Agency Information Collection Activities: Proposed Request and Comment Request, 34181-34184 [E6-9147]
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jlentini on PROD1PC65 with NOTICES
Federal Register / Vol. 71, No. 113 / Tuesday, June 13, 2006 / Notices
overpaid individuals with an initial
notice of overpayment, and the SSA–
4589 is sent to overpaid individuals
who have been previously notified of
their debt. The SSA–4588 is sent out
only once to the debtor, with the official
first notice of overpayment, while the
SSA–4589 is sent on a monthly basis
until the debt is repaid. Respondents are
Title II beneficiaries and Title XVI
recipients who have outstanding
overpayments.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 60,000.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 5,000
hours.
6. Continuing Education Information
Collection under Non-Attorney
Demonstration Project—0960–NEW.
Section 303 of the Social Security
Protection Act of 2004 (SSPA) provides
for a 5-year demonstration project to be
conducted by SSA under which the
direct payment of SSA approved fees is
extended to certain non-attorney
claimant representatives. Under the
demonstration project, to be eligible for
direct payment of fees, a non-attorney
representative must fulfill a series of
statutory requirements. One of these
steps is to demonstrate completion of
relevant continuing education courses.
Through the services of a private
contractor, SSA must collect the
requested information to determine if a
non-attorney representative has met this
statutory requirement to be eligible for
direct payment of fees for his or her
claimant representation services. The
information collection is needed to
comply with the legislation. The
respondents are non-attorney
representatives who apply for direct
payment of fees.
Type of Request: Collection in use
without OMB number.
Number of Respondents: 300.
Frequency of Response: 1.
Average Burden Per Response: 30
minutes.
Estimated Annual Burden: 150 hours.
II. The information collection listed
below has been submitted to OMB for
clearance. Your comments on the
information collection 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.
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Instructions for Completion of Federal
Assistance Application—0960–0184.
The information on Form SSA–96 will
be used to assist SSA in selecting grant
proposals for funding based on their
technical merits. The information will
also assist in evaluating the soundness
of the design of the proposed activities,
the possibilities of obtaining productive
results, the adequacy of resources to
conduct the activities and the
relationship to other similar activities
that have been or are being conducted.
The respondents are State and local
governments, State-designated
protection and advocacy groups,
colleges and universities and profit and
nonprofit private organizations.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 400.
Frequency of Response: 2.
Average Burden Per Response: 14
hours.
Estimated Annual Burden: 11,200
hours.
III. Notice of Office of Management
and Budget Approval
Administrative Review Process for
Adjudicating Disability, Parts 404, 405,
416 and 422. As required by the
Paperwork Reduction Act, SSA is
providing notice of the Office of
Management and Budget’s approval of
the information collections contained in
20 CFR parts, 404, 416 and 422. The
OMB number for this collection is
0960–0710, expiring March 31, 2009.
Dated: June 6, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. E6–9146 Filed 6–12–06; 8:45 am]
BILLING CODE 4191–02–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
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,
PO 00000
Frm 00130
Fmt 4703
Sfmt 4703
34181
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, 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. Special Benefits for Certain World
War II Veterans—20 CFR 408, Subparts
G, H, I, J & L—0960–0683. Title VIII of
the Social Security Act, Special Benefits
for Certain World War II Veterans (SVB),
allows, under certain circumstances, the
payment of SVB to qualified veterans
who reside outside the United States.
The accompanying regulations set out
the requirements an individual must
meet in order to establish continuing
eligibility to, and insure correct
payment amount of, SVB and/or State
recognition payments.
Additionally, they provide
requirements that a State must meet in
order to elect, modify, or terminate a
Federal agreement. The respondents are
individuals who receive Title VIII SVB,
and/or States that elect Federal
administration of their recognition
payments.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 60.
Estimated Annual Burden: 22 hours.
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Federal Register / Vol. 71, No. 113 / Tuesday, June 13, 2006 / Notices
Number of
respondents
Section No.
§ 408.704–.714 ..............................................................................................
§ 408.802(b) ...................................................................................................
§ 408.814 .......................................................................................................
§ 408.820(c) ...................................................................................................
§ 408.923(b) ...................................................................................................
§ 408.931(b) &§ 408.932(d) ...........................................................................
§ 408.932(c) ...................................................................................................
§ 408.932(e) ...................................................................................................
§ 408.941(b) &.
§ 408.942 .......................................................................................................
§ 408.944(a) ...................................................................................................
§ 408.1000(a) .................................................................................................
§ 408.1007;.
§ 408.1009(a)–(b) ...........................................................................................
§ 408.1009(c) .................................................................................................
§ 408.1210(c)–(d) ...........................................................................................
§ 408.1215 .....................................................................................................
§ 408.1230 .....................................................................................................
2. Uniform Administrative
Requirements for Grants and
Agreements with Institutions of Higher
Learning, Hospitals and Other NonProfit Organizations—20 CFR 435—
0960–0616. The information contained
in 20 CFR 435 of the Code of Federal
Regulations provides SSA’s standards in
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1
1
1
1
1
1
1
1
60
15
15
15
60
60
15
15
1
1.25
1.25
1.25
1
1
.50
.50
1
1
1
15
30
60
.50
1
1
1
1
1
10
20
Rec-kp ........................................................................................
Rec-kp ........................................................................................
Rpt .............................................................................................
Rpt .............................................................................................
Rpt .............................................................................................
Rpt .............................................................................................
Rec-kp ........................................................................................
Rpt .............................................................................................
Rpt .............................................................................................
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1
1
1
1
1
60
60
120
15
15
1
1
2
2.50
5.00
1
143
157
1
1
196
196
1
1
Frm 00131
Fmt 4703
Sfmt 4703
Respondents are applicants and
recipients for grants and agreements
with SSA.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 196.
Estimated Annual Burden: 12,871
hours.
Frequency of
response
N/A ........................
Quarterly (4) ..........
Biannually (2) ........
Annually (1) ...........
Annually (1) ...........
Quarterly (4) ..........
Annually (1) ...........
Annually (1) ...........
Annually (1) ...........
review the Psychiatric Review
Technique Form for quality purposes.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 344.
Frequency of Response: 194.
Total Annual Responses: 66,736.
Average Burden per Response: 12
minutes.
Estimated Annual Burden: 13,347
hours.
4. Privacy and Disclosure of Official
Records and Information; Availability of
Information and Records to the Public—
20 CFR 401.40(b)&(c), 401.55(b),
401.100(a), 402.130, 402.185—0960–
0566. The Privacy Act of 1974 (5 U.S.C.
552a) authorizes SSA to collect certain
information for access to and
amendment or correction of records.
The information collected is used by
PO 00000
Estimated
annual
burden
2
2
1
Number of
responses
3. Medical Consultant’s Review of
Psychiatric Review Technique Form—20
CFR 404.1520a, 404.1640, 404.1643,
404.1645, 416.920a—0960–0677. SSA
measures the performance of the State
Disability Determination Services
(DDSs) in the area of quality of
documentation and determinations on
claims. In mental claims, a Psychiatric
Review Technique Form (PRTF) is
completed by the DDS. The SSA–3023
is only completed when an adjudicating
component’s PRTF is in the file. An
SSA–3023 is required for each
completed PRTF and is used by the
regional review component to facilitate
SSA’s medical/psychological
consultants’ review of the PRTF for
quality purposes. The respondents are
medical/psychological consultants who
Average
burden
per response
(minutes)
1
5
5
5
1
1
2
2
the administration of grants and
agreements awarded to institutions of
higher learning, hospitals, other nonprofit and/or commercial organizations.
It provides administrative guidelines
and reporting, recordkeeping and
disclosure requirements for applicable
recipients of grants and agreements.
Section No.
435.21
435.23
435.25
435.33
435.44
435.51
435.53
435.81
435.82
Frequency of
response
Average
burden
per response
(hours)
40
1
4
1
2
12
8
16
8
Estimated
annual burden
(hours)
40
572
1,256
1
2
9,408
1,568
16
8
SSA to: (1) Identify individuals who
request access to their records; (2)
designate an individual to receive and
review their medical records; (3) amend
or correct records; (4) obtain consent
from an individual to release his/her
records to others (consent is submitted
by letter in writing or by use of the
SSA–3288, or other consent form). The
Freedom of Information Act authorizes
SSA to collect information needed to
facilitate the release of information from
SSA records. Respondents are
individuals or businesses requesting
access to, correction of, or disclosure of
SSA records.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 3,028,500.
Estimated Annual Burden: 159,133
hours.
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Federal Register / Vol. 71, No. 113 / Tuesday, June 13, 2006 / Notices
Number of
respondents
Type of request
Frequency of
response
34183
Average
burden
per response
Estimated
annual burden
(hours)
10,000
3,000
100
3,000,000
15,000
400
1
1
1
1
1
1
11 minutes ..
2 hours ........
10 ................
3 minutes ....
5 minutes ....
5 minutes ....
1,833
6,000
17
150,000
1,250
33
Totals ..........................................................................................................
jlentini on PROD1PC65 with NOTICES
Access to Records .............................................................................................
Designating a Representative for Disclosure of Records ..................................
Amendment of Records .....................................................................................
Consent of Release of Records .........................................................................
FOIA Requests for Records ...............................................................................
Waiver/Reduction of Fees ..................................................................................
3,028,500
........................
.....................
159,133
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. Request for Withdrawal of
Application—20 CFR 404.640—0960–
0015. The filing of an application for
Social Security benefits may be to the
claimant’s disadvantage. The
withdrawal procedure provides a
method for overcoming and nullifying
this disadvantage. The SSA–521 collects
the required information to effectuate
withdrawal of benefits or of an
application for benefits. The
respondents are applicants or claimants
for Social Security benefits.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 8,333
hours.
2. Statement of Claimant or Other
Person—20 CFR 404.702, 416.570—
0960–0045. The SSA–795 is used to
obtain information from claimants or
other persons having knowledge of facts
in connection with claims for Social
Security or Supplemental Security
Income (SSI) benefits when there is no
standard form which collects the
needed information. The information is
used by SSA to process claims for
benefits or for ongoing issues related to
the above programs. The respondents
are applicants/beneficiaries for Social
Security benefits or SSI payments, or
others who are in a position to provide
information pertinent to the claims.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 305,500.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
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Estimated Annual Burden: 76,375
hours.
3. Application for Search of Census
Records for Proof of Age—20 CFR
404.716–0960–0097. The information
collected on Form SSA–1535–U3 is
needed to provide sufficient identifying
information to allow an accurate search
of census records to establish proof of
age for an individual applying for Social
Security benefits. It is used for
individuals who must establish proof of
age as a factor of entitlement, and
cannot otherwise document their date of
birth. The respondents are applicants
for Social Security benefits who must
establish their date of birth as a factor
of entitlement.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 18,030.
Frequency of Response: 1.
Average Burden per Response: 12
minutes.
Estimated Annual Burden: 3,606
hours.
4. Claim for Amounts Due in the Case
of a Deceased Beneficiary—20 CFR
404.503(b)–0960–0101. SSA collects
information using form SSA–1724 when
there is insufficient information in the
file to identify the person(s) entitled to
an underpayment, or that person’s
address. This information is needed
when there is an underpayment due to
a deceased beneficiary. Generally, the
SSA–1724 is used in cases where a
surviving widow(er) is not already
entitled to a monthly benefit on the
same earnings record, or is not filing for
a lump-sum death payment as a livingwith spouse. The respondents are
applicants for underpayments in cases
of deceased beneficiaries.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 300,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 50,000
hours.
5. Statement of Care and
Responsibility for Beneficiary—20 CFR
404.2020, 404.2025, 408.620, 408.625,
416.620, 416.625–0960–0109. Form
PO 00000
Frm 00132
Fmt 4703
Sfmt 4703
SSA–788 is used to obtain information
from the beneficiary’s custodian about
the representative payee applicant’s
concern and responsibility for the
beneficiary. The respondents are
individuals who have custody of the
beneficiary where someone else has
filed to be the beneficiary’s
representative payee.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 130,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 21,667
hours.
6. Self-Employment/Corporate Officer
Questionnaire—20 CFR 404.435(e),
404.446–0960–0487. Form SSA–4184 is
used to develop earnings and
corroborate the claimant’s allegations of
retirement when the claimant is selfemployed or a corporate officer. The
information collected is used to
determine the benefit amount. The
respondents are self-employed
individuals or corporate officers who
apply for retirement or survivors’
insurance benefits.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden per Response: 20
minutes.
Estimated Annual Burden: 16,667
hours.
7. Application for Special Benefits for
World War II Veterans—20 CFR 408,
Subparts B, C and D–0960–0615. Title
VIII of the Social Security Act (Special
Benefits for Certain World War II
Veterans) allows for the payment of a
monthly benefit to a qualified World
War II veteran who resides outside the
United States. The regulations set out
the requirements an individual must
meet in order to qualify for and become
entitled to Special Veterans Benefits
(SVB). SSA–2000–F6 is the application
used to elicit the information necessary
to determine entitlement to SVB. The
respondents are individuals who are
applying for SVB under Title VIII of the
Social Security Act.
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Federal Register / Vol. 71, No. 113 / Tuesday, June 13, 2006 / Notices
Type of Request: Revision of an OMBapproved information collection.
Estimated Annual Burden: 359 hours.
Number of
respondents
Section No.
Average
burden
per response
(minutes)
Frequency of
response
325
5
5
5
2
2
5
2
20
20
230
215
230
20
1
1
1
1
1
1
1
1
1
1
1
1
1
1
20
15
15
15
15
30
15
15
15
15
15
30
15
30
Totals ......................................................................................................
jlentini on PROD1PC65 with NOTICES
§ 408.202(d); § 408.210; § 408.230(a); § 408.305; §§ 408.310–.315 ............
§ 408.232(a) ...................................................................................................
§ 408.320 .......................................................................................................
§ 408.340 .......................................................................................................
§ 408.345 .......................................................................................................
§ 408.351(d) & (f) ...........................................................................................
§ 408.355(a) ...................................................................................................
§ 408.360(a) ...................................................................................................
§ 408.404(c) ...................................................................................................
§ 408.410–412 ...............................................................................................
§ 408.420(a), (b) ............................................................................................
§ 408.430 & .432 ............................................................................................
§ 408.435(a), (b),(c) .......................................................................................
§ 408.437(b), (c),(d) .......................................................................................
1,086
........................
........................
8. Prohibition of Payment of SSI
Benefits to Fugitive Felons and Parole/
Probation Violators—20 CFR
416.708(o)–0960–0617. Section
1611(e)(4) of the Social Security Act
precludes eligibility for SSI benefits for
certain fugitives and probation/parole
violators. Regulations at 20 CFR
416.708(o) require that a report is given
to SSA when an individual is fleeing to
avoid prosecution for a crime, fleeing to
avoid custody or confinement after
conviction of a crime, or violating a
condition of probation or parole. The
respondents are SSI applicants/
recipients or representative payees of
SSI recipients who are reporting that a
recipient is a fugitive felon or probation/
parole violator.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 1,000.
Frequency of Response: 1.
Average Burden per Response: 1
minute.
Estimated Annual Burden: 17 hours.
9. Application for SSA Employee
Testimony—20 CFR 403.100–155—
0960–0619. SSA’s regulations at 20 CFR
403.100–155 establish policies and
procedures whereby an individual,
organization, or governmental entity
may request official Agency
information, records, or testimony of an
agency employee in a legal proceeding
to which the agency is not a party. The
request, which must be in writing to the
Commissioner, must fully set out the
nature and relevance of the sought
testimony. Respondents are individuals
or entities who request testimony from
SSA employees in a legal proceeding.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 100.
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Frequency of Response: 1.
Average Burden per Response: 60
minutes.
Estimated Annual Burden: 100 hours.
10. Representative Payee ReportSpecial Veterans Benefits—20 CFR
408.665—0960–0621. Title VIII allows
the payment of monthly benefits by the
Commissioner of Social Security to
qualified World War II veterans who
reside outside the U.S. A representative
payee may be appointed to receive and
manage the monthly payment for the
beneficiary’s use and benefit. The SSA–
2001–F6 is completed by the payee to
determine if he has used the benefits
properly and continues to demonstrate
strong concern for the beneficiary.
Respondents are persons or
organizations who act on behalf of
beneficiaries receiving SVB.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 100.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 17 hours.
Dated: June 6, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. E6–9147 Filed 6–12–06; 8:45 am]
BILLING CODE 4191–02–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
PO 00000
Frm 00133
Fmt 4703
Sfmt 4703
Estimated
annual hour
burden
108
1.25
1.25
1.25
.50
1.00
1.25
.50
5.00
5.00
58.00
108.00
58.00
10.00
359
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 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, 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
E:\FR\FM\13JNN1.SGM
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]]>Agencies
[Federal Register Volume 71, Number 113 (Tuesday, June 13, 2006)]
[Notices]
[Pages 34181-34184]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-9147]
-----------------------------------------------------------------------
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. Special Benefits for Certain World War II Veterans--20 CFR 408,
Subparts G, H, I, J & L--0960-0683. Title VIII of the Social Security
Act, Special Benefits for Certain World War II Veterans (SVB), allows,
under certain circumstances, the payment of SVB to qualified veterans
who reside outside the United States. The accompanying regulations set
out the requirements an individual must meet in order to establish
continuing eligibility to, and insure correct payment amount of, SVB
and/or State recognition payments.
Additionally, they provide requirements that a State must meet in
order to elect, modify, or terminate a Federal agreement. The
respondents are individuals who receive Title VIII SVB, and/or States
that elect Federal administration of their recognition payments.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 60.
Estimated Annual Burden: 22 hours.
[[Page 34182]]
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Section No. respondents response response annual burden
(minutes)
----------------------------------------------------------------------------------------------------------------
Sec. 408.704-.714............................. 1 1 60 1
Sec. 408.802(b)............................... 5 1 15 1.25
Sec. 408.814.................................. 5 1 15 1.25
Sec. 408.820(c)............................... 5 1 15 1.25
Sec. 408.923(b)............................... 1 1 60 1
Sec. 408.931(b) &Sec. 408.932(d)............ 1 1 60 1
Sec. 408.932(c)............................... 2 1 15 .50
Sec. 408.932(e)............................... 2 1 15 .50
Sec. 408.941(b) &.............................
Sec. 408.942.................................. 2 1 15 .50
Sec. 408.944(a)............................... 2 1 30 1
Sec. 408.1000(a).............................. 1 1 60 1
Sec. 408.1007;................................
Sec. 408.1009(a)-(b).......................... 1 1 60 1
Sec. 408.1009(c).............................. 1 1 60 1
Sec. 408.1210(c)-(d).......................... 1 1 120 2
Sec. 408.1215................................. 10 1 15 2.50
Sec. 408.1230................................. 20 1 15 5.00
----------------------------------------------------------------------------------------------------------------
2. Uniform Administrative Requirements for Grants and Agreements
with Institutions of Higher Learning, Hospitals and Other Non-Profit
Organizations--20 CFR 435--0960-0616. The information contained in 20
CFR 435 of the Code of Federal Regulations provides SSA's standards in
the administration of grants and agreements awarded to institutions of
higher learning, hospitals, other non-profit and/or commercial
organizations. It provides administrative guidelines and reporting,
recordkeeping and disclosure requirements for applicable recipients of
grants and agreements. Respondents are applicants and recipients for
grants and agreements with SSA.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 196.
Estimated Annual Burden: 12,871 hours.
----------------------------------------------------------------------------------------------------------------
Average
Number of burden per Estimated
Section No. responses Frequency of response response annual burden
(hours) (hours)
----------------------------------------------------------------------------------------------------------------
435.21 Rec-kp..................... 1 N/A......................... 40 40
435.23 Rec-kp..................... 143 Quarterly (4)............... 1 572
435.25 Rpt........................ 157 Biannually (2).............. 4 1,256
435.33 Rpt........................ 1 Annually (1)................ 1 1
435.44 Rpt........................ 1 Annually (1)................ 2 2
435.51 Rpt........................ 196 Quarterly (4)............... 12 9,408
435.53 Rec-kp..................... 196 Annually (1)................ 8 1,568
435.81 Rpt........................ 1 Annually (1)................ 16 16
435.82 Rpt........................ 1 Annually (1)................ 8 8
----------------------------------------------------------------------------------------------------------------
3. Medical Consultant's Review of Psychiatric Review Technique
Form--20 CFR 404.1520a, 404.1640, 404.1643, 404.1645, 416.920a--0960-
0677. SSA measures the performance of the State Disability
Determination Services (DDSs) in the area of quality of documentation
and determinations on claims. In mental claims, a Psychiatric Review
Technique Form (PRTF) is completed by the DDS. The SSA-3023 is only
completed when an adjudicating component's PRTF is in the file. An SSA-
3023 is required for each completed PRTF and is used by the regional
review component to facilitate SSA's medical/psychological consultants'
review of the PRTF for quality purposes. The respondents are medical/
psychological consultants who review the Psychiatric Review Technique
Form for quality purposes.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 344.
Frequency of Response: 194.
Total Annual Responses: 66,736.
Average Burden per Response: 12 minutes.
Estimated Annual Burden: 13,347 hours.
4. Privacy and Disclosure of Official Records and Information;
Availability of Information and Records to the Public--20 CFR
401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185--0960-0566. The
Privacy Act of 1974 (5 U.S.C. 552a) authorizes SSA to collect certain
information for access to and amendment or correction of records. The
information collected is used by SSA to: (1) Identify individuals who
request access to their records; (2) designate an individual to receive
and review their medical records; (3) amend or correct records; (4)
obtain consent from an individual to release his/her records to others
(consent is submitted by letter in writing or by use of the SSA-3288,
or other consent form). The Freedom of Information Act authorizes SSA
to collect information needed to facilitate the release of information
from SSA records. Respondents are individuals or businesses requesting
access to, correction of, or disclosure of SSA records.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 3,028,500.
Estimated Annual Burden: 159,133 hours.
[[Page 34183]]
----------------------------------------------------------------------------------------------------------------
Estimated
Type of request Number of Frequency of Average burden per annual burden
respondents response response (hours)
----------------------------------------------------------------------------------------------------------------
Access to Records.................... 10,000 1 11 minutes............... 1,833
Designating a Representative for 3,000 1 2 hours.................. 6,000
Disclosure of Records.
Amendment of Records................. 100 1 10....................... 17
Consent of Release of Records........ 3,000,000 1 3 minutes................ 150,000
FOIA Requests for Records............ 15,000 1 5 minutes................ 1,250
Waiver/Reduction of Fees............. 400 1 5 minutes................ 33
--------------------------------------------------------------------------
Totals........................... 3,028,500 .............. ......................... 159,133
----------------------------------------------------------------------------------------------------------------
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. Request for Withdrawal of Application--20 CFR 404.640--0960-
0015. The filing of an application for Social Security benefits may be
to the claimant's disadvantage. The withdrawal procedure provides a
method for overcoming and nullifying this disadvantage. The SSA-521
collects the required information to effectuate withdrawal of benefits
or of an application for benefits. The respondents are applicants or
claimants for Social Security benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 8,333 hours.
2. Statement of Claimant or Other Person--20 CFR 404.702, 416.570--
0960-0045. The SSA-795 is used to obtain information from claimants or
other persons having knowledge of facts in connection with claims for
Social Security or Supplemental Security Income (SSI) benefits when
there is no standard form which collects the needed information. The
information is used by SSA to process claims for benefits or for
ongoing issues related to the above programs. The respondents are
applicants/beneficiaries for Social Security benefits or SSI payments,
or others who are in a position to provide information pertinent to the
claims.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 305,500.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 76,375 hours.
3. Application for Search of Census Records for Proof of Age--20
CFR 404.716-0960-0097. The information collected on Form SSA-1535-U3 is
needed to provide sufficient identifying information to allow an
accurate search of census records to establish proof of age for an
individual applying for Social Security benefits. It is used for
individuals who must establish proof of age as a factor of entitlement,
and cannot otherwise document their date of birth. The respondents are
applicants for Social Security benefits who must establish their date
of birth as a factor of entitlement.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 18,030.
Frequency of Response: 1.
Average Burden per Response: 12 minutes.
Estimated Annual Burden: 3,606 hours.
4. Claim for Amounts Due in the Case of a Deceased Beneficiary--20
CFR 404.503(b)-0960-0101. SSA collects information using form SSA-1724
when there is insufficient information in the file to identify the
person(s) entitled to an underpayment, or that person's address. This
information is needed when there is an underpayment due to a deceased
beneficiary. Generally, the SSA-1724 is used in cases where a surviving
widow(er) is not already entitled to a monthly benefit on the same
earnings record, or is not filing for a lump-sum death payment as a
living-with spouse. The respondents are applicants for underpayments in
cases of deceased beneficiaries.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 300,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 50,000 hours.
5. Statement of Care and Responsibility for Beneficiary--20 CFR
404.2020, 404.2025, 408.620, 408.625, 416.620, 416.625-0960-0109. Form
SSA-788 is used to obtain information from the beneficiary's custodian
about the representative payee applicant's concern and responsibility
for the beneficiary. The respondents are individuals who have custody
of the beneficiary where someone else has filed to be the beneficiary's
representative payee.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 130,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 21,667 hours.
6. Self-Employment/Corporate Officer Questionnaire--20 CFR
404.435(e), 404.446-0960-0487. Form SSA-4184 is used to develop
earnings and corroborate the claimant's allegations of retirement when
the claimant is self-employed or a corporate officer. The information
collected is used to determine the benefit amount. The respondents are
self-employed individuals or corporate officers who apply for
retirement or survivors' insurance benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden per Response: 20 minutes.
Estimated Annual Burden: 16,667 hours.
7. Application for Special Benefits for World War II Veterans--20
CFR 408, Subparts B, C and D-0960-0615. Title VIII of the Social
Security Act (Special Benefits for Certain World War II Veterans)
allows for the payment of a monthly benefit to a qualified World War II
veteran who resides outside the United States. The regulations set out
the requirements an individual must meet in order to qualify for and
become entitled to Special Veterans Benefits (SVB). SSA-2000-F6 is the
application used to elicit the information necessary to determine
entitlement to SVB. The respondents are individuals who are
[[Page 34184]]
applying for SVB under Title VIII of the Social Security Act.
Type of Request: Revision of an OMB-approved information
collection.
Estimated Annual Burden: 359 hours.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Section No. respondents response response annual hour
(minutes) burden
----------------------------------------------------------------------------------------------------------------
Sec. 408.202(d); Sec. 408.210; Sec. 325 1 20 108
408.230(a); Sec. 408.305; Sec. Sec.
408.310-.315...................................
Sec. 408.232(a)............................... 5 1 15 1.25
Sec. 408.320.................................. 5 1 15 1.25
Sec. 408.340.................................. 5 1 15 1.25
Sec. 408.345.................................. 2 1 15 .50
Sec. 408.351(d) & (f)......................... 2 1 30 1.00
Sec. 408.355(a)............................... 5 1 15 1.25
Sec. 408.360(a)............................... 2 1 15 .50
Sec. 408.404(c)............................... 20 1 15 5.00
Sec. 408.410-412.............................. 20 1 15 5.00
Sec. 408.420(a), (b).......................... 230 1 15 58.00
Sec. 408.430 & .432........................... 215 1 30 108.00
Sec. 408.435(a), (b),(c)...................... 230 1 15 58.00
Sec. 408.437(b), (c),(d)...................... 20 1 30 10.00
---------------------------------------------------------------
Totals...................................... 1,086 .............. .............. 359
----------------------------------------------------------------------------------------------------------------
8. Prohibition of Payment of SSI Benefits to Fugitive Felons and
Parole/Probation Violators--20 CFR 416.708(o)-0960-0617. Section
1611(e)(4) of the Social Security Act precludes eligibility for SSI
benefits for certain fugitives and probation/parole violators.
Regulations at 20 CFR 416.708(o) require that a report is given to SSA
when an individual is fleeing to avoid prosecution for a crime, fleeing
to avoid custody or confinement after conviction of a crime, or
violating a condition of probation or parole. The respondents are SSI
applicants/recipients or representative payees of SSI recipients who
are reporting that a recipient is a fugitive felon or probation/parole
violator.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 1,000.
Frequency of Response: 1.
Average Burden per Response: 1 minute.
Estimated Annual Burden: 17 hours.
9. Application for SSA Employee Testimony--20 CFR 403.100-155--
0960-0619. SSA's regulations at 20 CFR 403.100-155 establish policies
and procedures whereby an individual, organization, or governmental
entity may request official Agency information, records, or testimony
of an agency employee in a legal proceeding to which the agency is not
a party. The request, which must be in writing to the Commissioner,
must fully set out the nature and relevance of the sought testimony.
Respondents are individuals or entities who request testimony from SSA
employees in a legal proceeding.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 100.
Frequency of Response: 1.
Average Burden per Response: 60 minutes.
Estimated Annual Burden: 100 hours.
10. Representative Payee Report-Special Veterans Benefits--20 CFR
408.665--0960-0621. Title VIII allows the payment of monthly benefits
by the Commissioner of Social Security to qualified World War II
veterans who reside outside the U.S. A representative payee may be
appointed to receive and manage the monthly payment for the
beneficiary's use and benefit. The SSA-2001-F6 is completed by the
payee to determine if he has used the benefits properly and continues
to demonstrate strong concern for the beneficiary. Respondents are
persons or organizations who act on behalf of beneficiaries receiving
SVB.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 100.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 17 hours.
Dated: June 6, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-9147 Filed 6-12-06; 8:45 am]
BILLING CODE 4191-02-P
