Agency Information Collection Activities: Proposed Request and Comment Request, 961-963 [E6-34]
Download as PDF
<![CDATA[
Federal Register / Vol. 71, No. 4 / Friday, January 6, 2006 / Notices
• Send an e-mail to rulecomments@sec.gov. Please include File
Number SR–Phlx–2005–72 on the
subject line.
category, the Exchange proposes to
specifically refer to SQTs on the fee
schedule in order to help clarify that
SQTs are also included in the ROT
category.
2. Statutory Basis
The Exchange believes that its
proposal to amend its schedule of fees
is consistent with Section 6(b) of the
Act,17 in general, and furthers the
objectives of Section 6(b)(4) of the Act,18
in particular, in that it is an equitable
allocation of reasonable fees among
Exchange members.
B. Self-Regulatory Organization’s
Statement on Burden on Competition
The Exchange does not believe that
the proposed rule change will impose
any burden on competition not
necessary or appropriate in furtherance
of the purposes of the Act.
C. Self-Regulatory Organization’s
Statement on Comments on the
Proposed Rule Change Received From
Members, Participants or Others
No written comments were either
solicited or received.
III. Date of Effectiveness of the
Proposed Rule Change and Timing for
Commission Action
The foregoing proposed rule change
has been designated as a fee change
pursuant to Section 19(b)(3)(A)(ii) of the
Act 19 and Rule 19b–4(f)(2) 20
thereunder. Accordingly, the proposal
will take effect upon filing with the
Commission. At any time within 60
days of the filing of Amendment No. 1
to the proposed rule change, the
Commission may summarily abrogate
such rule change if it appears to the
Commission that such action is
necessary or appropriate in the public
interest, for the protection of investors,
or otherwise in furtherance of the
purposes of the Act.21
cprice-sewell on PROD1PC66 with NOTICES
IV. Solicitation of Comments
Interested persons are invited to
submit written data, views, and
arguments concerning the foregoing,
including whether the proposed rule
change is consistent with the Act.
Comments may be submitted by any of
the following methods:
Electronic Comments
• Use the Commission’s Internet
comment form (https://www.sec.gov/
rules/sro.shtml); or
17 15
U.S.C. 78f(b).
U.S.C. 78f(b)(4).
19 15 U.S.C. 78s(b)(3)(A)(ii).
20 17 CFR 240.19b–4(f)(2).
21 See supra note 6.
18 15
VerDate Aug<31>2005
15:23 Jan 05, 2006
Jkt 208001
961
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
Paper Comments
collections, approval of existing
• Send paper comments in triplicate
information collections, revisions to
to Jonathan G. Katz, Secretary,
OMB-approved information collections,
Securities and Exchange Commission,
and extensions (no change) of OMB100 F Street, NE., Washington, DC
approved information collections.
20549–9303.
SSA is soliciting comments on the
All submissions should refer to File
accuracy of the agency’s burden
Number SR–Phlx–2005–72. This file
estimate; the need for the information;
number should be included on the
its practical utility; ways to enhance its
subject line if e-mail is used. To help the quality, utility, and clarity; and on ways
Commission process and review your
to minimize burden on respondents,
comments more efficiently, please use
including the use of automated
only one method. The Commission will collection techniques or other forms of
post all comments on the Commission’s information technology. Written
Internet Web site (https://www.sec.gov/
comments and recommendations
rules/sro.shtml). Copies of the
regarding the information collection(s)
submission, all subsequent
should be submitted to the OMB Desk
amendments, all written statements
Officer and the SSA Reports Clearance
with respect to the proposed rule
Officer. The information can be mailed
change that are filed with the
and/or faxed to the individuals at the
Commission, and all written
addresses and fax numbers listed below:
communications relating to the
(OMB) Office of Management and
proposed rule change between the
Budget, Attn: Desk Officer for SSA, Fax:
Commission and any person, other than 202–395–6974.
those that may be withheld from the
(SSA) Social Security Administration,
public in accordance with the
DCFAM, Attn: Reports Clearance
provisions of 5 U.S.C. 552, will be
Officer, 1333 Annex Building, 6401
available for inspection and copying in
Security Blvd., Baltimore, MD 21235.
the Commission’s Public Reference
Fax: 410–965–6400.
Room. Copies of the filing also will be
I. The information collections listed
available for inspection and copying at
below are pending at SSA and will be
the principal office of the Exchange. All
submitted to OMB within 60 days from
comments received will be posted
the date of this notice. Therefore, your
without change; the Commission does
comments should be submitted to SSA
not edit personal identifying
within 60 days from the date of this
information from submissions. You
publication. You can obtain copies of
should submit only information that
you wish to make available publicly. All the collection instruments by calling the
SSA Reports Clearance Officer at 410–
submissions should refer to File
965–0454 or by writing to the address
Number SR–Phlx–2005–72 and should
listed above.
be submitted on or before January 27,
1. Work Activity Report—Employee—
2006.
20 CFR 404.1520(b), 404.1571–.1576,
For the Commission, by the Division of
404.1584–.1593, and 416.971–.976—
Market Regulation, pursuant to delegated
0960–0059. Form SSA–821–BK collects
22
authority.
information that provides evidence
Jonathan G. Katz,
necessary to determine initial or
Secretary.
continuing eligibility for Supplemental
[FR Doc. E6–21 Filed 1–5–06; 8:45 am]
Security Income (SSI) or Social Security
BILLING CODE 8010–01–P
disability benefits. An individual’s
entitlement to benefits ends if he/she
demonstrates an ability to perform
SOCIAL SECURITY ADMINISTRATION
substantial gainful activity (SGA). This
form is used to determine whether work
Agency Information Collection
an individual performs in employment
Activities: Proposed Request and
is at the SGA level. The respondents are
Comment Request
Social Security disability applicants and
beneficiaries; and SSI applicants.
The Social Security Administration
Type of Request: Extension of an
(SSA) publishes a list of information
OMB-approved information collection.
collection packages that will require
Number of Respondents: 300,000.
clearance by the Office of Management
Frequency of Response: 1.
and Budget (OMB) in compliance with
Average Burden per Response: 45
22 17 CFR 200.30–3(a)(12).
minutes.
PO 00000
Frm 00058
Fmt 4703
Sfmt 4703
E:\FR\FM\06JAN1.SGM
06JAN1
962
Federal Register / Vol. 71, No. 4 / Friday, January 6, 2006 / Notices
Estimated Annual Burden: 225,000
hours.
2. Homeless Outreach Project and
Evaluation (HOPE)—0960–0704.
Background. Congress passed the
McKinney Act of 1987 in recognition of
and in an effort to address situations
and conditions facing people without
permanent shelter. The Act funded 15
emergency services and nine individual
titles to authorize the provision of
specific programs by Federal agencies.
The Act also established the Interagency
Council on Homelessness (ICH)
composed of leaders from 15 Federal
agencies who are in charge of
coordinating efforts to assist people who
are homeless. During the past decade,
SSA and other ICH agencies have
compiled important data about people
who are homeless and have carried out
evaluations of services which have
generated evidence about ‘‘best’’ or
‘‘promising practices’’ well suited to
combating homelessness.
In fiscal year 2003, President George
W. Bush announced an initiative to end
chronic homelessness in 10 years. As a
result, SSA developed Project HOPE
and in May 2004 awarded 34
Cooperative Agreements to
organizations which provide outreach,
support services and benefit application
assistance to the chronically homeless
and other underserved populations. An
additional 7 cooperative agreements
were awarded in November 2004 for a
total of 41. The goal of Project HOPE is
to improve both the quantity and quality
of applications for disability benefits.
Project HOPE gives focused support to
Cooperative (co-op) awardees via a
training program and ongoing technical
assistance.
Evaluation of Project HOPE. SSA uses
the project HOPE evaluation to
determine the effectiveness and the
efficiency of the program. To obtain the
information needed for the evaluation,
SSA has developed an interactive Web
site that is used by co-op awardees to
input client and program data, and by
SSA to communicate project-wide
announcements to the awardees. The
respondents are HOPE grantees/nonprofit social services organizations
serving people who are homeless and
disabled.
Number of
respondents
Forms
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 41.
Frequency of Response: 12.
Average Burden Per Response: 65
minutes.
Estimated Annual Burden: 533 hours.
3. Report to United States Social
Security Administration by Person
Receiving Benefits for a Child or for an
Adult Unable to Handle Funds and
Report to United States Social Security
Administration—0960–0049. SSA needs
the information on Form SSA–7161–
OCR–SM to monitor the performance of
representative payees outside the U.S.
and the information on SSA–7162–
OCR–SM to determine continuing
entitlement to Social Security benefits
and correct benefit amounts for
beneficiaries outside the U.S. The
respondents are individuals outside the
U.S. who are receiving benefits either
for someone else, or on their own behalf
under title II of the Social Security Act.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(in minutes)
Burden hours
30,000
227,000
1
1
15
5
7,500
18,917
Totals ........................................................................................................
cprice-sewell on PROD1PC66 with NOTICES
SSA–7161–OCR–SM ......................................................................................
SSA–7162–OCR–SM ......................................................................................
257,000
........................
........................
26,417
II. The information collections listed
below have been submitted to OMB for
clearance. Your comments on the
information collections would be most
useful if received by OMB and SSA
within 30 days from the date of this
publication. You can obtain a copy of
the OMB clearance packages by calling
the SSA Reports Clearance Officer at
410–965–0454, or by writing to the
address listed above.
1. Report of New Information in
Disability Cases—20 CFR 404.460,
404.468, 404.408, and 404.1588—0960–
0071. The information collected on the
form SSA–612 is used to update the
disability records of a respondent based
on reported changes contained in the
form. These changes may affect the
respondent’s Title II disability benefits.
The respondents are applicants for Title
II disability benefits.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 27,000.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
VerDate Aug<31>2005
15:23 Jan 05, 2006
Jkt 208001
Estimated Annual Burden: 2,250
hours.
2. Statement of Marital Relationship
(By one of the parties)—20 CFR
404.726—0960–0038. SSA uses the
information collected on Form SSA–
754–F4 to determine whether the
conditions for establishing a commonlaw marriage under state law are met.
The respondents are applicants for
spouse’s benefits.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 30,000.
Frequency of Response: 1.
Average Burden per Response: 30
minutes.
Estimated Annual Burden: 15,000
hours.
3. Employee Verification Service
(EVS)—0960–0669. Background. Under
Internal Revenue Service regulations,
employers are required to provide wage
and tax data to SSA using form W–2,
Wage and Tax Statement or its
electronic equivalent. As part of this
process, the employer must furnish the
employee’s name and Social Security
Number (SSN). This information must
PO 00000
Frm 00059
Fmt 4703
Sfmt 4703
match SSA’s records in order for the
employee’s wage and tax data to be
properly posted to the earnings record.
Information that is incorrectly provided
to the Agency must be corrected by the
employer using an amended reporting
form, which is a labor-intensive and
time-consuming process for both SSA
and the employer. Therefore, to help
ensure that employers provide accurate
name and SSN information on their
wage reports, SSA offers the EVS service
whereby employers can verify, via
magnetic tape, cartridge, diskette, paper,
and telephone, if the reported name and
SSN of their employee matches SSA’s
records.
EVS Collection. SSA will use the
information collected through the EVS
to verify that the employee name and
SSN information, provided by
employers, matches SSA records. SSA
will respond to the employer informing
them only of matches and mismatches
of submitted information. Respondents
are employers who provide wage and
tax data to SSA who elect to use EVS
E:\FR\FM\06JAN1.SGM
06JAN1
963
Federal Register / Vol. 71, No. 4 / Friday, January 6, 2006 / Notices
to verify their employees’ names and
SSNs.
Type of Request: Extension of an
OMB-Approved Information Collection.
Number of Respondents: 50,000.
Frequency of Response: 12.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 100,000
hours.
4. Application for Parent’s Insurance
Benefits—20 CFR 404.370–404.374, 20
CFR 404.601–404.603—0960–0012.
Form SSA–7–F6 collects information to
entitle an individual to his parent’s
insurance benefits. The respondents are
individuals who wish to apply to
receive their parent’s insurance benefits.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 1,400.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Number of
respondents
Title of collection
Estimated Annual Burden: 350 hours.
5. Application for Supplemental
Security Income—20 CFR 416.305–
416.335—0960–0444. The information
collected on the SSA–8001–BK is
needed and used to determine eligibility
for SSI, and the amount of SSI benefits
payable to the applicant. Respondents
are applicants for SSI benefits.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(in minutes)
Burden hours
MISSICS ..........................................................................................................
MISSICS/Signature Proxy ...............................................................................
Paper ...............................................................................................................
Paper/Signature Proxy .....................................................................................
840,088
280,029
25,982
8,661
1
1
1
1
16
15
19
18
224,023
70,007
8,228
2,598
Totals ........................................................................................................
1,154,760
........................
........................
304,856
6. Medical Source Statement of
Ability To Do Work Related Activities
(Physical and Mental)—20 CFR
404.1512–404.1514, 404.912–404.914,
404.1517, 416.917, 404.1519–404.1520,
416.919–416.920, 404.946, 416.946—
0960–0662. The HA–1151 and HA–1152
are used to collect data that is required
to determine the residual functional
capacity (RFC) of individuals who are
appealing denied claims for benefits
based on disability. RFC must be
determined to decide cases that cannot
be decided based on current work
activity or on medical facts alone. The
respondents are medical sources that are
Number of
respondents
Forms
paid by SSA to provide reports based
either on existing medical evidence or
on consultative examinations conducted
for the purposes of the report. We
estimate each respondent will submit
approximately 20 responses per year.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(in minutes)
Burden hours
HA–1151 ..........................................................................................................
HA–1152 ..........................................................................................................
5,000
5,000
20
20
15
15
25,000
25,000
Totals ........................................................................................................
10,000
........................
........................
50,000
Dated: December 30, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. E6–34 Filed 1–5–06; 8:45 am]
BILLING CODE 4191–02–P
SOCIAL SECURITY ADMINISTRATION
cprice-sewell on PROD1PC66 with NOTICES
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
request included in this notice is for a
revision to an existing information
collection.
VerDate Aug<31>2005
15:23 Jan 05, 2006
Jkt 208001
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
should be submitted to the SSA Reports
Clearance Officer. The information can
be mailed and/or faxed to the
individuals at the addresses and fax
number listed below:
Social Security Administration,
DCFAM, (SSA), Attn: Reports Clearance
Officer, 1333 Annex Building, 6401
Security Blvd., Baltimore, MD 21235.
Fax: 410–965–6400.
The information collection listed
below is pending at SSA and will be
PO 00000
Frm 00060
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 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.
Application for a Social Security Card—20
CFR 422.103–.110—0960–0066. Forms SS–5
(used in the United States) and SS–5–FS
(used outside the United States) are used to
apply for original and replacement Social
Security cards. Changes are being made to
these forms to reflect new statutory limits on
the number of allowable replacement cards.
The respondents are requestors of new or
replacement Social Security cards.
Note: This Notice is for the full clearance
of the collection, which received a temporary
emergency clearance through April 2006.
E:\FR\FM\06JAN1.SGM
06JAN1
]]>Agencies
[Federal Register Volume 71, Number 4 (Friday, January 6, 2006)]
[Notices]
[Pages 961-963]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-34]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages that will require clearance by the
Office of Management and Budget (OMB) in compliance with Public Law
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995.
The information collection packages that may be included in this notice
are for new information collections, approval of existing information
collections, revisions to OMB-approved information collections, and
extensions (no change) of OMB-approved information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and on ways to minimize
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed and/or faxed to the individuals
at the addresses and fax numbers listed below:
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974.
(SSA) Social Security Administration, DCFAM, Attn: Reports
Clearance Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore,
MD 21235. Fax: 410-965-6400.
I. The information collections listed below are pending at SSA and
will be submitted to OMB within 60 days from the date of this notice.
Therefore, your comments should be submitted to SSA within 60 days from
the date of this publication. You can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
0454 or by writing to the address listed above.
1. Work Activity Report--Employee--20 CFR 404.1520(b),
404.1571-.1576, 404.1584-.1593, and 416.971-.976--0960-0059. Form SSA-
821-BK collects information that provides evidence necessary to
determine initial or continuing eligibility for Supplemental Security
Income (SSI) or Social Security disability benefits. An individual's
entitlement to benefits ends if he/she demonstrates an ability to
perform substantial gainful activity (SGA). This form is used to
determine whether work an individual performs in employment is at the
SGA level. The respondents are Social Security disability applicants
and beneficiaries; and SSI applicants.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 300,000.
Frequency of Response: 1.
Average Burden per Response: 45 minutes.
[[Page 962]]
Estimated Annual Burden: 225,000 hours.
2. Homeless Outreach Project and Evaluation (HOPE)--0960-0704.
Background. Congress passed the McKinney Act of 1987 in recognition of
and in an effort to address situations and conditions facing people
without permanent shelter. The Act funded 15 emergency services and
nine individual titles to authorize the provision of specific programs
by Federal agencies. The Act also established the Interagency Council
on Homelessness (ICH) composed of leaders from 15 Federal agencies who
are in charge of coordinating efforts to assist people who are
homeless. During the past decade, SSA and other ICH agencies have
compiled important data about people who are homeless and have carried
out evaluations of services which have generated evidence about
``best'' or ``promising practices'' well suited to combating
homelessness.
In fiscal year 2003, President George W. Bush announced an
initiative to end chronic homelessness in 10 years. As a result, SSA
developed Project HOPE and in May 2004 awarded 34 Cooperative
Agreements to organizations which provide outreach, support services
and benefit application assistance to the chronically homeless and
other underserved populations. An additional 7 cooperative agreements
were awarded in November 2004 for a total of 41. The goal of Project
HOPE is to improve both the quantity and quality of applications for
disability benefits. Project HOPE gives focused support to Cooperative
(co-op) awardees via a training program and ongoing technical
assistance.
Evaluation of Project HOPE. SSA uses the project HOPE evaluation to
determine the effectiveness and the efficiency of the program. To
obtain the information needed for the evaluation, SSA has developed an
interactive Web site that is used by co-op awardees to input client and
program data, and by SSA to communicate project-wide announcements to
the awardees. The respondents are HOPE grantees/non-profit social
services organizations serving people who are homeless and disabled.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 41.
Frequency of Response: 12.
Average Burden Per Response: 65 minutes.
Estimated Annual Burden: 533 hours.
3. Report to United States Social Security Administration by Person
Receiving Benefits for a Child or for an Adult Unable to Handle Funds
and Report to United States Social Security Administration--0960-0049.
SSA needs the information on Form SSA-7161-OCR-SM to monitor the
performance of representative payees outside the U.S. and the
information on SSA-7162-OCR-SM to determine continuing entitlement to
Social Security benefits and correct benefit amounts for beneficiaries
outside the U.S. The respondents are individuals outside the U.S. who
are receiving benefits either for someone else, or on their own behalf
under title II of the Social Security Act.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per
Forms respondents response response (in Burden hours
minutes)
----------------------------------------------------------------------------------------------------------------
SSA-7161-OCR-SM................................. 30,000 1 15 7,500
SSA-7162-OCR-SM................................. 227,000 1 5 18,917
-----------------
Totals...................................... 257,000 .............. .............. 26,417
----------------------------------------------------------------------------------------------------------------
II. The information collections listed below have been submitted to
OMB for clearance. Your comments on the information collections would
be most useful if received by OMB and SSA within 30 days from the date
of this publication. You can obtain a copy of the OMB clearance
packages by calling the SSA Reports Clearance Officer at 410-965-0454,
or by writing to the address listed above.
1. Report of New Information in Disability Cases--20 CFR 404.460,
404.468, 404.408, and 404.1588--0960-0071. The information collected on
the form SSA-612 is used to update the disability records of a
respondent based on reported changes contained in the form. These
changes may affect the respondent's Title II disability benefits. The
respondents are applicants for Title II disability benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 27,000.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 2,250 hours.
2. Statement of Marital Relationship (By one of the parties)--20
CFR 404.726--0960-0038. SSA uses the information collected on Form SSA-
754-F4 to determine whether the conditions for establishing a common-
law marriage under state law are met. The respondents are applicants
for spouse's benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 30,000.
Frequency of Response: 1.
Average Burden per Response: 30 minutes.
Estimated Annual Burden: 15,000 hours.
3. Employee Verification Service (EVS)--0960-0669. Background.
Under Internal Revenue Service regulations, employers are required to
provide wage and tax data to SSA using form W-2, Wage and Tax Statement
or its electronic equivalent. As part of this process, the employer
must furnish the employee's name and Social Security Number (SSN). This
information must match SSA's records in order for the employee's wage
and tax data to be properly posted to the earnings record. Information
that is incorrectly provided to the Agency must be corrected by the
employer using an amended reporting form, which is a labor-intensive
and time-consuming process for both SSA and the employer. Therefore, to
help ensure that employers provide accurate name and SSN information on
their wage reports, SSA offers the EVS service whereby employers can
verify, via magnetic tape, cartridge, diskette, paper, and telephone,
if the reported name and SSN of their employee matches SSA's records.
EVS Collection. SSA will use the information collected through the
EVS to verify that the employee name and SSN information, provided by
employers, matches SSA records. SSA will respond to the employer
informing them only of matches and mismatches of submitted information.
Respondents are employers who provide wage and tax data to SSA who
elect to use EVS
[[Page 963]]
to verify their employees' names and SSNs.
Type of Request: Extension of an OMB-Approved Information
Collection.
Number of Respondents: 50,000.
Frequency of Response: 12.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 100,000 hours.
4. Application for Parent's Insurance Benefits--20 CFR 404.370-
404.374, 20 CFR 404.601-404.603--0960-0012. Form SSA-7-F6 collects
information to entitle an individual to his parent's insurance
benefits. The respondents are individuals who wish to apply to receive
their parent's insurance benefits.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 1,400.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 350 hours.
5. Application for Supplemental Security Income--20 CFR 416.305-
416.335--0960-0444. The information collected on the SSA-8001-BK is
needed and used to determine eligibility for SSI, and the amount of SSI
benefits payable to the applicant. Respondents are applicants for SSI
benefits.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per
Title of collection respondents response response (in Burden hours
minutes)
----------------------------------------------------------------------------------------------------------------
MISSICS......................................... 840,088 1 16 224,023
MISSICS/Signature Proxy......................... 280,029 1 15 70,007
Paper........................................... 25,982 1 19 8,228
Paper/Signature Proxy........................... 8,661 1 18 2,598
-----------------
Totals...................................... 1,154,760 .............. .............. 304,856
----------------------------------------------------------------------------------------------------------------
6. Medical Source Statement of Ability To Do Work Related
Activities (Physical and Mental)--20 CFR 404.1512-404.1514, 404.912-
404.914, 404.1517, 416.917, 404.1519-404.1520, 416.919-416.920,
404.946, 416.946--0960-0662. The HA-1151 and HA-1152 are used to
collect data that is required to determine the residual functional
capacity (RFC) of individuals who are appealing denied claims for
benefits based on disability. RFC must be determined to decide cases
that cannot be decided based on current work activity or on medical
facts alone. The respondents are medical sources that are paid by SSA
to provide reports based either on existing medical evidence or on
consultative examinations conducted for the purposes of the report. We
estimate each respondent will submit approximately 20 responses per
year.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per
Forms respondents response response (in Burden hours
minutes)
----------------------------------------------------------------------------------------------------------------
HA-1151......................................... 5,000 20 15 25,000
HA-1152......................................... 5,000 20 15 25,000
-----------------
Totals...................................... 10,000 .............. .............. 50,000
----------------------------------------------------------------------------------------------------------------
Dated: December 30, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-34 Filed 1-5-06; 8:45 am]
BILLING CODE 4191-02-P
