Agency Information Collection Activities: Proposed Request and Comment Request, 27379-27380 [E9-13316]
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Federal Register / Vol. 74, No. 109 / Tuesday, June 9, 2009 / Notices
those that may be withheld from the
public in accordance with the
provisions of 5 U.S.C. 552, will be
available for inspection and copying in
the Commission’s Public Reference
Room, on official business days between
the hours of 10 a.m. and 3 p.m. Copies
of such filing also will be available for
inspection and copying at the principal
office of the Exchange. All comments
received will be posted without change;
the Commission does not edit personal
identifying information from
submissions. You should submit only
information that you wish to make
available publicly. All submissions
should refer to File Number SR–
NYSEAmex–2009–19 and should be
submitted on or before June 30, 2009.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.30
Florence E. Harmon,
Deputy Secretary.
[FR Doc. E9–13394 Filed 6–8–09; 8:45 am]
BILLING CODE 8010–01–P
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages 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 revisions and extensions of
OMB-approved information collections
and a new 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 shown
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
30 17
CFR 200.30–3(a)(12).
VerDate Nov<24>2008
14:45 Jun 08, 2009
Jkt 217001
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. To be sure we consider your
comments, we must receive them no
later than August 10, 2009. 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 we list
above.
1. Psychiatric Review Technique—20
CFR 404.1520a, 416.920a—0960–0413.
The SSA–2506–BK assists the Disability
Determination Services (DDS) offices in
evaluating mental impairments by
helping to organize and present the
mental findings in a clear, concise, and
consistent manner; consider and
evaluate all aspects of the mental
impairment relevant to the individual’s
ability to perform work-related mental
functions; and identify additional
evidence needed to determine
impairment severity.
The respondents are the State DDSs
and Federal DDSs administering the
Title II and Title XVI programs.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 54.
Frequency of Response: 27,553.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 371,966
hours.
2. Certificate of Election for Reduced
Spouse’s Benefits—20 CFR 404.421—
0960–0398. Reduced benefits are not
payable to an already entitled spouse, at
least age 62 but under full retirement
age, who no longer has a child in care
unless the spouse elects to receive
reduced benefits. If a spouse decides to
elect reduced benefits, they must
complete Form SSA–25. SSA uses the
information collected on Form SSA–25
to pay a qualified spouse who elects to
receive a reduced benefit. Respondents
are entitled spouses seeking reduced
benefits.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 30,000.
Frequency of Response: 1.
Average Burden per Response: 2
minutes.
Estimated Annual Burden: 1,000
hours.
II. SSA has submitted the information
collections we list below to OMB for
clearance. Your comments on the
information collections would be most
useful if OMB and SSA receive them
PO 00000
Frm 00104
Fmt 4703
Sfmt 4703
27379
within 30 days from the date of this
publication. To be sure we consider
your comments, we must receive them
no later than July 9, 2009. 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 e-mail address.
1. Statement of Employer—20 CFR
404.801–404.803—0960–0030. SSA uses
Form SSA–7011–F4 to substantiate
allegations of wages paid to workers
when those wages do not appear in
SSA’s records of earnings and the
worker does not have proof of those
earnings. SSA uses the information from
this form to process claims for Social
Security benefits and to resolve
discrepancies in the individual’s Social
Security earnings record. We only send
Form SSA–7011–F4 to employers if we
deem it necessary. We make every effort
to locate the earnings information
within our records before we contact the
employer. The respondents are
employers who can verify wage
allegations made by wage earners.
Note: This is a correction notice. SSA
published this information collection as an
extension on April 07, 2009 at 74 FR 15808.
Since we are revising the Privacy Act
Statement, this is now a revision of an OMBapproved information collection.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 925,000.
Frequency of Response: 1.
Average Burden per Response: 20
minutes.
Estimated Annual Burden: 308,333
hours.
2. Statement of Claimant or Other
Person—20 CFR 404.702 & 416.570—
0960–0045. SSA uses the SSA–795 to
obtain information from claimants or
other persons having knowledge of facts
in connection with claims for
Supplemental Security Income (SSI) or
Social Security benefits when there is
no standard form to collect the needed
information. SSA uses the information
to process claims for benefits or for
ongoing issues related to the above
programs. The respondents are
applicants/recipients of SSI or Social
Security benefits, or others who are in
a position to provide information
pertinent to the claim(s).
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 305,500.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 76,375
hours.
3. Statement of Self-Employment
Income—20 CFR 404.101, 404.110,
E:\FR\FM\09JNN1.SGM
09JNN1
27380
Federal Register / Vol. 74, No. 109 / Tuesday, June 9, 2009 / Notices
404.1096(a)–(d)—0960–0046. SSA
collects the information on Form SSA–
766 to expedite the payment of benefits
to an individual who is self-employed
and who is establishing insured status.
The form elicits the information
necessary to determine if the individual
will have the minimum amount of selfemployment income for quarters of
coverage. Respondents are selfemployed individuals who may be
eligible for Social Security benefits.
Note: This is a correction notice. SSA
published this information collection as an
extension on April 7, 2009 at 74 FR 15808.
Since we are revising the Privacy Act
Statement, this is now a revision of an OMBapproved information collection.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 2,500.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 417 hours.
4. Certification by Religious Group—
20 CFR 404.1075—0960–0093. SSA uses
information from Form SSA–1458 to
determine whether a religious group
meets the qualifications contained in
Section 1402(g) of the Internal Revenue
Code, which exempts members of
certain religious groups and sects from
payment of Self-Employment
Contribution Act taxes. The respondents
are spokespersons for religious groups
or sects.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 180.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 45 hours.
5. Instructions for Completion of
Federal Assistance Application—0960–
0184. SSA uses information from Form
SSA–BK–96 to select grant proposals for
funding based on their technical merits.
This information assists the agency 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 of
the respondents. The respondents are
State and local governments, Statedesignated protection and advocacy
groups, colleges and universities and
profit and nonprofit private
organizations.
Note: This is a correction notice. SSA
published this information collection as an
extension on April 7, 2009 at 74 FR 15808.
Since we are revising the Privacy Act
Statement, this is now a revision of an OMBapproved information collection.
VerDate Nov<24>2008
14:45 Jun 08, 2009
Jkt 217001
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 400.
Frequency of Response: 2 hours.
Average Burden per Response: 14
hours.
Estimated Annual Burden: 11,200
hours.
6. Representative Payee Report—
Special Veterans Benefits—20 CFR
408.665—0960–0621. Title VIII of the
Social Security Act allows the payment
of monthly benefits (referred to as
Special Veterans Benefits) by the
Commissioner of Social Security to
qualified World War II veterans who
reside outside the United States. An
SSA-appointed representative payee
may receive and manage the monthly
payment for the beneficiary’s use and
benefit. SSA uses the Form SSA–2001–
F6 to determine if the payee 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 Special Veterans
Benefits.
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.
7. Request for Deceased Individual’s
Social Security Record—20 CFR
402.130—0960–0665. SSA uses the
Form SSA–711 to process requests from
the public for a microprint of the SS–
5, Application for Social Security Card,
for a deceased individual. Respondents
are members of the public who are
requesting deceased individuals’ Social
Security records.
Note: This is a correction notice. SSA
published this information collection as an
extension on April 7, 2009 at 74 FR 15808.
Since we are revising the Privacy Act
Statement, this is now a revision of OMBapproved information.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden per Response: 7
minutes.
Estimated Annual Burden: 5,834
hours.
8. Request for Business Entity
Taxpayer Information—0960–0731. SSA
uses the SSA–1694 to collect
information from law firms or other
business entities that have partners or
employees to facilitate direct payment
of SSA-authorized fees for representing
claimants before SSA. SSA will use this
information to meet any requirement for
PO 00000
Frm 00105
Fmt 4703
Sfmt 4703
issuance of a Form 1099–MISC. The
respondent law firms or other business
entities that represent claimants before
SSA.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 2,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 333 hours.
Type of Request: Revision of an OMBapproved information collection.
9. Electronic Records Express—0960–
0753. Electronic Records Express (ERE)
is a Web-based SSA program that allows
medical providers to electronically
submit disability claimant data to SSA.
Medical providers and other third
parties with connections to disability
applicants/recipients can use this
system. This information collection
request (ICR) includes the registration
process for becoming a certified ERE
user. We are expanding this ICR to
include increased functionality by
giving medical providers the ability to
submit invoices electronically. The
respondents are medical providers who
evaluate or treat disability claimants/
recipients and other third parties.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 17,689.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 2,948
hours.
III. Correction Notices
1. Function Report Adult—Third
Party—20 CFR 404.1512 & 416.912—
0960–0635. This is a correction notice:
SSA inadvertently published duplicate
notices for this collection at 74 FR
23764 on 5/20/09 and again at 74 FR
23916 on 5/21/09. The first publication
was in error. Therefore, we request
comments only for the second
publication with a submission date no
later than July 20, 2009.
2. Function Report Adult—20 CFR
404.1512 & 416.912—0960–0681. This is
a correction notice: SSA inadvertently
published duplicate notices for this
collection at 74 FR 23764 on 5/20/09
and again at 74 FR 23916 on 5/21/09.
The first publication was in error.
Therefore, we request comments only
for the second publication with a
submission date no later than July 20,
2009.
Dated: June 2, 2009.
John Biles,
Reports Clearance Officer, Center for Reports
Clearance, Social Security Administration.
[FR Doc. E9–13316 Filed 6–8–09; 8:45 am]
BILLING CODE 4191–02–P
E:\FR\FM\09JNN1.SGM
09JNN1
]]>Agencies
[Federal Register Volume 74, Number 109 (Tuesday, June 9, 2009)]
[Notices]
[Pages 27379-27380]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-13316]
=======================================================================
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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 revisions and extensions of OMB-approved
information collections and a new 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 shown 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. To be
sure we consider your comments, we must receive them no later than
August 10, 2009. 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 we list above.
1. Psychiatric Review Technique--20 CFR 404.1520a, 416.920a--0960-
0413. The SSA-2506-BK assists the Disability Determination Services
(DDS) offices in evaluating mental impairments by helping to organize
and present the mental findings in a clear, concise, and consistent
manner; consider and evaluate all aspects of the mental impairment
relevant to the individual's ability to perform work-related mental
functions; and identify additional evidence needed to determine
impairment severity.
The respondents are the State DDSs and Federal DDSs administering
the Title II and Title XVI programs.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 54.
Frequency of Response: 27,553.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 371,966 hours.
2. Certificate of Election for Reduced Spouse's Benefits--20 CFR
404.421--0960-0398. Reduced benefits are not payable to an already
entitled spouse, at least age 62 but under full retirement age, who no
longer has a child in care unless the spouse elects to receive reduced
benefits. If a spouse decides to elect reduced benefits, they must
complete Form SSA-25. SSA uses the information collected on Form SSA-25
to pay a qualified spouse who elects to receive a reduced benefit.
Respondents are entitled spouses seeking reduced benefits.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 30,000.
Frequency of Response: 1.
Average Burden per Response: 2 minutes.
Estimated Annual Burden: 1,000 hours.
II. SSA has submitted the information collections we list below to
OMB for clearance. Your comments on the information collections would
be most useful if OMB and SSA receive them within 30 days from the date
of this publication. To be sure we consider your comments, we must
receive them no later than July 9, 2009. 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 e-mail address.
1. Statement of Employer--20 CFR 404.801-404.803--0960-0030. SSA
uses Form SSA-7011-F4 to substantiate allegations of wages paid to
workers when those wages do not appear in SSA's records of earnings and
the worker does not have proof of those earnings. SSA uses the
information from this form to process claims for Social Security
benefits and to resolve discrepancies in the individual's Social
Security earnings record. We only send Form SSA-7011-F4 to employers if
we deem it necessary. We make every effort to locate the earnings
information within our records before we contact the employer. The
respondents are employers who can verify wage allegations made by wage
earners.
Note: This is a correction notice. SSA published this
information collection as an extension on April 07, 2009 at 74 FR
15808. Since we are revising the Privacy Act Statement, this is now
a revision of an OMB-approved information collection.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 925,000.
Frequency of Response: 1.
Average Burden per Response: 20 minutes.
Estimated Annual Burden: 308,333 hours.
2. Statement of Claimant or Other Person--20 CFR 404.702 &
416.570--0960-0045. SSA uses the SSA-795 to obtain information from
claimants or other persons having knowledge of facts in connection with
claims for Supplemental Security Income (SSI) or Social Security
benefits when there is no standard form to collect the needed
information. SSA uses the information to process claims for benefits or
for ongoing issues related to the above programs. The respondents are
applicants/recipients of SSI or Social Security benefits, or others who
are in a position to provide information pertinent to the claim(s).
Type of Request: Revision 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. Statement of Self-Employment Income--20 CFR 404.101, 404.110,
[[Page 27380]]
404.1096(a)-(d)--0960-0046. SSA collects the information on Form SSA-
766 to expedite the payment of benefits to an individual who is self-
employed and who is establishing insured status. The form elicits the
information necessary to determine if the individual will have the
minimum amount of self-employment income for quarters of coverage.
Respondents are self-employed individuals who may be eligible for
Social Security benefits.
Note: This is a correction notice. SSA published this
information collection as an extension on April 7, 2009 at 74 FR
15808. Since we are revising the Privacy Act Statement, this is now
a revision of an OMB-approved information collection.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 2,500.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 417 hours.
4. Certification by Religious Group--20 CFR 404.1075--0960-0093.
SSA uses information from Form SSA-1458 to determine whether a
religious group meets the qualifications contained in Section 1402(g)
of the Internal Revenue Code, which exempts members of certain
religious groups and sects from payment of Self-Employment Contribution
Act taxes. The respondents are spokespersons for religious groups or
sects.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 180.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 45 hours.
5. Instructions for Completion of Federal Assistance Application--
0960-0184. SSA uses information from Form SSA-BK-96 to select grant
proposals for funding based on their technical merits. This information
assists the agency 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 of the respondents. The
respondents are State and local governments, State-designated
protection and advocacy groups, colleges and universities and profit
and nonprofit private organizations.
Note: This is a correction notice. SSA published this
information collection as an extension on April 7, 2009 at 74 FR
15808. Since we are revising the Privacy Act Statement, this is now
a revision of an OMB-approved information collection.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 400.
Frequency of Response: 2 hours.
Average Burden per Response: 14 hours.
Estimated Annual Burden: 11,200 hours.
6. Representative Payee Report--Special Veterans Benefits--20 CFR
408.665--0960-0621. Title VIII of the Social Security Act allows the
payment of monthly benefits (referred to as Special Veterans Benefits)
by the Commissioner of Social Security to qualified World War II
veterans who reside outside the United States. An SSA-appointed
representative payee may receive and manage the monthly payment for the
beneficiary's use and benefit. SSA uses the Form SSA-2001-F6 to
determine if the payee 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 Special
Veterans Benefits.
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.
7. Request for Deceased Individual's Social Security Record--20 CFR
402.130--0960-0665. SSA uses the Form SSA-711 to process requests from
the public for a microprint of the SS-5, Application for Social
Security Card, for a deceased individual. Respondents are members of
the public who are requesting deceased individuals' Social Security
records.
Note: This is a correction notice. SSA published this
information collection as an extension on April 7, 2009 at 74 FR
15808. Since we are revising the Privacy Act Statement, this is now
a revision of OMB-approved information.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden per Response: 7 minutes.
Estimated Annual Burden: 5,834 hours.
8. Request for Business Entity Taxpayer Information--0960-0731. SSA
uses the SSA-1694 to collect information from law firms or other
business entities that have partners or employees to facilitate direct
payment of SSA-authorized fees for representing claimants before SSA.
SSA will use this information to meet any requirement for issuance of a
Form 1099-MISC. The respondent law firms or other business entities
that represent claimants before SSA.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 2,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 333 hours.
Type of Request: Revision of an OMB-approved information
collection.
9. Electronic Records Express--0960-0753. Electronic Records
Express (ERE) is a Web-based SSA program that allows medical providers
to electronically submit disability claimant data to SSA. Medical
providers and other third parties with connections to disability
applicants/recipients can use this system. This information collection
request (ICR) includes the registration process for becoming a
certified ERE user. We are expanding this ICR to include increased
functionality by giving medical providers the ability to submit
invoices electronically. The respondents are medical providers who
evaluate or treat disability claimants/recipients and other third
parties.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 17,689.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 2,948 hours.
III. Correction Notices
1. Function Report Adult--Third Party--20 CFR 404.1512 & 416.912--
0960-0635. This is a correction notice: SSA inadvertently published
duplicate notices for this collection at 74 FR 23764 on 5/20/09 and
again at 74 FR 23916 on 5/21/09. The first publication was in error.
Therefore, we request comments only for the second publication with a
submission date no later than July 20, 2009.
2. Function Report Adult--20 CFR 404.1512 & 416.912--0960-0681.
This is a correction notice: SSA inadvertently published duplicate
notices for this collection at 74 FR 23764 on 5/20/09 and again at 74
FR 23916 on 5/21/09. The first publication was in error. Therefore, we
request comments only for the second publication with a submission date
no later than July 20, 2009.
Dated: June 2, 2009.
John Biles,
Reports Clearance Officer, Center for Reports Clearance, Social
Security Administration.
[FR Doc. E9-13316 Filed 6-8-09; 8:45 am]
BILLING CODE 4191-02-P
