Listing of All the Small Business Administration Currently Approved Information Collections, 3092-3093 [05-990]
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3092
Federal Register / Vol. 70, No. 12 / Wednesday, January 19, 2005 / Notices
Annual Responses: 486,000.
Annual Burden: 487,600.
SMALL BUSINESS ADMINISTRATION
Jacqueline White,
Chief, Administrative Information Branch.
[FR Doc. 05–989 Filed 1–18–05; 8:45 am]
BILLING CODE 8025–01–P
Listing of All the Small Business
Administration Currently Approved
Information Collections
Small Business Administration.
Notice.
AGENCY:
ACTION:
SUMMARY: In accordance with the
Paperwork Reduction Act of 1995, this
notice announces the U.S. Small
Business Administration’s currently
approved information collections.
FOR FURTHER INFORMATION CONTACT:
Curtis B. Rich, Management Analyst,
202–205–7030, curtis.rich@sba.gov.
OMB
Control No.
Title of collection
Surety Bond Guarantee Assistance ............................................................................................................................
Size Status Declaration ...............................................................................................................................................
Request from Borrowers (Financial Statements) ........................................................................................................
Disaster Business Loan Application ............................................................................................................................
Disaster Home Loan Application .................................................................................................................................
Pro-Net .........................................................................................................................................................................
SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App. and Mgmt.
Assessment Questionnaire ......................................................................................................................................
SBIC Financial Reports ...............................................................................................................................................
U.S. Small Business Administration Application for Section 504 Loan ......................................................................
CDC Annual Report Guide ..........................................................................................................................................
Training Program Evaluation .......................................................................................................................................
Notice to New SBA Borrowers ....................................................................................................................................
Reports to SBA; Provisions of 13 CFR 120.472 .........................................................................................................
Portfolio Financing Report ...........................................................................................................................................
Statement of Personal History .....................................................................................................................................
25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent 34-Bank ID 1065 Appl. Lic, Assure. of
Compliance ..............................................................................................................................................................
Disaster Home/Business Loan Inquiry Record ...........................................................................................................
Nomination for the Small Business Prime Contractor & Nomination of the Small Business Subcontractor of the
Year Award ..............................................................................................................................................................
Application for Small Business Size Determination ....................................................................................................
Request for Information Concerning Portfolio Financing ............................................................................................
Borrower’s Progress Certification Form ......................................................................................................................
Financial Institution Confirmation Form .......................................................................................................................
Disclosure Statement, Leveraged Licenses and Disclosure Statement Non-Leveraged Licensees ..........................
Governor’s Request for Disaster Declaration ..............................................................................................................
Transaction Report on Loans Serviced by Lenders ....................................................................................................
Lender Transcript of Account ......................................................................................................................................
Disaster Survey Worksheet .........................................................................................................................................
Federal Cash Transaction Report, Financial Status Report Program Income report, Narrative Program report ......
Stockholders Confirmation (Corporation) Ownership Confirmation (Partnership) ......................................................
Statement of Personal History .....................................................................................................................................
SBA Counseling Evaluation .........................................................................................................................................
Servicing Agent Agreement .........................................................................................................................................
Settlement Sheet .........................................................................................................................................................
7(a) Loan Closing Forms .............................................................................................................................................
8(a) Annual Update .....................................................................................................................................................
Secondary Market Assignment and Disclosure Form .................................................................................................
Small Business Administration; Application for Certificate of Competency ................................................................
Representatives Used and Compensation Paid for Services in Connection with obtaining Federal Contracts ........
Financing Eligibility Statement—Social Disadvantage ................................................................................................
Disadvantage/Economic Disadvantage
8(a)/SDB Paper and Electronic Application ................................................................................................................
Voluntary Customer Surveys in accordance with E.O. 12862 ....................................................................................
HUBZone internet Application Form ............................................................................................................................
Entrepreneurial Development Management Information System (EDMIS) Counseling Information Form & Management Training Report .........................................................................................................................................
Pre-Disaster Mitigation Small Business Loan Application ..........................................................................................
New Market Venture Capital (NMVC) Program Application Funding and reporting ...................................................
NMVC Program Application interview Question; SSBIC Applicant Tech. Proposal; Request for Approval of Management Services ....................................................................................................................................................
Veterans Business Ownership Survey ........................................................................................................................
Costs of litigation to small business; executive Interview questionnaire ....................................................................
PCLP Quarterly loan lose reserve report and PCLP Request ....................................................................................
Small Business questionnaire (Use of Telecommunications) .....................................................................................
SBA Express Information Collection ...........................................................................................................................
HUBzone Application Data Update .............................................................................................................................
Entrepreneurial Development Impact Survey ..............................................................................................................
Microloan Program Electronic Reporting System (MPERS) .......................................................................................
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3245–0007
3245–0009
3245–0012
3245–0017
3245–0018
3245–0024
3/31/2007
8/31/2007
5/31/2005
7/31/2007
9/30/2006
2/28/2007
3245–0062
3245–0063
3245–0071
3245–0074
3245–0075
3245–0076
3245–0077
3245–0078
3245–0080
4/30/2007
10/31/2007
4/30/2005
8/31/2007
3/31/2007
5/31/2007
9/30/2006
9/30/2007
12/31/2006
3245–0081
3245–0084
7/31/2005
9/30/2006
3245–0096
3245–0101
3245–0109
3245–0110
3245–0116
3245–0118
3245–0121
3245–0131
3245–0132
3245–0136
3245–0169
3245–0172
3245–0178
3245–0183
3245–0193
3245–0200
3245–0201
3245–0205
3245–0212
3245–0225
3245–0270
12/31/2005
8/31/2006
9/30/2006
9/30/2006
8/31/2006
11/30/2005
5/31/2006
5/31/2006
3/31/2005
3/31/2007
3/31/2007
8/31/2007
9/30/2006
5/31/2005
5/31/2005
3/31/2005
5/31/2005
10/31/2005
12/31/2005
9/30/2007
12/31/2005
3245–0301
3245–0313
3245–0314
3245–0320
9/30/2007
8/31/2007
6/30/2005
2/28/2006
3245–0324
3245–0326
3245–0332
9/30/2006
9/30/2006
9/30/2005
3245–0338
3245–0340
3245–0345
3245–0346
3245–0347
3245–0348
3245–0350
3245–0351
3245–0352
7/31/2005
4/30/2006
8/31/2006
2/28/2007
8/31/2006
2/28/2006
12/31/2005
12/31/2005
7/31/2007
Federal Register / Vol. 70, No. 12 / Wednesday, January 19, 2005 / Notices
Jacqueline White,
Chief, Administrative Information Branch.
[FR Doc. 05–990 Filed 1–18–05; 8:45 am]
BILLING CODE 8025–01–P
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection
Activities: Proposed 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.
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 collections
should be submitted to the SSA Reports
Clearance Officer. The information can
be mailed and/or faxed to the address
and fax number listed below: (SSA),
Social Security Administration,
DCFAM, Attn: Reports Clearance
Officer, 1338 Annex Building, 6401
Security Blvd., Baltimore, MD 21235.
Fax: 410–965–6400.
OPLM.RCO@ssa.gov.
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 Help with Medicare
Prescription Drug Plan Costs, SSA–
1020SC—0960–NEW. The Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003 (Public Law
108–173; MMA) establishes a new
Medicare Part D program for voluntary
prescription drug coverage for premium,
deductible, and cost-sharing subsidies
for certain low-income individuals. The
MMA stipulates that subsidies must be
available for individuals who are
eligible for the program and who meet
eligibility criteria for help with
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premium, deductible, and/or copayment costs.
Individuals who receive these
subsidies may ask SSA to redetermine
the amount of help they receive if they
experience a ‘‘subsidy-changing event,’’
including marriage, separation, divorce,
an annulment, or the death of a spouse.
Until late 2006, when redetermination
forms will become available, SSA will
use form SSA–1020–SC, the Application
for Help with Medicare Prescription
Drug Plan Costs, to make
redeterminations based on subsidychanging events. The respondents are
individuals whose application for help
toward the costs for this program has
been approved and are requesting a
redetermination of their subsidy based
on a subsidy-changing event.
Type of Request: New information
collection.
Number of Respondents: 76,000.
Frequency of Response: 1.
Average Burden Per Response: 35
minutes.
Estimated Annual Burden: 44,333
hours.
2. Application for Help with Medicare
Prescription Drug Plan Costs—0960–
NEW (Internet/Intranet Application
Screens). The Medicare Prescription
Drug, Improvement, and Modernization
Act of 2003 (Public Law 108–173;
MMA) establishes a new Medicare Part
D program for voluntary prescription
drug coverage for premium, deductible,
and cost-sharing subsidies for certain
low-income individuals. The MMA
stipulates that subsidies must be
available for individuals who are
eligible for the program and who meet
eligibility criteria for help with
premium, deductible, and/or copayment costs. Form SSA–1020, the
Application for Help with Medicare
Prescription Drug Plan Costs, collects
information about an applicant’s
resources and is used by SSA to
determine eligibility for this assistance.
We are proposing electronic versions
of the SSA–1020, which will collect the
information via the Intranet (the
information is provided by the
respondent during an interview at a
Social Security field office) or the
Internet (i1020) (if respondents
complete the Internet screens on their
own and submit them electronically).
The respondents are individuals who
are eligible for enrollment in the
Medicare Part D program and are
requesting assistance with the related
costs.
Type of Request: New information
collection.
Number of Respondents: 2,000,000.
Frequency of Response: 1.
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3093
Average Burden Per Response: 45
minutes.
Estimated Annual Burden: 1,500,000.
Dated: January 12, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 05–1022 Filed 1–18–05; 8:45 am]
BILLING CODE 4191–02–P
SOCIAL SECURITY ADMINISTRATION
Privacy Act of 1974 as Amended;
Computer Matching Program (SSA/
Department of Homeland Security
(DHS) Number 1010)
AGENCY:
Social Security Administration
(SSA).
Notice of a modification to a
computer matching program.
ACTION:
SUMMARY: In accordance with the
provisions of the Privacy Act, as
amended, this notice announces a
modification of a computer matching
program that SSA conducts with DHS.
DATES: SSA will file a report of the
subject matching program with the
Committee on Governmental Affairs of
the Senate, the Committee on
Government Reform of the House of
Representatives and the Office of
Information and Regulatory Affairs,
Office of Management and Budget
(OMB). The matching program will be
effective as indicated below.
ADDRESSES: Interested parties may
comment on this notice either by telefax
to (410) 965–5961 or writing to the
Associate Commissioner for Income
Security Programs, 245 Altmeyer
Building, 6401 Security Boulevard,
Baltimore, MD 21235–6401. All
comments received will be available for
public inspection at this address.
FOR FURTHER INFORMATION CONTACT: The
Associate Commissioner for Income
Security Programs as shown above.
SUPPLEMENTARY INFORMATION:
A. General
The Computer Matching and Privacy
Protection Act of 1988 (Public Law (P.
L.) 100–503), amended the Privacy Act
(5 U.S.C. § 552a) by describing the
manner in which computer matching
involving Federal agencies could be
performed and adding certain
protections for individuals applying for
and receiving Federal benefits. Section
7201 of the Omnibus Budget
Reconciliation Act of 1990 (Pub. L. 101–
508) further amended the Privacy Act
regarding protections for such
individuals.
The Privacy Act, as amended,
regulates the use of computer matching
E:\FR\FM\19JAN1.SGM
19JAN1
]]>Agencies
[Federal Register Volume 70, Number 12 (Wednesday, January 19, 2005)]
[Notices]
[Pages 3092-3093]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-990]
-----------------------------------------------------------------------
SMALL BUSINESS ADMINISTRATION
Listing of All the Small Business Administration Currently
Approved Information Collections
AGENCY: Small Business Administration.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In accordance with the Paperwork Reduction Act of 1995, this
notice announces the U.S. Small Business Administration's currently
approved information collections.
FOR FURTHER INFORMATION CONTACT: Curtis B. Rich, Management Analyst,
202-205-7030, curtis.rich@sba.gov.
------------------------------------------------------------------------
OMB Control Expiration
Title of collection No. date
------------------------------------------------------------------------
Surety Bond Guarantee Assistance............ 3245-0007 3/31/2007
Size Status Declaration..................... 3245-0009 8/31/2007
Request from Borrowers (Financial 3245-0012 5/31/2005
Statements)................................
Disaster Business Loan Application.......... 3245-0017 7/31/2007
Disaster Home Loan Application.............. 3245-0018 9/30/2006
Pro-Net..................................... 3245-0024 2/28/2007
SBIC Management Assessment Questionnaire & 3245-0062 4/30/2007
License Application; Exhibits to SBIC
License App. and Mgmt. Assessment
Questionnaire..............................
SBIC Financial Reports...................... 3245-0063 10/31/2007
U.S. Small Business Administration 3245-0071 4/30/2005
Application for Section 504 Loan...........
CDC Annual Report Guide..................... 3245-0074 8/31/2007
Training Program Evaluation................. 3245-0075 3/31/2007
Notice to New SBA Borrowers................. 3245-0076 5/31/2007
Reports to SBA; Provisions of 13 CFR 120.472 3245-0077 9/30/2006
Portfolio Financing Report.................. 3245-0078 9/30/2007
Statement of Personal History............... 3245-0080 12/31/2006
25-Model Corp. Resol. or GP Certif., 33- 3245-0081 7/31/2005
Model Letter to Selling Agent 34-Bank ID
1065 Appl. Lic, Assure. of Compliance......
Disaster Home/Business Loan Inquiry Record.. 3245-0084 9/30/2006
Nomination for the Small Business Prime 3245-0096 12/31/2005
Contractor & Nomination of the Small
Business Subcontractor of the Year Award...
Application for Small Business Size 3245-0101 8/31/2006
Determination..............................
Request for Information Concerning Portfolio 3245-0109 9/30/2006
Financing..................................
Borrower's Progress Certification Form...... 3245-0110 9/30/2006
Financial Institution Confirmation Form..... 3245-0116 8/31/2006
Disclosure Statement, Leveraged Licenses and 3245-0118 11/30/2005
Disclosure Statement Non-Leveraged
Licensees..................................
Governor's Request for Disaster Declaration. 3245-0121 5/31/2006
Transaction Report on Loans Serviced by 3245-0131 5/31/2006
Lenders....................................
Lender Transcript of Account................ 3245-0132 3/31/2005
Disaster Survey Worksheet................... 3245-0136 3/31/2007
Federal Cash Transaction Report, Financial 3245-0169 3/31/2007
Status Report Program Income report,
Narrative Program report...................
Stockholders Confirmation (Corporation) 3245-0172 8/31/2007
Ownership Confirmation (Partnership).......
Statement of Personal History............... 3245-0178 9/30/2006
SBA Counseling Evaluation................... 3245-0183 5/31/2005
Servicing Agent Agreement................... 3245-0193 5/31/2005
Settlement Sheet............................ 3245-0200 3/31/2005
7(a) Loan Closing Forms..................... 3245-0201 5/31/2005
8(a) Annual Update.......................... 3245-0205 10/31/2005
Secondary Market Assignment and Disclosure 3245-0212 12/31/2005
Form.......................................
Small Business Administration; Application 3245-0225 9/30/2007
for Certificate of Competency..............
Representatives Used and Compensation Paid 3245-0270 12/31/2005
for Services in Connection with obtaining
Federal Contracts..........................
Financing Eligibility Statement--Social 3245-0301 9/30/2007
Disadvantage...............................
Disadvantage/Economic Disadvantage..........
8(a)/SDB Paper and Electronic Application... 3245-0313 8/31/2007
Voluntary Customer Surveys in accordance 3245-0314 6/30/2005
with E.O. 12862............................
HUBZone internet Application Form........... 3245-0320 2/28/2006
Entrepreneurial Development Management 3245-0324 9/30/2006
Information System (EDMIS) Counseling
Information Form & Management Training
Report.....................................
Pre-Disaster Mitigation Small Business Loan 3245-0326 9/30/2006
Application................................
New Market Venture Capital (NMVC) Program 3245-0332 9/30/2005
Application Funding and reporting..........
NMVC Program Application interview Question; 3245-0338 7/31/2005
SSBIC Applicant Tech. Proposal; Request for
Approval of Management Services............
Veterans Business Ownership Survey.......... 3245-0340 4/30/2006
Costs of litigation to small business; 3245-0345 8/31/2006
executive Interview questionnaire..........
PCLP Quarterly loan lose reserve report and 3245-0346 2/28/2007
PCLP Request...............................
Small Business questionnaire (Use of 3245-0347 8/31/2006
Telecommunications)........................
SBA Express Information Collection.......... 3245-0348 2/28/2006
HUBzone Application Data Update............. 3245-0350 12/31/2005
Entrepreneurial Development Impact Survey... 3245-0351 12/31/2005
Microloan Program Electronic Reporting 3245-0352 7/31/2007
System (MPERS).............................
------------------------------------------------------------------------
[[Page 3093]]
Jacqueline White,
Chief, Administrative Information Branch.
[FR Doc. 05-990 Filed 1-18-05; 8:45 am]
BILLING CODE 8025-01-P
