .............. .............. 304,856
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6. Medical Source Statement of Ability To Do Work Related
Activities (Physical and Mental)--20 CFR 404.1512-404.1514, 404.912-
404.914, 404.1517, 416.917, 404.1519-404.1520, 416.919-416.920,
404.946, 416.946--0960-0662. The HA-1151 and HA-1152 are used to
collect data that is required to determine the residual functional
capacity (RFC) of individuals who are appealing denied claims for
benefits based on disability. RFC must be determined to decide cases
that cannot be decided based on current work activity or on medical
facts alone. The respondents are medical sources that are paid by SSA
to provide reports based either on existing medical evidence or on
consultative examinations conducted for the purposes of the report. We
estimate each respondent will submit approximately 20 responses per
year.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Number of Frequency of burden per
Forms respondents response response (in Burden hours
minutes)
----------------------------------------------------------------------------------------------------------------
HA-1151......................................... 5,000 20 15 25,000
HA-1152......................................... 5,000 20 15 25,000
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Totals...................................... 10,000 .............. .............. 50,000
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Dated: December 30, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-34 Filed 1-5-06; 8:45 am]
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