Agency Information Collection Activities: Proposed Request and Comment Request, 35330-35332 [05-11974]

Download as PDF 35330 Federal Register / Vol. 70, No. 116 / Friday, June 17, 2005 / Notices servicing or other authorities granted to ALP or PCLP CDCs. The CDC is required to retain a copy of all loan application documents in its file regardless of whether they are submitted to SBA. Authority: 13 CFR 120.3. James E. Rivera, Associate Administrator for Financial Assistance. Appendix 1—‘‘Loan Package Score’’ (LPS) The quality level of loan packages being presented by the CDC is the key to the SLPC’s ability to expedite processing of approval requests. During the processing of each 504 loan application, the SBA loan specialist evaluates the quality and presentation of the package and assigns a grade based on the following standards. On the official start date of the pilot, SLPC will determine the CDC’s score based on the 25 most recent loans submitted to the Center. A CDC not eligible for ASM because of its LPS score at the start of the pilot will become eligible for ASM when its most recent 25 loans submitted have a numeric equivalent average LPS of no more than ‘‘1.9’’. The SLPC will notify a CDC when it becomes eligible for ASM. In the case of an ALP or PCLP lender that has submitted fewer than 25 loans, the Center will base the score on all loans submitted. If, at the start of the pilot, a CDC was not ALP or PCLP and did not have 25 loans submitted during the preceding 12 months, it will be notified as soon as it submits its 25th loan if it has an acceptable score. The SLPC will continue to monitor CDC performance by maintaining a ‘‘rolling’’ average that includes the most recent twentyfive (25) loans submitted. After receiving ASM status, if the CDC’s numeric equivalent average LPS exceeds ‘‘1.9’’ or if the CDC’s submission of any one loan package rates a ‘‘C’’ or lower, the CDC will lose its ASM status. In the case of a numeric equivalent average LPS that exceeds ‘‘1.9’’ the CDC will again become eligible for ASM once its numeric equivalent average rating is no more than ‘‘1.9’’. In the case of a single loan package rated ‘‘C’’ or lower, the CDC will again become eligible with the subsequent submission of five (5) sequential non-ASM loan packages that rate a numeric equivalent average of no more than ‘‘1.9’’. SLPC staff rates every 504 loan application processed by SLPC. The rating will range from ‘‘A’’ to ‘‘E’’ with ‘‘A’’ being the highest possible rating. (For purposes of numeric calculation the ‘‘A’’ through ‘‘E’’ designation will be converted as follows: ‘‘A’’ = 1, ‘‘B’’ = 2, ‘‘C’’ = 3, ‘‘D’’ = 4 and ‘‘E’’ = 5.) SLPC computes the rating by evaluating the following three factors to comprise a composite score: 1. CDC submitted all necessary documents and data. 2. CDC completely and accurately analyzed the eligibility of the transaction. 3. CDC produced a complete and thorough credit analysis. The following describes each rating level: VerDate jul<14>2003 17:59 Jun 16, 2005 Jkt 205001 A—A level ‘‘A’’ application package is complete in all respects. The CDC’s credit memo provides a clear representation of the loan proposal, and a complete analysis of the business including management, financial capacity, eligibility, and project costs. The credit memo also explains why the transaction completely satisfies SBA’s credit and eligibility standards. Ownership of all entities including potential affiliates is broken down with full analysis completed and true affiliates identified. The 1244 is complete and the information contained matches the credit memo and the financial documents in the file. The package is in exhibit order of the 1244 with all exhibits included and complete. This would also include: —All required signatures on the 1244 Part C. —All required 912s are completed —All required personal, corporate and affiliate tax returns and financial statements. —Project property is clearly identified with cost documents to support the project cost. —All required SBA forms are included and completed properly, including appropriate signatures as required. —The draft authorization is consistent with the CDC’s recommendation on the 1244 and the credit memo, is presented in the current version being used, and has all the relevant provisions included. In summary, a level ‘‘A’’ application package is complete and stands on its own. The SBA loan specialist is able to review the CDC’s credit memo and quickly identify all of the entities for which exhibit information is required. At this level, additional contact with the CDC is rarely necessary. B—A level ‘‘B’’ application package is well prepared however it is not complete. The SBA loan specialist must contact the CDC to obtain further information to clarify the proposal or to obtain a missing document. The information usually will not change the structure of the proposal but is required for the package to be complete and eligibility to be established. Common items missed that would create a level ‘‘B’’ assessment are missing signatures/dates on the 1244; missing 912s; incomplete or missing financial information; misidentified or unidentified affiliates; missing INS verification; missing costs documents; stale dated documents. At this level, the CDC’s credit memo is well prepared, making the identification of the missing documents relatively easy. Usually, only one or two items are needed to complete the file. The missing information can usually be faxed or overnight mailed with minimal delay in processing. C—A level ‘‘C’’ application package is missing substantially more information than a level ‘‘B’’. The SBA loan specialist will provide a list of missing items and/or those needing clarification via e-mail to the CDC. The CDC’s credit memo is lacking in one or more key areas making the identification of the scope of the project difficult. The information contained in the 1244 and exhibits often do not match the credit memo and/or the draft authorization. The information requested may result in additional questions/issues being identified. PO 00000 Frm 00110 Fmt 4703 Sfmt 4703 Very often this results in a change to the structure and dollar amount of the project. Areas of concern, in addition to those identified in level ‘‘B’’ are: ineligible project costs; ineligible structure due to new business or single purpose property; miscalculated equity injection; existing SBA loan that limits project participation. The volume of missing information or the incorrect structure of the project can cause extended delays in the processing of the request. D—Level ‘‘D’’ application packages are seriously incomplete and often contain an ineligible structure. The CDC’s credit memo, if included, does not provide adequate information to establish that the file meets SBA credit and eligibility standards. Many of the exhibits are missing or incomplete. It is difficult for the SBA loan specialist to determine, based on the contents of the file, what the actual project involves. These files usually require repeated requests to the CDC for information in order for the SBA loan specialist to construct a file that is complete enough to make a decision. E—Level ‘‘E’’ application packages are missing many critical documents which make it difficult to determine the scope of the proposed project or the principals or companies involved. Packages graded at this level are rare and are likely to come from new CDCs that are just beginning to learn the process. [FR Doc. 05–11961 Filed 6–16–05; 8:45 am] BILLING CODE 8025–01–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 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 E:\FR\FM\17JNN1.SGM 17JNN1 35331 Federal Register / Vol. 70, No. 116 / Friday, June 17, 2005 / Notices 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, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410–965–6400. I. The information collections listed below are pending at SSA and will be submitted to OMB within 60 days from the date of this notice. Therefore, your comments should be submitted to SSA within 60 days from the date of this publication. You can obtain copies of the collection instruments by calling the SSA Reports Clearance Officer at 410– 965–0454 or by writing to the address listed above. 1. Marriage Certification—20 CFR 404.725—0960–0009. When the worker and spouse are not filing concurrently, the Social Security Administration uses Form SSA–3–F6 to record any changes/ additions to the worker’s marital history since the worker’s claim was adjudicated. The marital history of the claimant’s wife or husband, when compared to the worker’s marital history (as supplemented by Form SSA– 3–F6), enables the fact finder to determine if the claimant has the necessary relationship to the worker. In cases where the spouse and worker were ceremonially married, the worker’s statement on his/her marital history that he/she was ceremonially married to the claimant’s spouse and the claimant’s spouse’s statement that he/she was ceremonially married to the worker generally constitute evidence of a ceremonial marriage in lieu of obtaining a marriage certificate. Type of Request: Extension of an OMB-approved information collection. Number of Respondents: 180,000. Frequency of Response: 1. Average Burden Per Response: 5 minutes. Estimated Annual Burden: 15,000 hours. 2. Request To Be Selected As Payee— 20 CFR 404.2025 and 416.625—0960– 0014. The information established by the form SSA–11–BK is necessary to determine the proper payee for a Social Security beneficiary and Supplemental Security Income (SSI) recipient. The form is designed to aid in the investigation of a payee applicant. The use of the form will establish the applicant’s relationship to the beneficiary/recipient, his/her justification and his/her concern for the beneficiary/recipient, as well as the manner in which the benefits will be used. The respondents are applicants for representative payee. Type of Request: Revision of an OMBapproved information collection. Number of Respondents: 2,121,686. Frequency of Response: 1. Average Burden Per Response: 10.5 minutes. Estimated Annual Burden: 371,295 hours. 3. Statement for Determining Continuing Eligibility for Supplemental Security Income Payments—Adult, Form SSA–3988; Statement for Determining Continuing Eligibility for Supplemental Security Income Payments—Child, Form SSA–3989–20 CFR Subpart B—416.204—0960–NEW. Forms Respondents SSA–3988 ........................................................................................................ SSA–3989 ........................................................................................................ 4. Denial of Title II Benefits to Fugitive Felons—0960–New. Specifically, Section 203 of the SSPA prohibits payment of title II benefits: • To persons fleeing to avoid prosecution or custody or confinement after conviction, under the laws of the place from which the person flees, for a crime, or an attempt to commit a crime, which is a felony under the laws of the place from which the person flees; or • In jurisdictions that do not define crimes as felonies, where the crime is punishable by death or imprisonment for a term exceeding 1 year regardless of the actual sentence imposed; and VerDate jul<14>2003 17:59 Jun 16, 2005 Jkt 205001 Frm 00111 Fmt 4703 Sfmt 4703 The Social Security Act mandates periodic redeterminations of nonmedical factors relating to SSI recipient’s continuing eligibility for SSI payments. SSA studies have indicated that as many as two-thirds of these scheduled redeterminations, which are completed with the assistance of an SSA employee, do not result in any change in circumstances that affects the recipients payment. SSA has conducted extensive testing of both of the SSA– 3988 and SSA–3989, under OMB control number 0960–0643, and has validated that these redetermination formats result in significant operational savings and a decrease in recipient inconvenience while still obtaining timely, accurate data to determine continuing eligibility through the process. The Collection Forms SSA–3988 and SSA–3989 will be used to determine whether SSI recipients have met and continue to meet all statutory and regulatory nonmedical requirements for SSI eligibility, and whether they have been and are still receiving the correct payment amount. The SSA–3988 and SSA–3989 are designed as self-help forms that will be mailed to recipients or to their representative payees for completion and return to SSA. The respondents are recipients of SSI payments or their representatives. Type of Request: New information collection. Frequency of response 650,000 65,000 • To persons violating a condition of probation or parole imposed under Federal or State law. To identify claimants who should not be receiving benefits, the Commissioner directed that we add specific questions to title II applications that solicit information about any outstanding felony warrants or warrants for parole/ probation violations. In addition, SSA will collect supplemental information if a claimant responds affirmatively to either or both of the two fugitive felon questions on title II applications, thereby indicating that they have an unsatisfied warrant. Answers to these questions will be used PO 00000 Background 1 1 Average burden per response (minutes) 26 26 Estimated annual burden (hours) 281,667 28,167 to verify that a warrant is still outstanding. An SSA claims representative will contact beneficiaries by telephone to collect the information. Respondents will be claimants for benefits who indicated on their application that they have an unsatisfied warrant. Type of Request: New information collection. Number of Respondents: 10,000. Frequency of Response: 1. Average Burden Per Response: 8 minutes. Estimated Annual Burden: 1,333 hours. E:\FR\FM\17JNN1.SGM 17JNN1 35332 Federal Register / Vol. 70, No. 116 / Friday, June 17, 2005 / Notices 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. 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. VerDate jul<14>2003 17:59 Jun 16, 2005 Jkt 205001 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 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 based 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. PO 00000 Frm 00112 Fmt 4703 Sfmt 4703 Estimated Annual Burden: 504,559 hours. Dated: June 13, 2005. Elizabeth A. Davidson, Reports Clearance Officer, Social Security Administration. [FR Doc. 05–11974 Filed 6–16–05; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice 5110] In the Matter of the Designation of the Islamic Jihad Group, aka the Jama’at al-Jihad, aka the Libyan Society, aka the Kazakh Jama’at, aka the Jamaat Mojahedin, aka Jamiyat, aka Jamiat alJihad al-Islami, aka Dzhamaat Modzhakhedov, aka Islamic Jihad Group of Uzbekistan, aka al-Djihad alIslami (Including Any and All Transliterations of Its Name) as a Foreign Terrorist Organization Pursuant to Section 219 of the Immigration and Nationality Act, as Amended Based upon a review of the Administrative Record assembled in this matter, and in consultation with the Attorney General and the Secretary of the Treasury, the Secretary of State has concluded that there is a sufficient factual basis to find that the relevant circumstances described in section 219 of the Immigration and Nationality Act, as amended (8 U.S.C. section 1189), exist with respect to the Islamic Jihad Group, aka the Jama’at al-Jihad, aka the Libyan Society, aka the Kazakh Jama’at, aka the Jamaat Mojahedin, aka Jamiyat, aka Jamiat al-Jihad al-Islami, aka Dzhamaat Modzhakhedov, aka Islamic Jihad Group of Uzbekistan, aka alDjihad al-Islami (including any and all transliterations of its name). Therefore, effective upon the date of publication in the Federal Register, the Secretary of State hereby designates that organization as a foreign terrorist organization pursuant to section 219 of the INA. Dated: June 12, 2005. Karen Aguilar, Acting Coordinator for Counterterrorism, Department of State. [FR Doc. 05–12010 Filed 6–16–05; 5:00 pm] BILLING CODE 4710–10–P E:\FR\FM\17JNN1.SGM 17JNN1

Agencies

Social Security Administration

[Federal Register Volume 70, Number 116 (Friday, June 17, 2005)]
[Notices]
[Pages 35330-35332]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-11974]

=======================================================================
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SOCIAL SECURITY ADMINISTRATION

Agency Information Collection Activities: Proposed Request and
Comment Request

The Social Security Administration (SSA) publishes a list of
information collection packages that will require clearance by the
Office of Management and Budget (OMB) in compliance with 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

[[Page 35331]]

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,
1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, Fax:
410-965-6400.
I. The information collections listed below are pending at SSA and
will be submitted to OMB within 60 days from the date of this notice.
Therefore, your comments should be submitted to SSA within 60 days from
the date of this publication. You can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
0454 or by writing to the address listed above.
1. Marriage Certification--20 CFR 404.725--0960-0009. When the
worker and spouse are not filing concurrently, the Social Security
Administration uses Form SSA-3-F6 to record any changes/additions to
the worker's marital history since the worker's claim was adjudicated.
The marital history of the claimant's wife or husband, when compared to
the worker's marital history (as supplemented by Form SSA-3-F6),
enables the fact finder to determine if the claimant has the necessary
relationship to the worker. In cases where the spouse and worker were
ceremonially married, the worker's statement on his/her marital history
that he/she was ceremonially married to the claimant's spouse and the
claimant's spouse's statement that he/she was ceremonially married to
the worker generally constitute evidence of a ceremonial marriage in
lieu of obtaining a marriage certificate.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 180,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 15,000 hours.
2. Request To Be Selected As Payee--20 CFR 404.2025 and 416.625--
0960-0014. The information established by the form SSA-11-BK is
necessary to determine the proper payee for a Social Security
beneficiary and Supplemental Security Income (SSI) recipient. The form
is designed to aid in the investigation of a payee applicant. The use
of the form will establish the applicant's relationship to the
beneficiary/recipient, his/her justification and his/her concern for
the beneficiary/recipient, as well as the manner in which the benefits
will be used. The respondents are applicants for representative payee.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 2,121,686.
Frequency of Response: 1.
Average Burden Per Response: 10.5 minutes.
Estimated Annual Burden: 371,295 hours.
3. Statement for Determining Continuing Eligibility for
Supplemental Security Income Payments--Adult, Form SSA-3988; Statement
for Determining Continuing Eligibility for Supplemental Security Income
Payments--Child, Form SSA-3989-20 CFR Subpart B--416.204--0960-NEW.

Background

The Social Security Act mandates periodic redeterminations of non-
medical factors relating to SSI recipient's continuing eligibility for
SSI payments. SSA studies have indicated that as many as two-thirds of
these scheduled redeterminations, which are completed with the
assistance of an SSA employee, do not result in any change in
circumstances that affects the recipients payment. SSA has conducted
extensive testing of both of the SSA-3988 and SSA-3989, under OMB
control number 0960-0643, and has validated that these redetermination
formats result in significant operational savings and a decrease in
recipient inconvenience while still obtaining timely, accurate data to
determine continuing eligibility through the process.

The Collection

Forms SSA-3988 and SSA-3989 will be used to determine whether SSI
recipients have met and continue to meet all statutory and regulatory
non-medical requirements for SSI eligibility, and whether they have
been and are still receiving the correct payment amount. The SSA-3988
and SSA-3989 are designed as self-help forms that will be mailed to
recipients or to their representative payees for completion and return
to SSA. The respondents are recipients of SSI payments or their
representatives.
Type of Request: New information collection.

----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Forms Respondents Frequency of per response annual burden
response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3988........................................ 650,000 1 26 281,667
SSA-3989........................................ 65,000 1 26 28,167
----------------------------------------------------------------------------------------------------------------

4. Denial of Title II Benefits to Fugitive Felons--0960-New.
Specifically, Section 203 of the SSPA prohibits payment of title II
benefits:
To persons fleeing to avoid prosecution or custody or
confinement after conviction, under the laws of the place from which
the person flees, for a crime, or an attempt to commit a crime, which
is a felony under the laws of the place from which the person flees; or
In jurisdictions that do not define crimes as felonies,
where the crime is punishable by death or imprisonment for a term
exceeding 1 year regardless of the actual sentence imposed; and
To persons violating a condition of probation or parole
imposed under Federal or State law.
To identify claimants who should not be receiving benefits, the
Commissioner directed that we add specific questions to title II
applications that solicit information about any outstanding felony
warrants or warrants for parole/probation violations.
In addition, SSA will collect supplemental information if a
claimant responds affirmatively to either or both of the two fugitive
felon questions on title II applications, thereby indicating that they
have an unsatisfied warrant. Answers to these questions will be used to
verify that a warrant is still outstanding. An SSA claims
representative will contact beneficiaries by telephone to collect the
information. Respondents will be claimants for benefits who indicated
on their application that they have an unsatisfied warrant.
Type of Request: New information collection.
Number of Respondents: 10,000.
Frequency of Response: 1.
Average Burden Per Response: 8 minutes.
Estimated Annual Burden: 1,333 hours.

[[Page 35332]]

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.
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.
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 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 based 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.

Dated: June 13, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 05-11974 Filed 6-16-05; 8:45 am]
BILLING CODE 4191-02-P

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