Agency Information Collection Activities: Proposed Request and Comment Request, 42863-42867 [2014-17275]

Download as PDF 42863 Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices available for Web site viewing and printing in the Commission’s Public Reference Room, 100 F Street NE., Washington, DC 20549, on official business days between the hours of 10:00 a.m. and 3:00 p.m. Copies of such filing will also be available for inspection and copying at the principal office of the Exchange. All comments received will be posted without change; the Commission does not edit personal identifying information from submissions. You should submit only information that you wish to make available publicly. All submissions should refer to File No. SR–BATS– 2014–026 and should be submitted on or before August 13, 2014. For the Commission, by the Division of Trading and Markets, pursuant to delegated authority.44 Kevin M. O’Neill, Deputy Secretary. [FR Doc. 2014–17265 Filed 7–22–14; 8:45 am] BILLING CODE 8011–01–P SOCIAL SECURITY ADMINISTRATION Agency Information Collection Activities: Proposed Request and Comment Request The Social Security Administration (SSA) publishes a list of information collection packages requiring 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. This notice includes extensions and revisions 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 ways to minimize burden on respondents, including the use of automated collection techniques or other forms of information technology. Mail, email, or fax your comments and recommendations on the information collection(s) to the OMB Desk Officer and SSA Reports Clearance Officer at the following addresses or fax numbers. (OMB) Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 202–395–6974, Email address: OIRA_ Submission@omb.eop.gov. (SSA) Social Security Administration, OLCA, Attn: Reports Clearance Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410– 966–2830, Email address: OR.Reports.Clearance@ssa.gov. I. The information collections below are pending at SSA. SSA will submit them to OMB within 60 days from the date of this notice. To be sure we consider your comments, we must receive them no later than September 22, 2014. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Application for Search of Census Records for Proof of Age—20 CFR 404.716—0960–0097. When preferred evidence of age is not available, or the available evidence is not convincing, SSA may ask the U.S. Department of Commerce, Bureau of the Census, to search its records to establish a claimant’s date of birth. SSA collects information from claimants using Form SSA–1535–U3 to provide the Census Bureau with sufficient identification information to allow an accurate search of census records. Additionally, the Census Bureau uses a completed, signed SSA–1535–U3 to bill SSA for the search. The respondents are applicants for Social Security benefits who need to establish their date of birth as a factor of entitlement. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–1535–U3 ......................................................................................................... 18,030 1 12 3,606 broadcasting systems so they can inform the public about various programs and activities SSA conducts. SSA frequently sends follow-up business reply cards for these public information materials to obtain suggestions for improving them. 2. Public Information Campaign— 0960–0544. Periodically, SSA sends various public information materials, including public service announcements, news releases, and educational tapes, to public The respondents are broadcast television sources. Type of Request: Extension of an OMB-approved information collection. Number of respondents Frequency of response Average burden per response (minutes) Estimated total burden (hours) Television ................................................................................................................. mstockstill on DSK4VPTVN1PROD with NOTICES Modality of completion 1,000 2 1 33 3. Medicare Subsidy Quality Review Forms—20 CFR 418(b)(5)—0960–0707. The Medicare Modernization Act (MMA) of 2003 mandated the creation of the Medicare Part D prescription drug coverage program and provides certain subsidies for eligible Medicare beneficiaries to help pay for the cost of 44 17 prescription drugs. As part of its stewardship duties of the Medicare Part D subsidy program, SSA must conduct periodic quality review checks of the information Medicare beneficiaries report on their subsidy applications (Form SSA–1020). SSA uses the Medicare Quality Review program to conduct these checks. The respondents are applicants for the Medicare Part D subsidy whom SSA chose to undergo a quality review. Type of Request: Revision of an OMBapproved information collection. CFR 200.30–3(a)(12). VerDate Mar<15>2010 17:33 Jul 22, 2014 Jkt 232001 PO 00000 Frm 00109 Fmt 4703 Sfmt 4703 E:\FR\FM\23JYN1.SGM 23JYN1 42864 Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices Frequency of response Average burden per response (minutes Estimated total annual burden (hours) 3,500 1 30 1,750 3,500 1 15 875 350 7,000 3,500 450 50 1 1 1 1 1 15 15 5 15 15 88 1,750 292 113 13 2,500 1 15 625 Number of respondents Modality of completion SSA–9301 (Medicare Subsidy Quality Review Case Analysis Questionnaire) ...... SSA–9302 (Notice of Quality Review Acknowledgement Form for those with Phones) ................................................................................................................ SSA–9303 (Notice of Quality Review Acknowledgement Form for those without Phones) ................................................................................................................ SSA–9308 (Request for Information) ...................................................................... SSA–9310 (Request for Documents) ...................................................................... SSA–9311 (Notice of Appointment—Denial—Reviewer Will Call) .......................... SSA–9312 (Notice of Appointment—Denial—Please Call Reviewer) ..................... SSA–9313 (Notice of Quality Review Acknowledgement Form for those with Phones) ................................................................................................................ SSA–9314 (Notice of Quality Review Acknowledgement Form for those without Phones) ................................................................................................................ SSA–8510 (Authorization to the Social Security Administration to Obtain Personal Information) ................................................................................................ 500 1 15 125 3,500 1 5 292 Totals ................................................................................................................ 24,850 ¥ ¥ 5,923 4. Application to Collect a Fee for Payee Service—20 CFR 416.640.640(a), 416.1103(f)—0960–0719. Sections 205(j)(4)(A) and (B) and 1631(a)(2) of the Social Security Act (Act) allow SSA to authorize certain organizational representative payees to collect a fee for sector businesses or State and local government offices applying to become fee-for-service organizational representative payees. Type of Request: Revision of an OMBapproved information collection. providing payee services. Before organizations may collect this fee, they complete and submit Form SSA–445. SSA uses the information to determine whether to authorize or deny permission to collect fees for payee services. The respondents are private Number of responses Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Private sector business ........................................................................................... State/local government offices ................................................................................ 90 10 1 1 10 10 15 2 Totals ................................................................................................................ 100 .................... .................... 17 5. Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs—0960–0723. As per the requirements of the MMA of 2003, SSA conducts low-income subsidy eligibility redeterminations for Medicare beneficiaries who currently receive the Medicare Part D subsidy and who meet certain criteria. Respondents complete Form SSA–1026–REDE under the following circumstances: (1) When individuals became entitled to the Medicare Part D subsidy during the past 12 months; (2) if they were eligible for the Part D subsidy for more than 12 months; or (3) if they reported a change in income, resources, or household size. Part D beneficiaries complete the SSA– 1026–SCE when they need to report a potentially subsidy-changing event, including the following: (1) Marriage, (2) spousal separation, (3) divorce, (4) Number of respondents Modality of completion annulment of a marriage, (5) spousal death, or (6) moving back in with one’s spouse following a separation. The respondents are current recipients of the Medicare Part D low-income subsidy who will undergo an eligibility redetermination for one of the reasons mentioned above. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) 9,176 161,766 1 1 18 18 2,753 48,530 Total .................................................................................................................. mstockstill on DSK4VPTVN1PROD with NOTICES SSA–1026–OCR–MS–SCE ..................................................................................... SSA–1026–OCR–SM–REDE .................................................................................. 170,942 .................... .................... 51,283 6. Electronic Records Express (Third Parties)—20 CFR 404.1700–404.1715— 0960–0767. Electronic Records Express (ERE) is an online system which enables medical providers and various third party representatives to download and VerDate Mar<15>2010 17:33 Jul 22, 2014 Jkt 232001 submit disability claimant information electronically to SSA as part of the disability application process. To ensure only authorized people access ERE, SSA requires third parties to complete a unique registration process if they wish PO 00000 Frm 00110 Fmt 4703 Sfmt 4703 to use this system. This information collection request (ICR) includes the third-party registration process; the burden for submitting evidence to SSA is part of other, various ICRs. The respondents are third party E:\FR\FM\23JYN1.SGM 23JYN1 42865 Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices representatives of disability applicants or recipients who want to use ERE to electronically access clients’ disability files online and submit information to SSA. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Number of responses Average burden per response (minutes) Estimated total annual burden (hours) ERE .............................................................................................. 12,000 281 (3,372,000) 1 56,200 7. Screen Pop—20 CFR 401.45— 0960–0790. Section 205(a) of the Act requires SSA to verify the identity of individuals who request a record or information pertaining to themselves, and to establish procedures for disclosing personal information. SSA established Screen Pop, an automated telephone process, to increase speed of verification for such individuals. Accessing Screen Pop, callers enter their Social Security number (SSN) using their telephone keypad or speech technology prior to speaking with a National 800 Number Network (N8NN) agent. The automated Screen Pop application collects the SSN and routes it to the ‘‘Start New Call’’ Customer Help and Information (CHIP) screen. Functionality for the Screen Pop application ends once the SSN connects to the CHIP screen and the SSN routes to the agent’s screen. When the call connects to the N8NN agent, the agent can use the SSN to access the caller’s record as needed. The respondents for this collection are individuals who contact SSA’s N8NN to speak with an agent. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of responses Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Screen Pop .............................................................................................................. 55,600,000 1 1 926,667 II. SSA submitted the information collections below to OMB for clearance. Your comments regarding the information collections would be most useful if OMB and SSA receive them 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than August 22, 2014. Individuals can obtain copies of the OMB clearance packages by writing to OR.Reports.Clearance@ ssa.gov. 1. Statement Regarding Date of Birth and Citizenship—20 CFR 404.716— 0960–0016. Section 205(a) of the Act gives the Commissioner of SSA the authority to make rules and regulations, and to establish procedures for collecting evidence from individuals applying for Social Security benefits. When individuals apply for Social Security benefits and cannot provide preferred methods of proving age or citizenship, SSA uses Form SSA–702 to establish these facts. Specifically, SSA uses the SSA–702 to establish age as a factor of entitlement to Social Security benefits or U.S. citizenship as a payment factor. Respondents are individuals with knowledge about the date of birth or citizenship of applicants filing for one or more Social Security benefits who need to establish age or citizenship. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–7157 ................................................................................................................ 1,200 1 10 200 mstockstill on DSK4VPTVN1PROD with NOTICES 2. Application for Benefits under a U.S. International Social Security Agreement—20 CFR 404.1925—0960– 0448. Section 233(a) of the Act authorizes the President of the United States to broker international Social Security agreements (Totalization Agreements) between the United States and foreign countries. SSA collects information using Form SSA–2490–BK to determine entitlement to Social Security benefits from the United States, or from a country that enters into a totalization agreement with the United Number of respondents Modality of completion States. The respondents are individuals applying for Old Age, Survivors, and Disability Insurance benefits from the United States or from a Totalization Agreement country. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–2490–BK (Modernized Claims System) ......................................................... SSA–2490–BK (paper) ............................................................................................ 14,175 2,025 1 1 30 30 7,088 1,013 Totals ................................................................................................................ 16,200 .................... .................... 8,101 VerDate Mar<15>2010 18:52 Jul 22, 2014 Jkt 232001 PO 00000 Frm 00111 Fmt 4703 Sfmt 4703 E:\FR\FM\23JYN1.SGM 23JYN1 42866 Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices 3. Teacher Questionnaire and Request for Administrative Information—20 CFR 416.1103(f)—0960–0646. When determining the effects of a child’s impairment for children applying for Title II childhood disability benefits, SSA obtains information about the child’s functioning from teachers, parents, and others who observe the child on a daily basis. SSA obtains results of formal testing, teacher reports, therapy progress notes, individualized education programs, and other records of a child’s educational aptitude and Number of respondents Modality of completion achievement using Forms SSA–5665– BK and SSA–5666. The respondents are parents, teachers, and other education personnel. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–5665–BK (electronic) ...................................................................................... SSA–5665 (paper form) ........................................................................................... SSA–5666 (electronic) ............................................................................................. SSA–5666 (paper form) ........................................................................................... 368,098 2,562 137,590 1,843 1 1 1 1 40 40 30 30 245,399 1,708 68,795 922 Totals ................................................................................................................ 510,093 .................... .................... 316,824 4. Medicare Part D Subsidies Regulations—20 CFR 418.3625, 418.3645, 418.3665(a), and 418.3670— 0960–0702. The MMA of 2003 established the Medicare Part D program for voluntary prescription drug coverage of premium, deductible, and copayment costs for certain low-income individuals. The MMA also mandated the provision of subsidies for those individuals who qualify for the program and who meet eligibility criteria for help with premium, deductible, or copayment costs. This law requires SSA to make eligibility determinations and to provide a process for appealing SSA’s determinations. Regulation sections 418.3625(c), 418.3645, 418.3665(a), and Number of respondents Modality of completion 418.3670 contain public reporting requirements pertaining to administrative review hearings. Respondents are applicants for the Medicare Part D subsidies who request an administrative review hearing. Type of Request: Extension of an existing OMB-approved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) 418.3625(c) .............................................................................................................. 418.3645 .................................................................................................................. 418.3665(a) .............................................................................................................. 418.3670 .................................................................................................................. 150 10 300 0 1 1 1 1 5 20 5 10 13 3 25 0 Total .................................................................................................................. 460 .................... .................... 41 5. Help America Vote Act—0960– 0706. House Rule 3295, the Help America Vote Act of 2002, mandates that States verify the identities of newly registered voters. When newly registered voters do not have driver’s licenses or State-issued ID cards, they must supply the last four digits of their Social Security number to their local State election agencies for verification. The election agencies forward this information to their State Motor Vehicle Administration (MVA), who inputs the data into the American Association of MVAs, a central consolidation system that routes the voter data to SSA’s Help America Vote Verification (HAVV) system. Once SSA’s HAVV system has confirmed the identity of the voter, the information will return along the same route in reverse until it reaches the State election agency. The official respondents for this collection are the State MVAs. Note: This is a correction notice: SSA published the incorrect burden information for this collection at 79 FR 37828 on 07/02/14. We are correcting this error here. Type of Request: Revision of an OMBapproved information collection. Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) HAVV ....................................................................................................................... mstockstill on DSK4VPTVN1PROD with NOTICES Modality of completion 4,878,239 1 2 162,608 Dated: July 18, 2014. Faye Lipsky, Reports Clearance Director, Social Security Administration. [FR Doc. 2014–17275 Filed 7–22–14; 8:45 am] BILLING CODE 4191–02–P VerDate Mar<15>2010 18:52 Jul 22, 2014 Jkt 232001 PO 00000 Frm 00112 Fmt 4703 Sfmt 4703 E:\FR\FM\23JYN1.SGM 23JYN1 Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices SOCIAL SECURITY ADMINISTRATION [Docket No. SSA–2014–0038] Finding Regarding Foreign Social Insurance or Pension System— Slovenia Social Security Administration. Notice of Finding Regarding Foreign Social Insurance or Pension System—Slovenia. AGENCY: mstockstill on DSK4VPTVN1PROD with NOTICES ACTION: Finding: Section 202(t)(1) of the Social Security Act (42 U.S.C. 402(t)(1)) prohibits payment of monthly benefits to any individual who is not a United States citizen or national for any month after he or she has been outside the United States for 6 consecutive months. This prohibition does not apply to such an individual where one of the exceptions described in section 202(t)(2) through 202(t)(5) of the Social Security Act (42 U.S.C. 402(t)(2) through 402(t)(5)) affects his or her case. Section 202(t)(2) of the Social Security Act provides that, subject to certain residency requirements of Section 202(t)(11), the prohibition against payment shall not apply to any individual who is a citizen of a country which the Commissioner of Social Security finds has in effect a social insurance or pension system which is of general application in such country and which: (a) Pays periodic benefits, or the actuarial equivalent thereof, on account of old age, retirement, or death; and (b) permits individuals who are United States citizens but not citizens of that country and who qualify for such benefits to receive those benefits, or the actuarial equivalent thereof, while outside the foreign country regardless of the duration of the absence. The Commissioner of Social Security has delegated the authority to make such a finding to the Associate Commissioner of the Office of International Programs. Under that authority, the Associate Commissioner of the Office of International Programs approved a finding that Slovenia, beginning April 1, 1992, has a social insurance system of general application which: (a) Pays periodic benefits, or the actuarial equivalent thereof, on account of old age, retirement, or death; and (b) permits United States citizens who are not citizens of Slovenia to receive such benefits, or their actuarial equivalent, at the full rate without qualification or restriction while outside Slovenia. Accordingly, notice is given that it has been determined and found that VerDate Mar<15>2010 18:52 Jul 22, 2014 Jkt 232001 Slovenia has in effect, beginning April 1, 1992, a social insurance system which meets the requirements of section 202(t)(2) of the Social Security Act (42 U.S.C. 402(t)(2)). This determination is our first finding under section 202(t) of the Social Security Act for Slovenia. On April 1, 1992, the United States recognized Slovenia as an independent nation. Before that time, it was considered to be part of former Yugoslavia which, on March 25, 1959, had been determined to have a system that met section 202(t)(2) of the Social Security Act. The system remained in force in Slovenia until the Law on Pension and Disability Insurance went into effect on April 1, 1992. Thus, prior to that date Slovenian citizens were afforded the social insurance exception to the alien nonpayment provision based on the Yugoslavian system which was then in effect. FOR FURTHER INFORMATION CONTACT: Donna L. Powers, 3700 Robert Ball Building, 6401 Security Boulevard, Baltimore, MD 21235–6401, (410) 965– 3558. 42867 significance. The objects are imported pursuant to loan agreements with the foreign owners or custodians. I also determine that the exhibition or display of the exhibit objects at the Museum of Modern Art, New York, New York, from on or about October 12, 2014, until on or about February 8, 2015, and at possible additional exhibitions or venues yet to be determined, is in the national interest. I have ordered that Public Notice of these Determinations be published in the Federal Register. For further information, including a list of the imported objects, contact Paul W. Manning, Attorney-Adviser, Office of the Legal Adviser, U.S. Department of State (telephone: 202–632–6469). The mailing address is U.S. Department of State, SA–5, L/PD, Fifth Floor (Suite 5H03), Washington, DC 20522–0505. FOR FURTHER INFORMATION CONTACT: Dated: July 16, 2014. Kelly Keiderling, Principal Deputy Assistant Secretary, Bureau of Educational and Cultural Affairs, Department of State. (Catalog of Federal Domestic Assistance: Program Nos. 96.001 Social Security— Disability Insurance; 96.00S Social Security—Retirement Insurance; 96–004 Social Security—Survivors Insurance). [FR Doc. 2014–17333 Filed 7–22–14; 8:45 am] Dated: July 16, 2014. Vance Teel, Associate Commissioner Office of International Programs. DEPARTMENT OF TRANSPORTATION [FR Doc. 2014–17283 Filed 7–22–14; 8:45 am] BILLING CODE 4710–05–P Connected Vehicle Reference Implementation Architecture Workshop; Notice of Public Meeting BILLING CODE 4191–02–P ITS Joint Program Office, Office of the Assistant Secretary for Research and Technology, U.S. Department of Transportation. AGENCY: DEPARTMENT OF STATE [Public Notice: 8806] ACTION: Culturally Significant Objects Imported for Exhibition Determinations: ‘‘Henri Matisse: The Cut-Outs’’ Notice is hereby given of the following determinations: Pursuant to the authority vested in me by the Act of October 19, 1965 (79 Stat. 985; 22 U.S.C. 2459), Executive Order 12047 of March 27, 1978, the Foreign Affairs Reform and Restructuring Act of 1998 (112 Stat. 2681, et seq.; 22 U.S.C. 6501 note, et seq.), Delegation of Authority No. 234 of October 1, 1999, and Delegation of Authority No. 236–3 of August 28, 2000 (and, as appropriate, Delegation of Authority No. 257 of April 15, 2003), I hereby determine that the objects to be included in the exhibition ‘‘Henri Matisse: The Cut-Outs,’’ imported from abroad for temporary exhibition within the United States, are of cultural SUMMARY: PO 00000 Frm 00113 Fmt 4703 Sfmt 4703 Notice. The U.S. Department of Transportation (USDOT) Intelligent Transportation System Joint Program Office (ITS JPO) will host a free Connected Vehicle Reference Implementation Architecture (CVRIA) public workshop meeting to present and seek input on the emerging results of its Connected Vehicle interfaces and standards analysis. The public meeting will take place August 20, 2014, 8:30 a.m.–5:00 p.m. PDT and August 21, 2014, 8:30 a.m.–4:00 p.m. PDT at the Holiday Inn Golden Gateway Hotel, 1500 Van Ness Ave, San Francisco, California 94109. To register for the CVRIA Workshop, please visit www.itsa.org/ cvriaregistration. E:\FR\FM\23JYN1.SGM 23JYN1

Agencies

[Federal Register Volume 79, Number 141 (Wednesday, July 23, 2014)]
[Notices]
[Pages 42863-42867]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-17275]


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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 requiring 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. This notice 
includes extensions and revisions 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 ways to minimize burden 
on respondents, including the use of automated collection techniques or 
other forms of information technology. Mail, email, or fax your 
comments and recommendations on the information collection(s) to the 
OMB Desk Officer and SSA Reports Clearance Officer at the following 
addresses or fax numbers.
    (OMB) Office of Management and Budget, Attn: Desk Officer for SSA, 
Fax: 202-395-6974, Email address: OIRA_Submission@omb.eop.gov.
    (SSA) Social Security Administration, OLCA, Attn: Reports Clearance 
Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 410-966-2830, Email address: OR.Reports.Clearance@ssa.gov.
    I. The information collections below are pending at SSA. SSA will 
submit them to OMB within 60 days from the date of this notice. To be 
sure we consider your comments, we must receive them no later than 
September 22, 2014. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Application for Search of Census Records for Proof of Age--20 
CFR 404.716--0960-0097. When preferred evidence of age is not 
available, or the available evidence is not convincing, SSA may ask the 
U.S. Department of Commerce, Bureau of the Census, to search its 
records to establish a claimant's date of birth. SSA collects 
information from claimants using Form SSA-1535-U3 to provide the Census 
Bureau with sufficient identification information to allow an accurate 
search of census records. Additionally, the Census Bureau uses a 
completed, signed SSA-1535-U3 to bill SSA for the search. The 
respondents are applicants for Social Security benefits who need to 
establish their date of birth as a factor of entitlement.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                       Number of       Frequency    burden per   Estimated total
              Modality of completion                  respondents     of response    response     annual burden
                                                                                     (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1535-U3.......................................          18,030             1            12            3,606
----------------------------------------------------------------------------------------------------------------

    2. Public Information Campaign--0960-0544. Periodically, SSA sends 
various public information materials, including public service 
announcements, news releases, and educational tapes, to public 
broadcasting systems so they can inform the public about various 
programs and activities SSA conducts. SSA frequently sends follow-up 
business reply cards for these public information materials to obtain 
suggestions for improving them. The respondents are broadcast 
television sources.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                       Number of     Frequency of   burden per   Estimated total
              Modality of completion                  respondents      response      response    burden  (hours)
                                                                                     (minutes)
----------------------------------------------------------------------------------------------------------------
Television........................................           1,000             2             1               33
----------------------------------------------------------------------------------------------------------------

    3. Medicare Subsidy Quality Review Forms--20 CFR 418(b)(5)--0960-
0707. The Medicare Modernization Act (MMA) of 2003 mandated the 
creation of the Medicare Part D prescription drug coverage program and 
provides certain subsidies for eligible Medicare beneficiaries to help 
pay for the cost of prescription drugs. As part of its stewardship 
duties of the Medicare Part D subsidy program, SSA must conduct 
periodic quality review checks of the information Medicare 
beneficiaries report on their subsidy applications (Form SSA-1020). SSA 
uses the Medicare Quality Review program to conduct these checks. The 
respondents are applicants for the Medicare Part D subsidy whom SSA 
chose to undergo a quality review.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 42864]]



----------------------------------------------------------------------------------------------------------------
                                                                                       Average       Estimated
                                                           Number of     Frequency    burden per   total annual
                Modality of completion                    respondents   of response    response       burden
                                                                                       (minutes       (hours)
----------------------------------------------------------------------------------------------------------------
SSA-9301 (Medicare Subsidy Quality Review Case                   3,500            1           30           1,750
 Analysis Questionnaire)..............................
SSA-9302 (Notice of Quality Review Acknowledgement               3,500            1           15             875
 Form for those with Phones)..........................
SSA-9303 (Notice of Quality Review Acknowledgement                 350            1           15              88
 Form for those without Phones).......................
SSA-9308 (Request for Information)....................           7,000            1           15           1,750
SSA-9310 (Request for Documents)......................           3,500            1            5             292
SSA-9311 (Notice of Appointment--Denial--Reviewer Will             450            1           15             113
 Call)................................................
SSA-9312 (Notice of Appointment--Denial--Please Call                50            1           15              13
 Reviewer)............................................
SSA-9313 (Notice of Quality Review Acknowledgement               2,500            1           15             625
 Form for those with Phones)..........................
SSA-9314 (Notice of Quality Review Acknowledgement                 500            1           15             125
 Form for those without Phones).......................
SSA-8510 (Authorization to the Social Security                   3,500            1            5             292
 Administration to Obtain Personal Information).......
                                                       ---------------------------------------------------------
    Totals............................................          24,850            -            -           5,923
----------------------------------------------------------------------------------------------------------------

    4. Application to Collect a Fee for Payee Service--20 CFR 
416.640.640(a), 416.1103(f)--0960-0719. Sections 205(j)(4)(A) and (B) 
and 1631(a)(2) of the Social Security Act (Act) allow SSA to authorize 
certain organizational representative payees to collect a fee for 
providing payee services. Before organizations may collect this fee, 
they complete and submit Form SSA-445. SSA uses the information to 
determine whether to authorize or deny permission to collect fees for 
payee services. The respondents are private sector businesses or State 
and local government offices applying to become fee-for-service 
organizational representative payees.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                       Average       Estimated
                                                           Number of     Frequency    burden per   total annual
                Modality of completion                     responses    of response    response       burden
                                                                                      (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
Private sector business...............................              90            1           10              15
State/local government offices........................              10            1           10               2
                                                       ---------------------------------------------------------
    Totals............................................             100  ...........  ...........              17
----------------------------------------------------------------------------------------------------------------

    5. Redetermination of Eligibility for Help with Medicare 
Prescription Drug Plan Costs--0960-0723. As per the requirements of the 
MMA of 2003, SSA conducts low-income subsidy eligibility 
redeterminations for Medicare beneficiaries who currently receive the 
Medicare Part D subsidy and who meet certain criteria. Respondents 
complete Form SSA-1026-REDE under the following circumstances: (1) When 
individuals became entitled to the Medicare Part D subsidy during the 
past 12 months; (2) if they were eligible for the Part D subsidy for 
more than 12 months; or (3) if they reported a change in income, 
resources, or household size. Part D beneficiaries complete the SSA-
1026-SCE when they need to report a potentially subsidy-changing event, 
including the following: (1) Marriage, (2) spousal separation, (3) 
divorce, (4) annulment of a marriage, (5) spousal death, or (6) moving 
back in with one's spouse following a separation. The respondents are 
current recipients of the Medicare Part D low-income subsidy who will 
undergo an eligibility redetermination for one of the reasons mentioned 
above.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                       Average       Estimated
                                                           Number of     Frequency    burden per   total annual
                Modality of completion                    respondents   of response    response       burden
                                                                                      (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1026-OCR-MS-SCE...................................           9,176            1           18           2,753
SSA-1026-OCR-SM-REDE..................................         161,766            1           18          48,530
                                                       ---------------------------------------------------------
    Total.............................................         170,942  ...........  ...........          51,283
----------------------------------------------------------------------------------------------------------------

    6. Electronic Records Express (Third Parties)--20 CFR 404.1700-
404.1715--0960-0767. Electronic Records Express (ERE) is an online 
system which enables medical providers and various third party 
representatives to download and submit disability claimant information 
electronically to SSA as part of the disability application process. To 
ensure only authorized people access ERE, SSA requires third parties to 
complete a unique registration process if they wish to use this system. 
This information collection request (ICR) includes the third-party 
registration process; the burden for submitting evidence to SSA is part 
of other, various ICRs. The respondents are third party

[[Page 42865]]

representatives of disability applicants or recipients who want to use 
ERE to electronically access clients' disability files online and 
submit information to SSA.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
      Modality of completion          Number of     Frequency of    Number of    per  response    annual burden
                                     respondents      response      responses      (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
ERE..............................          12,000           281   (3,372,000)                1           56,200
----------------------------------------------------------------------------------------------------------------

    7. Screen Pop--20 CFR 401.45--0960-0790. Section 205(a) of the Act 
requires SSA to verify the identity of individuals who request a record 
or information pertaining to themselves, and to establish procedures 
for disclosing personal information. SSA established Screen Pop, an 
automated telephone process, to increase speed of verification for such 
individuals. Accessing Screen Pop, callers enter their Social Security 
number (SSN) using their telephone keypad or speech technology prior to 
speaking with a National 800 Number Network (N8NN) agent. The automated 
Screen Pop application collects the SSN and routes it to the ``Start 
New Call'' Customer Help and Information (CHIP) screen. Functionality 
for the Screen Pop application ends once the SSN connects to the CHIP 
screen and the SSN routes to the agent's screen. When the call connects 
to the N8NN agent, the agent can use the SSN to access the caller's 
record as needed. The respondents for this collection are individuals 
who contact SSA's N8NN to speak with an agent.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                       Number of     Frequency of   burden per   Estimated total
              Modality of completion                   responses       response      response     annual burden
                                                                                     (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
Screen Pop........................................      55,600,000             1             1          926,667
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding the information collections would be 
most useful if OMB and SSA receive them 30 days from the date of this 
publication. To be sure we consider your comments, we must receive them 
no later than August 22, 2014. Individuals can obtain copies of the OMB 
clearance packages by writing to OR.Reports.Clearance@ssa.gov.
    1. Statement Regarding Date of Birth and Citizenship--20 CFR 
404.716--0960-0016. Section 205(a) of the Act gives the Commissioner of 
SSA the authority to make rules and regulations, and to establish 
procedures for collecting evidence from individuals applying for Social 
Security benefits. When individuals apply for Social Security benefits 
and cannot provide preferred methods of proving age or citizenship, SSA 
uses Form SSA-702 to establish these facts. Specifically, SSA uses the 
SSA-702 to establish age as a factor of entitlement to Social Security 
benefits or U.S. citizenship as a payment factor. Respondents are 
individuals with knowledge about the date of birth or citizenship of 
applicants filing for one or more Social Security benefits who need to 
establish age or citizenship.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                       Number of     Frequency of   burden per   Estimated total
              Modality of completion                  respondents      response      response     annual burden
                                                                                     (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7157..........................................           1,200             1            10              200
----------------------------------------------------------------------------------------------------------------

    2. Application for Benefits under a U.S. International Social 
Security Agreement--20 CFR 404.1925--0960-0448. Section 233(a) of the 
Act authorizes the President of the United States to broker 
international Social Security agreements (Totalization Agreements) 
between the United States and foreign countries. SSA collects 
information using Form SSA-2490-BK to determine entitlement to Social 
Security benefits from the United States, or from a country that enters 
into a totalization agreement with the United States. The respondents 
are individuals applying for Old Age, Survivors, and Disability 
Insurance benefits from the United States or from a Totalization 
Agreement country.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                       Average       Estimated
                                                           Number of     Frequency    burden per   total annual
                Modality of completion                    respondents   of response    response       burden
                                                                                      (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2490-BK (Modernized Claims System)................          14,175            1           30           7,088
SSA-2490-BK (paper)...................................           2,025            1           30           1,013
                                                       ---------------------------------------------------------
    Totals............................................          16,200  ...........  ...........           8,101
----------------------------------------------------------------------------------------------------------------


[[Page 42866]]

    3. Teacher Questionnaire and Request for Administrative 
Information--20 CFR 416.1103(f)--0960-0646. When determining the 
effects of a child's impairment for children applying for Title II 
childhood disability benefits, SSA obtains information about the 
child's functioning from teachers, parents, and others who observe the 
child on a daily basis. SSA obtains results of formal testing, teacher 
reports, therapy progress notes, individualized education programs, and 
other records of a child's educational aptitude and achievement using 
Forms SSA-5665-BK and SSA-5666. The respondents are parents, teachers, 
and other education personnel.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                       Average       Estimated
                                                           Number of     Frequency    burden per   total annual
                Modality of completion                    respondents   of response    response       burden
                                                                                      (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
SSA-5665-BK (electronic)..............................         368,098            1           40         245,399
SSA-5665 (paper form).................................           2,562            1           40           1,708
SSA-5666 (electronic).................................         137,590            1           30          68,795
SSA-5666 (paper form).................................           1,843            1           30             922
                                                       ---------------------------------------------------------
    Totals............................................         510,093  ...........  ...........         316,824
----------------------------------------------------------------------------------------------------------------

    4. Medicare Part D Subsidies Regulations--20 CFR 418.3625, 
418.3645, 418.3665(a), and 418.3670--0960-0702. The MMA of 2003 
established the Medicare Part D program for voluntary prescription drug 
coverage of premium, deductible, and co-payment costs for certain low-
income individuals. The MMA also mandated the provision of subsidies 
for those individuals who qualify for the program and who meet 
eligibility criteria for help with premium, deductible, or co-payment 
costs. This law requires SSA to make eligibility determinations and to 
provide a process for appealing SSA's determinations. Regulation 
sections 418.3625(c), 418.3645, 418.3665(a), and 418.3670 contain 
public reporting requirements pertaining to administrative review 
hearings. Respondents are applicants for the Medicare Part D subsidies 
who request an administrative review hearing.
    Type of Request: Extension of an existing OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                       Average       Estimated
                                                           Number of     Frequency    burden per   total annual
                Modality of completion                    respondents   of response    response       burden
                                                                                      (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
418.3625(c)...........................................             150            1            5              13
418.3645..............................................              10            1           20               3
418.3665(a)...........................................             300            1            5              25
418.3670..............................................               0            1           10               0
                                                       ---------------------------------------------------------
    Total.............................................             460  ...........  ...........              41
----------------------------------------------------------------------------------------------------------------

    5. Help America Vote Act--0960-0706. House Rule 3295, the Help 
America Vote Act of 2002, mandates that States verify the identities of 
newly registered voters. When newly registered voters do not have 
driver's licenses or State-issued ID cards, they must supply the last 
four digits of their Social Security number to their local State 
election agencies for verification. The election agencies forward this 
information to their State Motor Vehicle Administration (MVA), who 
inputs the data into the American Association of MVAs, a central 
consolidation system that routes the voter data to SSA's Help America 
Vote Verification (HAVV) system. Once SSA's HAVV system has confirmed 
the identity of the voter, the information will return along the same 
route in reverse until it reaches the State election agency. The 
official respondents for this collection are the State MVAs.
    Note: This is a correction notice: SSA published the incorrect 
burden information for this collection at 79 FR 37828 on 07/02/14. We 
are correcting this error here.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                       Number of     Frequency of   burden per   Estimated total
              Modality of completion                  respondents      response      response     annual burden
                                                                                     (minutes)       (hours)
----------------------------------------------------------------------------------------------------------------
HAVV..............................................       4,878,239             1             2          162,608
----------------------------------------------------------------------------------------------------------------


    Dated: July 18, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-17275 Filed 7-22-14; 8:45 am]
BILLING CODE 4191-02-P
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