Agency Information Collection Activities: Proposed Request and Comment Request, 2642-2644 [E9-596]
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Federal Register / Vol. 74, No. 10 / Thursday, January 15, 2009 / Notices
SOCIAL SECURITY ADMINISTRATION
jlentini on PROD1PC65 with NOTICES
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
by the Office of Management and
Budget (OMB) in compliance with
Public Law (Pub. L.) 104–13, the
Paperwork Reduction Act of 1995,
effective October 1, 1995. This notice
includes a revision to an OMB-approved
information collection.
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 ways to
minimize the burden on respondents,
including the use of automated
collection techniques or other forms of
information technology. Mail, e-mail, or
fax your comments and
recommendations on the information
collection(s) to the OMB Desk Officer
and the SSA Reports Clearance Officer
to the addresses or 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, 1332 Annex Building, 6401
Security Blvd., Baltimore, MD 21235,
Fax: 410–965–6400, E-mail address:
OPLM.RCO@ssa.gov.
I. The information collection below is
pending at SSA. SSA will submit it to
OMB within 60 days from the date of
this notice. Therefore, your comments
would be most helpful if you submit
them to SSA within 60 days from the
date of this publication. Individuals can
obtain copies of the collection
instrument by calling the SSA Reports
Clearance Officer at 410–965–3758 or by
writing to the e-mail address listed
above.
1. Physician’s/Medical Officer’s
Statement of Patient’s Capability to
Manage Benefits—20 CFR 404.2015 and
416.615—0960–0024. SSA uses the
information collected on Form SSA–787
to determine an individual’s capability
to handle his or her own benefits. This
information assists SSA in determining
the need for a representative payee. The
respondents are physicians of the
beneficiaries’ or medical officers of the
institution in which the recipients
reside.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 24,000.
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Jkt 217001
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 6,000
hours.
2. Letter to Employer Requesting Wage
Information—20 CFR 404.726—0960–
0138. SSA uses Form SSA–L4201 to
collect information from employers to
establish and/or verify wage information
for Supplemental Security Income (SSI)
claimants and recipients. SSA also uses
the information to determine eligibility
and proper payment for SSI. The
respondents are employers of applicants
for and recipients of SSI payments.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 133,000.
Frequency of Response: 1.
Average Burden per Response: 30
minutes.
Estimated Annual Burden: 66,500
hours.
3. Statement of Living Arrangements,
In-Kind Support and Maintenance—20
CFR 416.1130–416.1148—0960–0174.
SSA uses Form SSA–8006–F4 to
establish in-kind support and
maintenance for SSI applicants and
recipients. A recipient’s need is the
basis for determining SSI payments.
Need is measured, in part, by the
amount of income an individual
receives. Income includes in-kind
support and maintenance in the form of
food and shelter provided by other
persons. Form SSA–8006–F4 collects
information to ensure that recipients are
eligible to receive SSI payments and to
determine the correct amount of
payments due. The information permits
SSA Administrative Law Judges to
determine the income value of in-kind
support and maintenance received by
SSI applicants and recipients. The
respondents are individuals who apply
for SSI payments, or complete an SSI
eligibility redetermination.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 173,380.
Frequency of Response: 1.
Average Burden per Response: 7
minutes.
Estimated Annual Burden: 20,228
hours.
4. Supplemental Security Income
(SSI) Claim Information Notice—20 CFR
416.210—0960–0324. SSA uses Form
SSA–L8050–U3 to collect information
on whether an SSI recipient is using all
sources of potential income for his or
her own support. SSI supplements other
income an individual has available.
Respondents are SSI applicants or
recipients who may be eligible for
benefits from public or private
programs.
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Fmt 4703
Sfmt 4703
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 7,500.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 1,250
hours.
5. Permanent Residence Under Color
of the Law (PRUCOL)—20 CFR 416.1615
and 416.1618—0960–0451. As
discussed in SSA regulations at 20 CFR
416.1415 and 416.1618, a PRUCOL alien
must present evidence of his/her alien
status at application and periodically
thereafter as part of the eligibility
determination process for SSI. SSA
verifies the validity of the evidence of
PRUCOL for grandfathered nonqualified
aliens with the Department of
Homeland Security (DHS). Based on the
DHS response, SSA will determine
whether the individual is PRUCOL.
Without this information, SSA is unable
to determine whether the individual is
eligible for SSI payments. The
respondents are individuals who have
alien status and live in the United Sates.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 1,300.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 108 hours.
6. QuickStart Automated Enrollment
System—31 CFR 210—0960–0564. The
financial institutions (FIs) collect Direct
Deposit (DD)/Electronic Funds Transfer
(EFT) information from their depositors
who are enrolling for the first time, or
who are changing DD/EFT information.
Information needed to enroll under
QuickStart is included in the
Department of Treasury’s Green Book,
which is available online. The
Department of Treasury’s Green Book
provides the data elements the recipient
completes in order to enroll in direct
deposit. The recipient submits the DD/
EFT information electronically;
therefore, it is not an SSA-prescribed
form used to send information to
Government agencies. SSA collects this
information to facilitate electronic
payment of funds. The respondents are
Social Security, SSI recipients, and their
FIs.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 3,950,000.
Frequency of Response: 1.
Average Burden per Response: 3
minutes.
Estimated Annual Burden: 197,500
hours.
7. Certification of Low Birth Weight
for SSI Eligibility of Funds You
Provided to Another and Statement of
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Federal Register / Vol. 74, No. 10 / Thursday, January 15, 2009 / Notices
Funds You Received—20 CFR 416.931,
416.926a(m), (7) and (8) and 416.924—
0960–0720. Form SSA–3830 assists
hospitals and claimants who file on
behalf of children in providing local
field offices (FOs) and Disability
Determination Services (DDSs) with
medical information for determining
disability of low birth weight infants.
FOs use the forms as protective filing
statements, and the medical information
for making presumptive disability
findings, which allow expedited
payment to eligible claimants. DDSs use
the medical information to determine
disability and the most appropriate
continuing disability review diaries.
The respondents are hospitals that have
information identifying low birth weight
babies and medical conditions those
babies may have.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 24,000.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 6,000
hours.
II. SSA has submitted the information
collections listed below 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
410–965–3758, or by writing to the
above listed address.
1. Application for Mother’s or Father’s
Insurance Benefits—20 CFR 404.339–
404.342, 20 CFR 404.601–404.603—
0960–0003. The Social Security Act
provides for the payment of monthly
benefits to the widow or widower of an
insured individual if the surviving
spouse is caring for the deceased
worker’s child who is entitled to Social
Security benefits. SSA uses the
information collected on Form SSA–5–
F6 to entitle an individual to their
mother’s or father’s insurance benefits
under the Old Age, Survivors and
Disability Insurance (OASDI) program.
SSA published this information
collection in the 60-day Federal
Register Notice on October 27, 2008 at
FR 63761 as an extension of an OMBapproved information collection. Since
then SSA made revisions and has
changed the type of request to a revision
to an OMB-approved information
collection.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Collection method
Estimated
completion
time
(minutes)
Burden hours
26,045
26,044
1,611
15
14
15
6,511
6,077
403
Totals ....................................................................................................................................
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MCS .............................................................................................................................................
MCS/Signature Proxy ..................................................................................................................
Paper ...........................................................................................................................................
53,700
........................
12,991
2. Supplement to Claim of Person
Outside the United States—20 CFR
404.460, 404.463, 422.505(b), 42 CFR
407.27(c)—0960–0051. SSA uses the
information it collects on Form SSA–21
to determine continuing entitlement to
Social Security benefits and the proper
benefit amounts of alien beneficiaries
living outside the United States. SSA
also uses the information to determine
whether benefits are subject to
withholding tax. The respondents are
individuals entitled to Social Security
benefits who are, will be, or have been
residing outside the United States.
Type of Request: Revision of an OMB
approved information collection.
Number of Respondents: 35,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 5,833
hours.
3. Coverage of Employees of State and
Local Governments—20 CFR 404,
Subpart M—0960–0425. The Code of
Federal Regulations at 20 CFR 404,
Subpart M prescribes the rules for states
submitting reports of deposits and
related recordkeeping to SSA. States
(and interstate instrumentalities) are
required to provide wage and depositrelated contribution information for pre1987 periods. The respondents are state
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18:58 Jan 14, 2009
Jkt 217001
and local governments or interstate
instrumentalities.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 52.
Frequency of Response: 1.
Average Burden per Response: 1 hour.
Estimated Annual Burden: 52 hours.
4. Marital Relationship
Questionnaire—20 CFR 416.1826—
0960–0460. SSA collects information on
Form SSA–4178 to determine, for SSI
purposes, whether unrelated
individuals of the opposite sex who live
together are holding themselves out to
the public as husband and wife. SSA
needs this information to determine
whether we are making correct
payments to SSI couples and
individuals. The respondents are
applicants for and recipients of SSI
payments.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 5,100.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 425 hours.
5. Medical Report on Child with
Allegation of Human Immunodeficiency
Virus Infection—20 CFR 416.993–416–
994—0960–0500. SSA uses Forms SSA–
4814–F5 and SSA–4815–F6 to collect
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Fmt 4703
Sfmt 4703
information necessary to determine if an
individual with Human
Immunodeficiency Virus (HIV) infection
who is applying for SSI disability
benefits, meets the requirements for
presumptive disability payments. The
respondents are the medical sources of
the applicants for SSI disability
payments.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 59,100.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 9,850.
6. Public Information Campaign—
0960–0544. Periodically, SSA sends
various public information materials,
including public service
announcements, news releases, and
educational tapes, to public
broadcasting systems so they can inform
the public about various programs and
activities conducted by SSA. SSA will
frequently send follow-up business
reply cards for these public information
materials to obtain suggestions for
improving them. The respondents are
media sources who have received public
information campaign materials (e.g.,
broadcast television and radio media
sources).
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Federal Register / Vol. 74, No. 10 / Thursday, January 15, 2009 / Notices
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 6,000.
Frequency of Response: 2.
Average Burden per Response: 1
minute.
Estimated Annual Burden: 200 hours.
7. Application to Collect a Fee for
Payee Services—416.640.640(a),
416.1103(f)—0960–0719. SSA uses
information it collects on Form SSA–
445 to determine whether to authorize
or deny permission to collect fees for
payee services. The respondents are
private sector businesses or state and
local government offices applying to
become a fee-for-service organizational
representative payee. SSA published
this information collection in the 60-day
Federal Register Notice on September
17, 2008 at FR 53919 as an extension of
an OMB-approved information
collection. Since then SSA made
revisions and has changed the type of
request to a revision to an OMBapproved information collection.
Type of Request: Revision to an OMBapproved information collection.
Number of Respondents: 100.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 17 hours.
Dated: January 8, 2009.
John Biles,
Reports Clearance Officer, Center for Reports
Clearance, Social Security Administration.
[FR Doc. E9–596 Filed 1–14–09; 8:45 am]
also determine that the exhibition or
display of the exhibit objects at the
Houston Museum of National Science,
Houston, TX, from on or about February
28, 2009, until on or about September 7,
2009; Denver Museum of Nature and
Science, Denver, CO, from on or about
October 10, 2009, until on or about
February 7, 2010, and at possible
additional exhibitions or venues yet to
be determined, is in the national
interest. Public Notice of these
Determinations is ordered to be
published in the Federal Register.
FOR FURTHER INFORMATION CONTACT: For
further information, including a list of
the exhibit objects, contact Julie
Simpson, Attorney-Adviser, Office of
the Legal Adviser, U.S. Department of
State (telephone: (202–453–8050)). The
address is U.S. Department of State, SA–
44, 301 4th Street, SW., Room 700,
Washington, DC 20547–0001.
Determinations is ordered to be
published in the Federal Register.
Dated: January 6, 2009.
C. Miller Crouch,
Principal Deputy Assistant Secretary for
Educational and Cultural Affairs, Department
of State.
[FR Doc. E9–657 Filed 1–14–09; 8:45 am]
Culturally Significant Objects Imported
for Exhibition Determinations: ‘‘Wine,
Worship and Sacrifice: The Golden
Graves of Ancient Vani’’
BILLING CODE 4710–05–P
ACTION:
DEPARTMENT OF STATE
[Public Notice 6482]
Culturally Significant Objects Imported
for Exhibition Determinations: ‘‘The El
Peru-Waka Archaeological Project’’
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice 6481]
jlentini on PROD1PC65 with NOTICES
Culturally Significant Objects Imported
for Exhibition Determinations:
‘‘Genghis Khan’’
SUMMARY: Notice is hereby given of the
following determinations: Pursuant to
the authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, Delegation of Authority
No. 236 of October 19, 1999, as
amended, and Delegation of Authority
No. 257 of April 15, 2003 [68 FR 19875],
I hereby determine that the objects in
the exhibition: ‘‘Genghis Khan,’’
imported from abroad for temporary
exhibition within the United States, are
of cultural significance. The objects are
imported pursuant to a loan agreement
with the foreign owner or custodian. I
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18:58 Jan 14, 2009
Jkt 217001
SUMMARY: Notice is hereby given of the
following determinations: Pursuant to
the authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, Delegation of Authority
No. 236 of October 19, 1999, as
amended, and Delegation of Authority
No. 257 of April 15, 2003 [68 FR 19875],
I hereby determine that the objects to be
included in the exhibition ‘‘The El PeruWaka Archaeological Project,’’ imported
from abroad for temporary exhibition
within the United States, are of cultural
significance. The objects are imported
pursuant to loan agreements with the
foreign owners or custodians. I also
determine that the exhibition or display
of the exhibit objects at the Kimbell Art
Museum, Fort Worth, TX, from on or
about July 19, 2009, until on or about
December 6, 2009, and at possible
additional exhibitions or venues yet to
be determined, is in the national
interest. Public Notice of these
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Fmt 4703
Sfmt 4703
FOR FURTHER INFORMATION CONTACT: For
further information, including a list of
the exhibit objects, contact Carol B.
Epstein, Attorney-Adviser, Office of the
Legal Adviser, U.S. Department of State
(telephone: 202/453–8048). The address
is U.S. Department of State, SA–44, 301
4th Street, SW., Room 700, Washington,
DC 20547–0001.
Dated: January 6, 2009.
C. Miller Crouch,
Principal Deputy Assistant Secretary for
Educational and Cultural Affairs, Department
of State.
[FR Doc. E9–660 Filed 1–14–09; 8:45 am]
BILLING CODE 4710–05–P
DEPARTMENT OF STATE
[Public Notice 6483]
Department of State.
Notice, correction.
AGENCY:
SUMMARY: On October 11, 2007, notice
was published on page 57987 of the
Federal Register (volume 72, number
196) of determinations made by the
Department of State pertaining to the
exhibition ‘‘Wine, Worship and
Sacrifice: The Golden Graves of Ancient
Vani.’’ On December 27, 2007, the
referenced notice was corrected on page
73415 of the Federal Register (volume
72, number 247) as to two additional
objects to be included in the exhibition.
The referenced notice is again corrected
here as to two additional objects to be
included in the exhibition. Notice is
hereby given of the following
determinations: Pursuant to the
authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, Delegation of Authority
No. 236 of October 19, 1999, as
amended, and Delegation of Authority
No. 257 of April 15, 2003 [68 FR 19875],
I hereby determine that the objects to be
included in the exhibition ‘‘Wine,
Worship and Sacrifice: The Golden
Graves of Ancient Vani,’’ imported from
abroad for temporary exhibition within
the United States, are of cultural
significance. The objects are imported
pursuant to loan agreements with the
foreign owners or custodians. I also
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[Federal Register Volume 74, Number 10 (Thursday, January 15, 2009)]
[Notices]
[Pages 2642-2644]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-596]
[[Page 2642]]
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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 requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law (Pub. L.)
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995.
This notice includes a revision to an OMB-approved information
collection.
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 ways to minimize the
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Mail, e-mail, or
fax your comments and recommendations on the information collection(s)
to the OMB Desk Officer and the SSA Reports Clearance Officer to the
addresses or 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, 1332 Annex Building, 6401 Security Blvd., Baltimore, MD 21235,
Fax: 410-965-6400, E-mail address: OPLM.RCO@ssa.gov.
I. The information collection below is pending at SSA. SSA will
submit it to OMB within 60 days from the date of this notice.
Therefore, your comments would be most helpful if you submit them to
SSA within 60 days from the date of this publication. Individuals can
obtain copies of the collection instrument by calling the SSA Reports
Clearance Officer at 410-965-3758 or by writing to the e-mail address
listed above.
1. Physician's/Medical Officer's Statement of Patient's Capability
to Manage Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA uses
the information collected on Form SSA-787 to determine an individual's
capability to handle his or her own benefits. This information assists
SSA in determining the need for a representative payee. The respondents
are physicians of the beneficiaries' or medical officers of the
institution in which the recipients reside.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 24,000.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 6,000 hours.
2. Letter to Employer Requesting Wage Information--20 CFR 404.726--
0960-0138. SSA uses Form SSA-L4201 to collect information from
employers to establish and/or verify wage information for Supplemental
Security Income (SSI) claimants and recipients. SSA also uses the
information to determine eligibility and proper payment for SSI. The
respondents are employers of applicants for and recipients of SSI
payments.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 133,000.
Frequency of Response: 1.
Average Burden per Response: 30 minutes.
Estimated Annual Burden: 66,500 hours.
3. Statement of Living Arrangements, In-Kind Support and
Maintenance--20 CFR 416.1130-416.1148--0960-0174. SSA uses Form SSA-
8006-F4 to establish in-kind support and maintenance for SSI applicants
and recipients. A recipient's need is the basis for determining SSI
payments. Need is measured, in part, by the amount of income an
individual receives. Income includes in-kind support and maintenance in
the form of food and shelter provided by other persons. Form SSA-8006-
F4 collects information to ensure that recipients are eligible to
receive SSI payments and to determine the correct amount of payments
due. The information permits SSA Administrative Law Judges to determine
the income value of in-kind support and maintenance received by SSI
applicants and recipients. The respondents are individuals who apply
for SSI payments, or complete an SSI eligibility redetermination.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 173,380.
Frequency of Response: 1.
Average Burden per Response: 7 minutes.
Estimated Annual Burden: 20,228 hours.
4. Supplemental Security Income (SSI) Claim Information Notice--20
CFR 416.210--0960-0324. SSA uses Form SSA-L8050-U3 to collect
information on whether an SSI recipient is using all sources of
potential income for his or her own support. SSI supplements other
income an individual has available. Respondents are SSI applicants or
recipients who may be eligible for benefits from public or private
programs.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 7,500.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 1,250 hours.
5. Permanent Residence Under Color of the Law (PRUCOL)--20 CFR
416.1615 and 416.1618--0960-0451. As discussed in SSA regulations at 20
CFR 416.1415 and 416.1618, a PRUCOL alien must present evidence of his/
her alien status at application and periodically thereafter as part of
the eligibility determination process for SSI. SSA verifies the
validity of the evidence of PRUCOL for grandfathered nonqualified
aliens with the Department of Homeland Security (DHS). Based on the DHS
response, SSA will determine whether the individual is PRUCOL. Without
this information, SSA is unable to determine whether the individual is
eligible for SSI payments. The respondents are individuals who have
alien status and live in the United Sates.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 1,300.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 108 hours.
6. QuickStart Automated Enrollment System--31 CFR 210--0960-0564.
The financial institutions (FIs) collect Direct Deposit (DD)/Electronic
Funds Transfer (EFT) information from their depositors who are
enrolling for the first time, or who are changing DD/EFT information.
Information needed to enroll under QuickStart is included in the
Department of Treasury's Green Book, which is available online. The
Department of Treasury's Green Book provides the data elements the
recipient completes in order to enroll in direct deposit. The recipient
submits the DD/EFT information electronically; therefore, it is not an
SSA-prescribed form used to send information to Government agencies.
SSA collects this information to facilitate electronic payment of
funds. The respondents are Social Security, SSI recipients, and their
FIs.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 3,950,000.
Frequency of Response: 1.
Average Burden per Response: 3 minutes.
Estimated Annual Burden: 197,500 hours.
7. Certification of Low Birth Weight for SSI Eligibility of Funds
You Provided to Another and Statement of
[[Page 2643]]
Funds You Received--20 CFR 416.931, 416.926a(m), (7) and (8) and
416.924--0960-0720. Form SSA-3830 assists hospitals and claimants who
file on behalf of children in providing local field offices (FOs) and
Disability Determination Services (DDSs) with medical information for
determining disability of low birth weight infants. FOs use the forms
as protective filing statements, and the medical information for making
presumptive disability findings, which allow expedited payment to
eligible claimants. DDSs use the medical information to determine
disability and the most appropriate continuing disability review
diaries. The respondents are hospitals that have information
identifying low birth weight babies and medical conditions those babies
may have.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 24,000.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 6,000 hours.
II. SSA has submitted the information collections listed below 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 410-965-3758,
or by writing to the above listed address.
1. Application for Mother's or Father's Insurance Benefits--20 CFR
404.339-404.342, 20 CFR 404.601-404.603--0960-0003. The Social Security
Act provides for the payment of monthly benefits to the widow or
widower of an insured individual if the surviving spouse is caring for
the deceased worker's child who is entitled to Social Security
benefits. SSA uses the information collected on Form SSA-5-F6 to
entitle an individual to their mother's or father's insurance benefits
under the Old Age, Survivors and Disability Insurance (OASDI) program.
SSA published this information collection in the 60-day Federal
Register Notice on October 27, 2008 at FR 63761 as an extension of an
OMB-approved information collection. Since then SSA made revisions and
has changed the type of request to a revision to an OMB-approved
information collection.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated
Collection method Number of completion Burden hours
respondents time (minutes)
----------------------------------------------------------------------------------------------------------------
MCS............................................................. 26,045 15 6,511
MCS/Signature Proxy............................................. 26,044 14 6,077
Paper........................................................... 1,611 15 403
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Totals...................................................... 53,700 .............. 12,991
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2. Supplement to Claim of Person Outside the United States--20 CFR
404.460, 404.463, 422.505(b), 42 CFR 407.27(c)--0960-0051. SSA uses the
information it collects on Form SSA-21 to determine continuing
entitlement to Social Security benefits and the proper benefit amounts
of alien beneficiaries living outside the United States. SSA also uses
the information to determine whether benefits are subject to
withholding tax. The respondents are individuals entitled to Social
Security benefits who are, will be, or have been residing outside the
United States.
Type of Request: Revision of an OMB approved information
collection.
Number of Respondents: 35,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 5,833 hours.
3. Coverage of Employees of State and Local Governments--20 CFR
404, Subpart M--0960-0425. The Code of Federal Regulations at 20 CFR
404, Subpart M prescribes the rules for states submitting reports of
deposits and related recordkeeping to SSA. States (and interstate
instrumentalities) are required to provide wage and deposit-related
contribution information for pre-1987 periods. The respondents are
state and local governments or interstate instrumentalities.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 52.
Frequency of Response: 1.
Average Burden per Response: 1 hour.
Estimated Annual Burden: 52 hours.
4. Marital Relationship Questionnaire--20 CFR 416.1826--0960-0460.
SSA collects information on Form SSA-4178 to determine, for SSI
purposes, whether unrelated individuals of the opposite sex who live
together are holding themselves out to the public as husband and wife.
SSA needs this information to determine whether we are making correct
payments to SSI couples and individuals. The respondents are applicants
for and recipients of SSI payments.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 5,100.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 425 hours.
5. Medical Report on Child with Allegation of Human
Immunodeficiency Virus Infection--20 CFR 416.993-416-994--0960-0500.
SSA uses Forms SSA-4814-F5 and SSA-4815-F6 to collect information
necessary to determine if an individual with Human Immunodeficiency
Virus (HIV) infection who is applying for SSI disability benefits,
meets the requirements for presumptive disability payments. The
respondents are the medical sources of the applicants for SSI
disability payments.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 59,100.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 9,850.
6. Public Information Campaign--0960-0544. Periodically, SSA sends
various public information materials, including public service
announcements, news releases, and educational tapes, to public
broadcasting systems so they can inform the public about various
programs and activities conducted by SSA. SSA will frequently send
follow-up business reply cards for these public information materials
to obtain suggestions for improving them. The respondents are media
sources who have received public information campaign materials (e.g.,
broadcast television and radio media sources).
[[Page 2644]]
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 6,000.
Frequency of Response: 2.
Average Burden per Response: 1 minute.
Estimated Annual Burden: 200 hours.
7. Application to Collect a Fee for Payee Services--416.640.640(a),
416.1103(f)--0960-0719. SSA uses information it collects on Form SSA-
445 to determine whether to authorize or deny permission to collect
fees for payee services. The respondents are private sector businesses
or state and local government offices applying to become a fee-for-
service organizational representative payee. SSA published this
information collection in the 60-day Federal Register Notice on
September 17, 2008 at FR 53919 as an extension of an OMB-approved
information collection. Since then SSA made revisions and has changed
the type of request to a revision to an OMB-approved information
collection.
Type of Request: Revision to 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: January 8, 2009.
John Biles,
Reports Clearance Officer, Center for Reports Clearance, Social
Security Administration.
[FR Doc. E9-596 Filed 1-14-09; 8:45 am]
BILLING CODE 4191-02-P
