Agency Information Collection Activities: Proposed Request and Comment Request, 67776-67778 [E7-23253]
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Federal Register / Vol. 72, No. 230 / Friday, November 30, 2007 / Notices
selection of derivative products based
on such Equity Reference Assets. The
Commission believes that the proposal
to adjust the minimum rebalancing
frequency requirement is reasonable,
given the increasing number of equaldollar or modified equal-dollar
weighted indexes that are rebalanced on
a semiannual-basis, and should allow
for the listing and trading of certain
Equity Index-Linked Securities that
would otherwise not be able to be listed
and traded on the Exchange.
The Commission finds good cause for
approving the proposed rule change
prior to the 30th day after the date of
publication of the notice of filing thereof
in the Federal Register. With respect to
the deletion of the provision requiring
Equity Reference Assets to be based on
certain specified calculation
methodologies, the Commission notes
that it has approved the deletion of a
similar requirement under NYSE listing
standards for Equity Index-Linked
Securities 11 and does not believe that
this proposal raises any novel regulatory
issues. With respect to the Exchange’s
proposal to adjust the minimum
rebalancing frequency for certain Equity
Reference Assets, accelerating approval
of this proposal should benefit investors
by providing, without undue delay,
additional Equity Index-Linked
Securities products for investors and
fostering competition in the market for
such products. Therefore, the
Commission finds good cause,
consistent with Section 19(b)(2) of the
Act,12 to approve the proposed rule
change on an accelerated basis.
V. Conclusion
It is therefore ordered, pursuant to
Section 19(b)(2) of the Act,13 that the
proposed rule change (SR–NYSEArca–
2007–118) be, and it hereby is, approved
on anaccelerated basis.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.14
Nancy M. Morris,
Secretary.
[FR Doc. E7–23204 Filed 11–29–07; 8:45 am]
rwilkins on PROD1PC63 with NOTICES
BILLING CODE 8011–01–P
11 Id.
12 15
U.S.C. 78s(b)(2).
13 Id.
14 17
CFR 200.30–3(a)(12).
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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
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,
faxed or emailed 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, E-mail address:
OIRA_Submission@omb.eop.gov.
(SSA), Social Security Administration,
DCBFM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401
Security Blvd., Baltimore, MD 21235,
Fax: 410–965–6400, E-mail address:
OPLM.RCO@ssa.gov.
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. Request for Review of Hearing
Decision/Order—20 CFR 404.967–
404.981, 416.1467–416.1481—0960–
0277. The HA–520 is needed in order to
afford claimants their statutory right
under the Social Security Act and
implementing regulations to request
review of an Administrative Law Judge’s
(ALJ) hearing decision or dismissal of a
hearing request on title II and title XVI
PO 00000
Frm 00081
Fmt 4703
Sfmt 4703
claims. An individual may request
Appeals Council review by filing a
written request. A completed HA–520
ensures that SSA receives the
information necessary to establish that
the claimant filed the request for review
within the prescribed time, and that the
claimant has completed the requisite
steps to permit review by the Appeals
Council. The Appeals Council also uses
the information to document the
claimant’s reason(s) for disagreeing with
the ALJ’ s decision or dismissal, to
determine whether the claimant has
additional evidence to submit, and to
determine whether the claimant has a
representative or wants to appoint one.
The respondents are claimants
requesting review of an ALJ’s decision
or dismissal of hearing on Social
Security.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 16,667
hours.
2. Epidemiological Research Report—
20 CFR 401.165—0960–0701. Section
311 of the Social Security Independence
and Program Improvements Act of 1994
directed SSA to provide support to
health researchers involved in
epidemiological research. Specifically,
when a study is determined to
contribute to a national health interest,
SSA will furnish information to
determine whether a study subject is
shown on the SSA administrative
records as being alive or deceased (vital
status). SSA will recoup all expenses
incurred in providing this information.
Web-posted questions solicit the
information SSA needs to provide the
data and to collect the fees. The
requestors are scientific researchers who
are applying to receive vital status
information about individuals from
Social Security administrative data
records.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 30.
Frequency of Response: 1.
Average Burden Per Response: 120
minutes.
Estimated Annual Burden: 60 hours.
3. Work Activity Report (SelfEmployed Person)—20 CFR 404.1520(b),
404.1571–404.1576, 404.1584–404.1593,
and 416.971–416.976—0960–0598. The
information on Form SSA–820–F4 is
used by SSA to determine initial or
continuing eligibility for Supplemental
Security Income (SSI) or Social Security
disability benefits. Under titles II and
XVI of the Act, applicants for disability
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Federal Register / Vol. 72, No. 230 / Friday, November 30, 2007 / Notices
benefits must prove an inability to
perform any kind of Substantial Gainful
Activity (SGA) generally available in the
national economy for which they might
be expected to qualify on the basis of
age, education, and work experience.
SSA needs to secure information about
this work in order to ascertain whether
the applicant was (or is) engaging in
SGA. Work after a claimant becomes
entitled can cause the cessation of
disability benefits. The information
obtained from form SSA–820–F4 is
needed to determine if a cessation of
benefits should occur. The respondents
are applicants and claimants for SSI or
Social Security disability benefits.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 30
minutes.
Estimated Annual Burden: 50,000
hours
4. Student Reporting Form—20 CFR
404.352(b)(2), 404.368, 404.415,
404.434, 422.135—0960–0088. The
information collected by form SSA–
1383 is used by SSA to determine the
impact of reported events on Social
Security student beneficiaries’
continuing entitlement to these benefits.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 75,000.
Frequency of Response: 1.
Average Burden Per Response: 6
minutes.
Number of respondents
Collection format
Estimated Annual Burden: 7,500
hours.
5. Electronic Death Registration
(EDR)—20 CFR 404.301; 404.310–311;
404.316; 404.330–341;404.350–352; and
404.371; 416.912—0960–0700. SSA has
contracted with the States to obtain
death certificate information in order to
compare it to SSA’s payment files. This
match ensures the accuracy of our
payment files by detecting unreported
or inaccurate dates of deaths of
beneficiaries. Entitlement to retirement,
disability, wife’s, husband’s or parent’s
benefits under the provisions of the
Social Security Act terminates when the
beneficiary dies.
Type of Request: Extension of an
OMB-approved information collection.
Average cost
per record
request
Frequency of responses
Estimated
nnual cost
burden
State Death Match—Manual Process ............
State Death Match—Electronic Death Registration (EDR).
35
18
50,000 per State ............................................
50,000 per State ............................................
$0.72
2.58
$1,260,000
2,322,000
Totals .......................................................
53
.........................................................................
........................
3,582,000
Estimated Annual Cost for all
respondents:
**Please note that both of these data
matching processes are entirely
electronic and there is no hourly burden
for the respondent to provide this
information. The cost burdens are based
on the four cost components incurred by
the respondents:
—software
—hardware
—average annual salaries of database
management personnel
—average annual salaries of support
personnel
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 Evidence from Doctor
or Hospital—20 CFR 404 Subpart I and
20 CFR 416 Subpart P—0960–0722.
Claimants are required to provide
medical evidence of their impairment(s)
in pursuing a disability claim under
titles II and XVI of the Social Security
Number of respondents
Form type
Act. The HA–66 and HA–67 will be
used by adjudicators of the Office of
Disability Adjudication and Review
(ODAR), the component of the Social
Security Administration (SSA) that
oversees the Administrative Law Judge
(ALJ) hearing level. The letters will be
used to request medical evidence from
medical and other sources the claimant
identifies as having information relative
to his or her impairments or ability to
do work-related activities. The
respondents are doctors and hospitals
where the claimant has been evaluated.
Type of Request: Revision of an OMBapproved information collection.
Average burden per response
(minutes)
Frequency of
response
Estimated annual burden
(hours)
10,000
10,000
20
20
15
15
50,000
50,000
Totals ........................................................................................................
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Request for Evidence from a Doctor (HA–66) ................................................
Request for Evidence from a Hospital (HA–67) ..............................................
20,000
........................
........................
100,000
2. Development for Participation in a
Vocational Rehabilitation or Similar
Program—20 CFR 404.316(c),
404.337(c), 404.352(d), 404.1586(g),
404.1596, 404.1597(a), 404.327,
404.328, and 416.1338(c) and (d)
416.1320(d), 416.1331(a)–(b), and
416.1338–0960–0282. State Disability
Determination Services must determine
if a recipient of disability benefits
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16:27 Nov 29, 2007
Jkt 214001
whose disability has ceased but who is
enrolled in a vocational rehabilitation
program can continue to receive SSA
benefits. To do this, information is
needed about the beneficiary, the type
of program he/she is enrolled in, and
the types of services the beneficiary is
receiving under the auspices of that
program. Form SSA–4290 is used to
collect this information. The
PO 00000
Frm 00082
Fmt 4703
Sfmt 4703
respondents are State employment
networks, vocational rehabilitation
agencies, or other providers of
education/job training services.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 3,000.
Frequency of Response: 1
Average Burden Per Response: 15
minutes.
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Federal Register / Vol. 72, No. 230 / Friday, November 30, 2007 / Notices
Estimated Annual Burden: 750 hours.
3. Medical Report (Individual with
Childhood Impairment)—20 CFR
404.1512–.1515 and 416.912–.915 & 20
CFR 422.125—0960–0102. The
information collected on form SSA–
3827 is used by SSA to determine the
childhood claimant’s physical status
prior to making a disability
determination and to document the
childhood disability claims folder with
the medical evidence. The respondents
are members of the medical community,
and include physicians, hospital
directors, medical records librarians,
and other medical personnel.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 12,000.
Frequency of Response: 1.
Average Burden per Response: 30
minutes.
Estimated Annual Burden: 6,000
hours.
4. Disability Hearing Officer’s Report
of Disability Hearing (DC)—SSA–1204–
BK—0906–0507. The information
collected on form SSA–1204–BK is used
by the Disability Hearing Officer (DHO)
to conduct and document disability
hearings, and to provide a structured
format that covers all conceivable issues
relating to SSI claims for disabled
children. The completed SSA–1204–BK
will aid the DHO in preparing the
disability decision and will provide a
record of what transpired in the hearing.
The respondents are DHO’s in the State
Disability Determination Services.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 2,000.
Frequency of Response: 1.
Average Burden per Response: 60
minutes.
Estimated Annual Burden: 2,000
hours.
Number of respondents
SSA–1020 (paper application form) ................................................................
i1020 (online equivalent) .................................................................................
.
Totals ........................................................................................................
rwilkins on PROD1PC63 with NOTICES
Notes: (1) When SSA published the 60-day
Notice for this collection on September 14,
2007 at 72 FR 52594, we described this as a
revision. However, since that time OMB has
determined that our proposed revisions were
non-substantive in nature and has approved
them. We are therefore now listing this
collection as an extension. A list of the nonsubstantive changes SSA made are available
if the public requests them. (2) The number
of respondents completing the i1020 is
greater and the number of respondents using
the paper SSA–1020 is less than the numbers
reported in the 60-day Federal Register
Notice for this collection. The reason for this
change is that SSA received updated data on
the percentage of respondents using the
i1020 since the 60-day Federal Register
Notice published.
6. Appeal of Determination for Help
with Medicare Prescription Drug Plan
Costs—0960–0695. The Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003 (Pub. L. 108–
173; MMA) established a new Medicare
Part D program for voluntary
prescription drug coverage for premium,
deductible and cost-sharing subsidies
for certain low-income individuals. The
MMA stipulates that subsidies must be
available for individuals who are
eligible for the program and who meet
eligibility criteria for help with
premium, deductible, and/or copayment costs. Form SSA–1021, the
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16:27 Nov 29, 2007
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Frm 00083
Fmt 4703
Sfmt 4703
Estimated annual burden
(hours)
1
1
35
45
1,485,001
285,296
2,926,110
........................
........................
1,770,297
Dated: November 26, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. E7–23253 Filed 11–29–07; 8:45 am]
PO 00000
Average burden per response
(minutes)
Frequency of
response
2,545,716
380,394
Appeal of Determination for Help with
Medicare Prescription Drug Plan Costs,
was developed to obtain information
from individuals who appeal SSA’s
decisions regarding eligibility or
continuing eligibility for a Medicare
Part D subsidy. The respondents are
applicants who are appealing SSA’s
eligibility or continuing eligibility
decisions.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 75,000.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 12,500
hours.
BILLING CODE 4191–02–P
5. Application for Help with Medicare
Prescription Drug Plan Costs—20 CFR
418.3101—0960–0696. Medicare Part D,
codified in 20 CFR 418, provides
voluntary prescription drug coverage of
premium, deductible, and co-payment
costs for certain low-income
individuals. As per 20 CFR 418.3101,
beneficiaries who meet eligibility
criteria may receive help with these
Medicare Part D costs. The Social
Security Administration, which helps to
administer the subsidy program, uses
form SSA–1020 (the Application for
Help with Medicare Prescription Drug
Plan Costs) and its online equivalent,
the i1020, to collect information that
will be used to make Medicare Part D
subsidy determinations. The
respondents are eligible beneficiaries
who want to apply for help with
Medicare Part D costs.
Type of Request: Extension of an
OMB-approved information collection.
DEPARTMENT OF STATE
[Public Notice 5999]
Termination of Statutory Debarment
and Reinstatement of Eligibility To
Apply for Export/Retransfer
Authorizations Pursuant to Section
38(g)(4) of the Arms Export Control
Act, for Morris Rothenberg & Son, Inc.
(d/b/a ROTHCO)
ACTION:
Notice.
SUMMARY: Notice is hereby given that
the Department of State has terminated
the statutory debarment against Morris
Rothenberg & Son, Inc. (d/b/a ROTHCO)
pursuant to section 38(g)(4) of the Arms
Export Control Act (AECA) (22 U.S.C.
2778(g)(4)).
EFFECTIVE DATE: November 20, 2007.
FOR FURTHER INFORMATION CONTACT:
David C. Trimble, Director Office of
Defense Trade Controls Compliance,
Directorate of Defense Trade Controls,
Bureau of Political-Military Affairs,
Department of State (202) 663–2807.
SUPPLEMENTARY INFORMATION: Section
38(g)(4) of the AECA (22 U.S.C. 2778)
prohibits the issuance of export licenses
to a person, if that person or any party
to the export has been convicted of
violating section 38 of the AECA and
E:\FR\FM\30NON1.SGM
30NON1
]]>Agencies
[Federal Register Volume 72, Number 230 (Friday, November 30, 2007)]
[Notices]
[Pages 67776-67778]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-23253]
=======================================================================
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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 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, faxed or emailed 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, E-mail address: OIRA--Submission@omb.eop.gov.
(SSA), Social Security Administration, DCBFM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235,
Fax: 410-965-6400, E-mail address: OPLM.RCO@ssa.gov.
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. Request for Review of Hearing Decision/Order--20 CFR 404.967-
404.981, 416.1467-416.1481--0960-0277. The HA-520 is needed in order to
afford claimants their statutory right under the Social Security Act
and implementing regulations to request review of an Administrative Law
Judge's (ALJ) hearing decision or dismissal of a hearing request on
title II and title XVI claims. An individual may request Appeals
Council review by filing a written request. A completed HA-520 ensures
that SSA receives the information necessary to establish that the
claimant filed the request for review within the prescribed time, and
that the claimant has completed the requisite steps to permit review by
the Appeals Council. The Appeals Council also uses the information to
document the claimant's reason(s) for disagreeing with the ALJ' s
decision or dismissal, to determine whether the claimant has additional
evidence to submit, and to determine whether the claimant has a
representative or wants to appoint one. The respondents are claimants
requesting review of an ALJ's decision or dismissal of hearing on
Social Security.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 16,667 hours.
2. Epidemiological Research Report--20 CFR 401.165--0960-0701.
Section 311 of the Social Security Independence and Program
Improvements Act of 1994 directed SSA to provide support to health
researchers involved in epidemiological research. Specifically, when a
study is determined to contribute to a national health interest, SSA
will furnish information to determine whether a study subject is shown
on the SSA administrative records as being alive or deceased (vital
status). SSA will recoup all expenses incurred in providing this
information. Web-posted questions solicit the information SSA needs to
provide the data and to collect the fees. The requestors are scientific
researchers who are applying to receive vital status information about
individuals from Social Security administrative data records.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 30.
Frequency of Response: 1.
Average Burden Per Response: 120 minutes.
Estimated Annual Burden: 60 hours.
3. Work Activity Report (Self-Employed Person)--20 CFR 404.1520(b),
404.1571-404.1576, 404.1584-404.1593, and 416.971-416.976--0960-0598.
The information on Form SSA-820-F4 is used by SSA to determine initial
or continuing eligibility for Supplemental Security Income (SSI) or
Social Security disability benefits. Under titles II and XVI of the
Act, applicants for disability
[[Page 67777]]
benefits must prove an inability to perform any kind of Substantial
Gainful Activity (SGA) generally available in the national economy for
which they might be expected to qualify on the basis of age, education,
and work experience. SSA needs to secure information about this work in
order to ascertain whether the applicant was (or is) engaging in SGA.
Work after a claimant becomes entitled can cause the cessation of
disability benefits. The information obtained from form SSA-820-F4 is
needed to determine if a cessation of benefits should occur. The
respondents are applicants and claimants for SSI or Social Security
disability benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 50,000 hours
4. Student Reporting Form--20 CFR 404.352(b)(2), 404.368, 404.415,
404.434, 422.135--0960-0088. The information collected by form SSA-1383
is used by SSA to determine the impact of reported events on Social
Security student beneficiaries' continuing entitlement to these
benefits.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 75,000.
Frequency of Response: 1.
Average Burden Per Response: 6 minutes.
Estimated Annual Burden: 7,500 hours.
5. Electronic Death Registration (EDR)--20 CFR 404.301; 404.310-
311; 404.316; 404.330-341;404.350-352; and 404.371; 416.912--0960-0700.
SSA has contracted with the States to obtain death certificate
information in order to compare it to SSA's payment files. This match
ensures the accuracy of our payment files by detecting unreported or
inaccurate dates of deaths of beneficiaries. Entitlement to retirement,
disability, wife's, husband's or parent's benefits under the provisions
of the Social Security Act terminates when the beneficiary dies.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average cost Estimated
Collection format Number of Frequency of responses per record annual cost
respondents request burden
----------------------------------------------------------------------------------------------------------------
State Death Match--Manual Process..... 35 50,000 per State........ $0.72 $1,260,000
State Death Match--Electronic Death 18 50,000 per State........ 2.58 2,322,000
Registration (EDR).
-------------------------------------------------------------------------
Totals............................ 53 ........................ .............. 3,582,000
----------------------------------------------------------------------------------------------------------------
Estimated Annual Cost for all respondents:
**Please note that both of these data matching processes are
entirely electronic and there is no hourly burden for the respondent to
provide this information. The cost burdens are based on the four cost
components incurred by the respondents:
--software
--hardware
--average annual salaries of database management personnel
--average annual salaries of support personnel
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 Evidence from Doctor or Hospital--20 CFR 404 Subpart
I and 20 CFR 416 Subpart P--0960-0722. Claimants are required to
provide medical evidence of their impairment(s) in pursuing a
disability claim under titles II and XVI of the Social Security Act.
The HA-66 and HA-67 will be used by adjudicators of the Office of
Disability Adjudication and Review (ODAR), the component of the Social
Security Administration (SSA) that oversees the Administrative Law
Judge (ALJ) hearing level. The letters will be used to request medical
evidence from medical and other sources the claimant identifies as
having information relative to his or her impairments or ability to do
work-related activities. The respondents are doctors and hospitals
where the claimant has been evaluated.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Form type Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Request for Evidence from a Doctor (HA-66)...... 10,000 20 15 50,000
Request for Evidence from a Hospital (HA-67).... 10,000 20 15 50,000
---------------------------------------------------------------
Totals...................................... 20,000 .............. .............. 100,000
----------------------------------------------------------------------------------------------------------------
2. Development for Participation in a Vocational Rehabilitation or
Similar Program--20 CFR 404.316(c), 404.337(c), 404.352(d),
404.1586(g), 404.1596, 404.1597(a), 404.327, 404.328, and 416.1338(c)
and (d) 416.1320(d), 416.1331(a)-(b), and 416.1338-0960-0282. State
Disability Determination Services must determine if a recipient of
disability benefits whose disability has ceased but who is enrolled in
a vocational rehabilitation program can continue to receive SSA
benefits. To do this, information is needed about the beneficiary, the
type of program he/she is enrolled in, and the types of services the
beneficiary is receiving under the auspices of that program. Form SSA-
4290 is used to collect this information. The respondents are State
employment networks, vocational rehabilitation agencies, or other
providers of education/job training services.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 3,000.
Frequency of Response: 1
Average Burden Per Response: 15 minutes.
[[Page 67778]]
Estimated Annual Burden: 750 hours.
3. Medical Report (Individual with Childhood Impairment)--20 CFR
404.1512-.1515 and 416.912-.915 & 20 CFR 422.125--0960-0102. The
information collected on form SSA-3827 is used by SSA to determine the
childhood claimant's physical status prior to making a disability
determination and to document the childhood disability claims folder
with the medical evidence. The respondents are members of the medical
community, and include physicians, hospital directors, medical records
librarians, and other medical personnel.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 12,000.
Frequency of Response: 1.
Average Burden per Response: 30 minutes.
Estimated Annual Burden: 6,000 hours.
4. Disability Hearing Officer's Report of Disability Hearing (DC)--
SSA-1204-BK--0906-0507. The information collected on form SSA-1204-BK
is used by the Disability Hearing Officer (DHO) to conduct and document
disability hearings, and to provide a structured format that covers all
conceivable issues relating to SSI claims for disabled children. The
completed SSA-1204-BK will aid the DHO in preparing the disability
decision and will provide a record of what transpired in the hearing.
The respondents are DHO's in the State Disability Determination
Services.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 2,000.
Frequency of Response: 1.
Average Burden per Response: 60 minutes.
Estimated Annual Burden: 2,000 hours.
5. Application for Help with Medicare Prescription Drug Plan
Costs--20 CFR 418.3101--0960-0696. Medicare Part D, codified in 20 CFR
418, provides voluntary prescription drug coverage of premium,
deductible, and co-payment costs for certain low-income individuals. As
per 20 CFR 418.3101, beneficiaries who meet eligibility criteria may
receive help with these Medicare Part D costs. The Social Security
Administration, which helps to administer the subsidy program, uses
form SSA-1020 (the Application for Help with Medicare Prescription Drug
Plan Costs) and its online equivalent, the i1020, to collect
information that will be used to make Medicare Part D subsidy
determinations. The respondents are eligible beneficiaries who want to
apply for help with Medicare Part D costs.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1020 (paper application form)............... 2,545,716 1 35 1,485,001
i1020 (online equivalent)....................... 380,394 1 45 285,296
Totals...................................... 2,926,110 .............. .............. 1,770,297
----------------------------------------------------------------------------------------------------------------
Notes: (1) When SSA published the 60-day Notice for this
collection on September 14, 2007 at 72 FR 52594, we described this
as a revision. However, since that time OMB has determined that our
proposed revisions were non-substantive in nature and has approved
them. We are therefore now listing this collection as an extension.
A list of the non-substantive changes SSA made are available if the
public requests them. (2) The number of respondents completing the
i1020 is greater and the number of respondents using the paper SSA-
1020 is less than the numbers reported in the 60-day Federal
Register Notice for this collection. The reason for this change is
that SSA received updated data on the percentage of respondents
using the i1020 since the 60-day Federal Register Notice published.
6. Appeal of Determination for Help with Medicare Prescription Drug
Plan Costs--0960-0695. The Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (Pub. L. 108-173; MMA) established a new
Medicare Part D program for voluntary prescription drug coverage for
premium, deductible and cost-sharing subsidies for certain low-income
individuals. The MMA stipulates that subsidies must be available for
individuals who are eligible for the program and who meet eligibility
criteria for help with premium, deductible, and/or co-payment costs.
Form SSA-1021, the Appeal of Determination for Help with Medicare
Prescription Drug Plan Costs, was developed to obtain information from
individuals who appeal SSA's decisions regarding eligibility or
continuing eligibility for a Medicare Part D subsidy. The respondents
are applicants who are appealing SSA's eligibility or continuing
eligibility decisions.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 75,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 12,500 hours.
Dated: November 26, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E7-23253 Filed 11-29-07; 8:45 am]
BILLING CODE 4191-02-P
