Agency Information Collection Activities: Proposed Request and Comment Request, 12772-12774 [05-4987]
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12772
Federal Register / Vol. 70, No. 49 / Tuesday, March 15, 2005 / Notices
Notice is
hereby given that as a result of the
Administrator’s disaster declaration on
03/02/2005, applications for disaster
loans may be filed at the address listed
above or other locally announced
locations.
The following areas have been
determined to be adversely affected by
the disaster:
Primary Counties: Mohave.
Contiguous Counties:
Arizona:
Coconino, La Paz, Yavapai.
California:
San Bernardino.
Nevada:
Clark, Lincoln.
Utah:
Kane, Washington.
The Interest Rates are:
SUPPLEMENTARY INFORMATION:
Percent
Homeowners With Credit Available Elsewhere: .....................
Homeowners Without Credit
Available Elsewhere: .............
Businesses With Credit Available Elsewhere: .....................
Businesses & Small Agricultural
Cooperatives Without Credit
Available Elsewhere: .............
Other (Including Non-Profit Organizations)
With
Credit
Available Elsewhere: .............
Businesses and Non-Profit Organizations Without Credit
Available Elsewhere: .............
2.937
Agency Information Collection
Activities: Proposed Request and
Comment Request
5.800
4.000
4.750
4.000
Dated: March 2, 2005.
Hector V. Barreto,
Administrator.
[FR Doc. 05–4998 Filed 3–14–05; 8:45 am]
BILLING CODE 8025–01–P
SMALL BUSINESS ADMINISTRATION
Public Federal Regulatory
Enforcement Fairness Hearing; Region
VII Regulatory Fairness Board
The Small Business Administration
Region VII Regulatory Fairness Board
and the SBA Office of the National
Ombudsman will hold a Public Hearing
on Wednesday, March 30, 2005 at 1
p.m. at Southeast Community College,
Gallup Campus, 301 South 68 Street
Place, Lincoln, NE 68510, phone (402)
221–4691, to receive comments and
Jkt 205001
BILLING CODE 8025–01–P
SOCIAL SECURITY ADMINISTRATION
(Catalog of Federal Domestic Assistance
Numbers 59002 and 59008)
15:31 Mar 14, 2005
Dated: March 4, 2005.
Peter Sorum,
Senior Advisor, Office of the National
Ombudsman.
[FR Doc. 05–4997 Filed 3–14–05; 8:45 am]
5.875
The number(s) assigned to this
disaster for physical damage is 10057 B
and for economic injury is 10058 0.
The States which received EIDL Decl
# are Arizona, Nevada, California, and
Utah.
VerDate jul<14>2003
testimony from small business owners,
small government entities, and small
non-profit organizations concerning
regulatory enforcement and compliance
actions taken by federal agencies.
Anyone wishing to attend or to make
a presentation must contact Deb Wilson
in writing or by fax, in order to be put
on the agenda. Deb Wilson, Public
Information Officer, SBA Nebraska
District Office, 11145 Mill Valley Road,
Omaha, NE 68154, phone (402) 221–
7222, fax (402) 221–3680, e-mail:
Deborah.Wilson@sba.gov.
For more information, see our Web
site at https://www.sba.gov/ombudsman.
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
Pub. L. 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 revisions to OMBapproved information collections and
extensions (no change) of OMBapproved 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, Fax: 202–395–6974. (SSA),
Social Security Administration,
DCFAM, Attn: Reports Clearance
Officer, 1338 Annex Building, 6401
Security Blvd., Baltimore, MD 21235,
Fax: 410–965–6400.
I. The information collection listed
below is pending at SSA and will be
PO 00000
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Fmt 4703
Sfmt 4703
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.
Social Security Benefits Application—
20 CFR Subpart D, 404.310–404.311
and 20 CFR Subpart F, 404.601–
404.603—0960–0618
One of the requirements for obtaining
Social Security benefits is the filing of
an application so that a determination
may be made on the applicant’s
eligibility for monthly benefits. In
addition to the traditional paper
application, SSA has developed various
options for the public to add
convenience and operational efficiency
to the application process. The total
estimated number of respondents to all
application collection formats is
3,874,369 with a cumulative total of
1,008,180 burden hours. The
respondents are applicants for
retirement insurance benefits (RIB),
disability insurance benefits (DIB), and/
or spouses’ benefits.
Please note that burden hours for
applications taken through the
Modernized Claims System (MCS) are
accounted for in the hardcopy collection
formats. Guided by the MCS collection
screens, an SSA representative
interviews the applicant and inputs the
information directly into the SSA’s
application database. MCS offers the
representative prompts based on the
type of application being filed and the
circumstances of the applicant. These
prompts facilitate a more complete
initial application, saving both the
agency and applicant time. MCS also
propagates identity and similar
information within the application,
which saves additional time.
Internet Social Security Benefits
Application (ISBA)
Type of Request: Revision of an OMBapproved information collection. (ISBA
collection only).
ISBA, which is available through
SSA’s Internet site, is one method that
an individual can choose to file an
application for benefits. Individuals can
use ISBA to apply for RIB, DIB and
spouse’s insurance benefits based on
age. SSA gathers only information
relevant to the individual applicant’s
circumstances and will use the
information collected by ISBA to entitle
individuals to RIB, DIB, and/or spouse’s
benefits. The respondents are applicants
for RIB, DIB, and/or spouse’s benefits.
E:\FR\FM\15MRN1.SGM
15MRN1
Federal Register / Vol. 70, No. 49 / Tuesday, March 15, 2005 / Notices
Number of Respondents: 200,000.
Frequency of Response: 1.
Average Burden Per Response: 21.9
minutes.
Estimated Annual Burden: 73,000
hours.
Paper Application Forms
Application for Retirement Insurance
Benefits (SSA–1)
Form SSA–1 is used by SSA to
determine an individual’s entitlement to
RIB. In order to receive Social Security
retirement insurance benefits, an
individual must file an application with
the SSA. Form SSA–1 is one application
that the Commissioner of Social
Security prescribes to meet this
requirement. The information that SSA
collects will be used to determine
entitlement to retirement benefits. The
respondents are individuals who choose
to apply for Social Security retirement
insurance.
Number of Respondents: 1,460,692.
Frequency of Response: 1.
Average Burden Per Response: 10.5
minutes.
Estimated Annual Burden: 255,621
hours.
Application for Wife’s or Husband’s
Insurance Benefits (SSA–2)
SSA uses the information collected on
Form SSA–2 to determine if an
applicant (including a divorced
applicant) can be entitled to benefits as
the spouse of the worker and the
amount of the spouse’s benefits. The
respondents are applicants for wife’s or
husband’s benefits, including those who
are divorced.
Number of Respondents: 700,000.
Frequency of Response: 1.
Average Burden Per Response: 15
minutes.
Estimated Annual Burden: 175,000
hours.
Application for Disability Insurance
Benefits (SSA–16)
Form SSA–16–F6 obtains the
information necessary to determine
whether the provisions of the Act have
been satisfied with respect to an
applicant for disability benefits, and
detects whether the applicant has
dependents who would qualify for
benefits on his or her earnings record.
The information collected on form SSA–
16–F6 helps to determine eligibility for
Social Security disability benefits. The
respondents are applicants for Social
Security disability benefits.
Number of Respondents: 1,513,677.
Frequency of Response: 1.
Average Burden Per Response: 20
minutes.
VerDate jul<14>2003
15:31 Mar 14, 2005
Jkt 205001
Estimated Annual Burden: 504,559
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 package by calling
the SSA Reports Clearance Officer at
410–965–0454, or by writing to the
address listed above.
1. Homeless Outreach Project and
Evaluation (HOPE)
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 is undertaking the project HOPE
evaluation to determine the
effectiveness and the efficiency of the
program. To obtain the information
needed for the evaluation, SSA is
developing an interactive Web site that
will be used by co-op awardees to input
client and program data, and by SSA to
communicate project-wide
announcements to the awardees. The
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Fmt 4703
Sfmt 4703
12773
respondents are HOPE grantees/nonprofit social services organizations
serving people who are homeless &
disabled.
Type of Request: New information
collection.
Number of Respondents: 41.
Frequency of Response: 12.
Average Burden Per Response: 65
minutes.
Estimated Annual Burden: 533 hours.
2. Appointment of Representative—20
CFR 404.1707, 404.1720, 404.1725,
410.684 and 416.1507—0960–0527
The information collected by SSA on
form SSA–1696–U4 is used to verify the
applicant’s appointment of a
representative. It allows SSA to inform
the representative of items which affect
the applicant’s claim. The affected
public consists of applicants who notify
SSA that they have appointed a person
to represent them in their dealings with
SSA when claiming a right to benefits.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 551,520.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 91,920
hours.
3. Petition To Obtain Approval of a Fee
for Representing a Claimant Before the
Social Security Administration—20
CFR Subpart R—404.1720, 404.1725,
Subpart F, 410.686b, Subpart O,
416.1520 and 416.1525—0960–0104
A representative of a claimant for
Social Security benefits must file either
a fee petition or a fee agreement with
SSA in order to charge a fee for
representing a claimant in proceedings
before SSA. The representative uses
form SSA–1560 to petition SSA for
authorization to charge and collect a fee.
A claimant may also use the form to
agree or disagree with the requested fee
amount or other information the
representative provides on the form.
SSA uses the information to determine
a reasonable fee that a representative
may charge and collect for his or her
services. The respondents are claimants,
their attorneys and other persons
representing them.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 34,624.
Frequency of Response: 1.
Average Burden Per Response: 30
minutes.
Estimated Annual Burden: 17,312
hours.
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15MRN1
12774
Federal Register / Vol. 70, No. 49 / Tuesday, March 15, 2005 / Notices
4. Employee Work Activity
Questionnaire—20 CFR 404.1574,
404.1592—0960–0483
When a possible unsuccessful work
attempt or a subsidy is involved, as
described in regulations 20 CFR
404.1574(a)(1), (2) and (3), form SSA–
3033 is used to request a description of
the employee’s work effort. The data is
evaluated to determine if the claimant
meets the disability requirements of the
law. The information is collected
through form SSA–3033 or by telephone
contact, only in cases where it cannot be
obtained through electronic data
matches with other Federal agencies
and/or State agencies.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 15,000.
Frequency of Response: 1.
Average Burden Per Response: 15
minutes.
Estimated Annual Burden: 3,750
hours.
5. Statement Regarding the Inferred
Death of an Individual by Reason of
Continued and Unexplained Absence—
20 CFR 404.720 and 404.721—0960–
0002
SSA will use the information
collected on form SSA–723 in making
its determination that the missing
person may be presumed deceased and,
if so, to establish a date of presumed
death. The respondents are persons who
have knowledge about the
disappearance of the missing person.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 3,000.
Frequency of Response: 1.
Average Burden Per Response: 30
minutes.
Estimated Annual Burden: 1,500
hours.
Dated: March 9, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 05–4987 Filed 3–14–05; 8:45 am]
BILLING CODE 4191–02–P
SOCIAL SECURITY ADMINISTRATION
Privacy Act of 1974; as Amended New
System of Records and New Routine
Use Disclosures
AGENCY:
Social Security Administration
(SSA).
Proposed new system of records
and proposed routine uses.
ACTION:
SUMMARY: In accordance with the
Privacy Act (5 U.S.C. 552a(e)(4) and
(e)(11)), we are issuing public notice of
VerDate jul<14>2003
15:31 Mar 14, 2005
Jkt 205001
our intent to establish a new system of
records entitled Representative Payee/
Misuse Restitution Control System (RP/
MRCS), 60–0318, and routine uses
applicable to this system of records.
Hereinafter, we will refer to the
proposed system of records as the RP/
MRCS. We invite public comments on
this proposal.
DATES: We filed a report of the proposed
new system of records and proposed
routine use disclosures with the
Chairman of the Senate Committee on
Homeland Security and Governmental
Affairs, the Chairman of the House
Committee on Government Reform, and
the Director, Office of Information and
Regulatory Affairs, Office of
Management and Budget (OMB) on
January 26, 2005. The proposed system
of records and routine uses will become
effective on March 6, 2005, unless we
receive comments warranting it not to
become effective.
ADDRESSES: Interested individuals may
comment on this publication by writing
to the Executive Director, Office of
Public Disclosure, Office of the General
Counsel, Social Security
Administration, Room 3–A–6
Operations Building, 6401 Security
Boulevard, Baltimore, Maryland 21235–
6401. All comments received will be
available for public inspection at the
above address.
FOR FURTHER INFORMATION CONTACT: Ms.
Joyce Schaul, Social Insurance
Specialist, Office of Public Disclosure,
Office of the General Counsel, Social
Security Administration, Room 3–A–6
Operations Building, 6401 Security
Boulevard, Baltimore, Maryland 21235,
e-mail address at joyce.schaul@ssa.gov,
or by telephone at (410) 965–5662.
SUPPLEMENTARY INFORMATION:
I. Background and Purpose of the
Proposed New System of Records
Entitled the RP/MRCS System
A. General Background
On March 4, 2004, President Bush
signed into law the Social Security
Protection Act of 2004 (Pub. L. 108–
203), which amended section 205(j) of
the Social Security Act. Included in the
amendment is a requirement for the
Commissioner of Social Security to reissue benefits under Title II or XVI
whenever an individual representative
payee serving 15 or more beneficiaries
or an organizational representative
payee is found to have misused a
beneficiary’s funds. This is effective for
determinations of misuse on or after
January 1, 1995. To carry out this
function as required under the amended
section 205(j), SSA must collect and
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Frm 00130
Fmt 4703
Sfmt 4703
maintain certain identifying information
about: (1) representative payees that
have misused benefits; (2) beneficiaries
whose benefits have been misused; and
(3) the relationship between the
representative payee and the
beneficiary.
B. Collection and Maintenance of the
Data for the Proposed New System of
Records Entitled the RP/MRCS System
SSA must collect and maintain
certain identifying information about
representative payees that have misused
benefits; beneficiaries whose benefits
have been misused; and, the
relationship between the representative
payee and the beneficiary. We will
retrieve information from the proposed
system of records by using the
individual’s name and/or Social
Security number. Thus the RP/MRCS
system will constitute a system of
records under the Privacy Act of 1974,
as amended.
II. Proposed Routine Use Disclosures of
Data Maintained in the Proposed RP/
MRCS
A. Proposed Routine Use Disclosures
We are proposing to establish routine
uses of information that will be
maintained in the proposed RP/MRCS
as discussed below.
1. To the Office of the President for
the purpose of responding to an
individual pursuant to an inquiry
received from that individual or from a
third party on his or her behalf.
We will disclose information under
this routine use only in situations in
which an individual may contact the
Office of the President, seeking that
Office’s assistance in a matter relating to
information contained in this system of
records. Information will be disclosed
when the Office of the President makes
an inquiry and indicates that it is acting
on behalf of the individual whose
record is requested.
2. To a congressional office in
response to an inquiry from that office
made at the request of the subject of a
record.
We will disclose information under
this routine use only in situations in
which an individual may ask his or her
congressional representative to
intercede in a matter relating to
information contained in this system of
records. Information will be disclosed
when the congressional representative
makes an inquiry and indicates that he
or she is acting on behalf of the
individual whose record is requested.
3. To the Department of Justice (DOJ),
a court or other tribunal, or another
party before such tribunal when:
E:\FR\FM\15MRN1.SGM
15MRN1
]]>Agencies
[Federal Register Volume 70, Number 49 (Tuesday, March 15, 2005)]
[Notices]
[Pages 12772-12774]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-4987]
=======================================================================
-----------------------------------------------------------------------
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 Pub. L. 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 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, Fax: 202-395-6974. (SSA), Social Security
Administration, DCFAM, Attn: Reports Clearance Officer, 1338 Annex
Building, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410-965-6400.
I. The information collection listed below is 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.
Social Security Benefits Application--20 CFR Subpart D, 404.310-404.311
and 20 CFR Subpart F, 404.601-404.603--0960-0618
One of the requirements for obtaining Social Security benefits is
the filing of an application so that a determination may be made on the
applicant's eligibility for monthly benefits. In addition to the
traditional paper application, SSA has developed various options for
the public to add convenience and operational efficiency to the
application process. The total estimated number of respondents to all
application collection formats is 3,874,369 with a cumulative total of
1,008,180 burden hours. The respondents are applicants for retirement
insurance benefits (RIB), disability insurance benefits (DIB), and/or
spouses' benefits.
Please note that burden hours for applications taken through the
Modernized Claims System (MCS) are accounted for in the hardcopy
collection formats. Guided by the MCS collection screens, an SSA
representative interviews the applicant and inputs the information
directly into the SSA's application database. MCS offers the
representative prompts based on the type of application being filed and
the circumstances of the applicant. These prompts facilitate a more
complete initial application, saving both the agency and applicant
time. MCS also propagates identity and similar information within the
application, which saves additional time.
Internet Social Security Benefits Application (ISBA)
Type of Request: Revision of an OMB-approved information
collection. (ISBA collection only).
ISBA, which is available through SSA's Internet site, is one method
that an individual can choose to file an application for benefits.
Individuals can use ISBA to apply for RIB, DIB and spouse's insurance
benefits based on age. SSA gathers only information relevant to the
individual applicant's circumstances and will use the information
collected by ISBA to entitle individuals to RIB, DIB, and/or spouse's
benefits. The respondents are applicants for RIB, DIB, and/or spouse's
benefits.
[[Page 12773]]
Number of Respondents: 200,000.
Frequency of Response: 1.
Average Burden Per Response: 21.9 minutes.
Estimated Annual Burden: 73,000 hours.
Paper Application Forms
Application for Retirement Insurance Benefits (SSA-1)
Form SSA-1 is used by SSA to determine an individual's entitlement
to RIB. In order to receive Social Security retirement insurance
benefits, an individual must file an application with the SSA. Form
SSA-1 is one application that the Commissioner of Social Security
prescribes to meet this requirement. The information that SSA collects
will be used to determine entitlement to retirement benefits. The
respondents are individuals who choose to apply for Social Security
retirement insurance.
Number of Respondents: 1,460,692.
Frequency of Response: 1.
Average Burden Per Response: 10.5 minutes.
Estimated Annual Burden: 255,621 hours.
Application for Wife's or Husband's Insurance Benefits (SSA-2)
SSA uses the information collected on Form SSA-2 to determine if an
applicant (including a divorced applicant) can be entitled to benefits
as the spouse of the worker and the amount of the spouse's benefits.
The respondents are applicants for wife's or husband's benefits,
including those who are divorced.
Number of Respondents: 700,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 175,000 hours.
Application for Disability Insurance Benefits (SSA-16)
Form SSA-16-F6 obtains the information necessary to determine
whether the provisions of the Act have been satisfied with respect to
an applicant for disability benefits, and detects whether the applicant
has dependents who would qualify for benefits on his or her earnings
record. The information collected on form SSA-16-F6 helps to determine
eligibility for Social Security disability benefits. The respondents
are applicants for Social Security disability benefits.
Number of Respondents: 1,513,677.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 504,559 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 package
by calling the SSA Reports Clearance Officer at 410-965-0454, or by
writing to the address listed above.
1. Homeless Outreach Project and Evaluation (HOPE)
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 is undertaking the project HOPE evaluation to determine the
effectiveness and the efficiency of the program. To obtain the
information needed for the evaluation, SSA is developing an interactive
Web site that will be 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 & disabled.
Type of Request: New information collection.
Number of Respondents: 41.
Frequency of Response: 12.
Average Burden Per Response: 65 minutes.
Estimated Annual Burden: 533 hours.
2. Appointment of Representative--20 CFR 404.1707, 404.1720, 404.1725,
410.684 and 416.1507--0960-0527
The information collected by SSA on form SSA-1696-U4 is used to
verify the applicant's appointment of a representative. It allows SSA
to inform the representative of items which affect the applicant's
claim. The affected public consists of applicants who notify SSA that
they have appointed a person to represent them in their dealings with
SSA when claiming a right to benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 551,520.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 91,920 hours.
3. Petition To Obtain Approval of a Fee for Representing a Claimant
Before the Social Security Administration--20 CFR Subpart R--404.1720,
404.1725, Subpart F, 410.686b, Subpart O, 416.1520 and 416.1525--0960-
0104
A representative of a claimant for Social Security benefits must
file either a fee petition or a fee agreement with SSA in order to
charge a fee for representing a claimant in proceedings before SSA. The
representative uses form SSA-1560 to petition SSA for authorization to
charge and collect a fee. A claimant may also use the form to agree or
disagree with the requested fee amount or other information the
representative provides on the form. SSA uses the information to
determine a reasonable fee that a representative may charge and collect
for his or her services. The respondents are claimants, their attorneys
and other persons representing them.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 34,624.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 17,312 hours.
[[Page 12774]]
4. Employee Work Activity Questionnaire--20 CFR 404.1574, 404.1592--
0960-0483
When a possible unsuccessful work attempt or a subsidy is involved,
as described in regulations 20 CFR 404.1574(a)(1), (2) and (3), form
SSA-3033 is used to request a description of the employee's work
effort. The data is evaluated to determine if the claimant meets the
disability requirements of the law. The information is collected
through form SSA-3033 or by telephone contact, only in cases where it
cannot be obtained through electronic data matches with other Federal
agencies and/or State agencies.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 15,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 3,750 hours.
5. Statement Regarding the Inferred Death of an Individual by Reason of
Continued and Unexplained Absence--20 CFR 404.720 and 404.721--0960-
0002
SSA will use the information collected on form SSA-723 in making
its determination that the missing person may be presumed deceased and,
if so, to establish a date of presumed death. The respondents are
persons who have knowledge about the disappearance of the missing
person.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 3,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 1,500 hours.
Dated: March 9, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 05-4987 Filed 3-14-05; 8:45 am]
BILLING CODE 4191-02-P
