Agency Information Collection Activities: Proposed Request and Comment Request, 59336-59338 [E9-27510]

Download as PDF 59336 Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices affiliations). In addition, SSA will use the information to meet any requirement to issue a Form 1099–MISC to law firms or other business entities pursuant to sections 6041 and 6045(f) of the Internal Revenue Code. The respondents are law firms or other business entities that wish to serve as appointed representatives and receive direct payment of fees. Type of Request: Revision to an OMBapproved information collection. Number of Respondents: 8,000. Frequency of Response: 1. Average Burden Per Response: 20 minutes. to do business with us; (2) allows them access to our records for the claimants they represent; (3) facilitates direct payment of authorized fees to appointed representatives; and (4) collects information needed to meet Internal Revenue Service (IRS) requirements to issue specific IRS forms, if we pay these representatives in excess of a specific amount. This ICR is for changes we will implement to the collection in 2010. The respondents are appointed claimant representatives. Type of Request: Revision to an OMBapproved information collection. Estimated Annual Burden: 2,667 hours. 3. Appointed Representative Services—0960–0732. SSA uses Form SSA–1699 to register: • Individuals appointed as representatives; • Individuals who will perform advocacy services on behalf of an appointed representative; • Individuals who will act on behalf of an appointed representative and want access to our electronic services; and • Individuals who will serve as administrators for an entity appointed as a representative. By registering these individuals, SSA: (1) Authenticates and authorizes them Number of respondents Modality of completion Average burden per response (minutes) Frequency of response Estimated annual burden (hours) SSA–1699 (paper form) ................................................................................... Internet-based SSA–1699 ............................................................................... 52,800 13,200 1 1 30 22 26,400 4,840 Totals ........................................................................................................ 66,000 ........................ ........................ 31,240 Dated: November 10, 2009, Elizabeth A. Davidson, Director, Center for Reports Clearance Social Security Administration. [FR Doc. E9–27509 Filed 11–16–09; 8:45 am] (OMB) Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 202– 395–6974, E-mail address: OIRA_Submion@omb.eop.gov. BILLING CODE 4191–02–P (SSA) Social Security Administration, DCBFM, Attn: Director, Center for Reports Clearance, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410–965– 0454, 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 January 19, 2010. Individuals can obtain copies of the collection instrument by calling the SSA Director for Reports Clearance at 410–965–0454 or by writing to the above email address. 1. Important Information about Your Appeal, Waiver Rights and Repayment Options—20 CFR 404.502–521–0960– NEW. SSA uses Form SSA–3105 in an overpayment situation to explain the claimant’s rights to reconsideration, waiver, or a different repayment rate. Claimants use Form SSA–3105 to inform SSA they do not agree with SSA’s initial overpayment determination, they are unable to repay the overpayment, or to request a waiver for repayment to SSA. The respondents are individuals who are overpaid claimants who are requesting a waiver of recovery for the overpayment, SOCIAL SECURITY ADMINISTRATION mstockstill on DSKH9S0YB1PROD 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 revisions and extensions 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 ways to minimize the burden on respondents, including the use of automated collection techniques or other forms of information technology. Mail, email, or fax your comments and recommendations on the information collection(s) to the OMB Desk Officer and the SSA Director for Reports Clearance to the addresses or fax numbers shown below. VerDate Nov<24>2008 20:50 Nov 16, 2009 Jkt 220001 PO 00000 Frm 00224 Fmt 4703 Sfmt 4703 reconsideration of the fact of the overpayment, or a lesser rate of withholding of the overpayment. Type of Request: New information collection. Number of Respondents: 800,000. Frequency of Response: 1. Average Burden per Response: 15 minutes. Estimated Annual Burden: 200,000 hours. 2. Notification of a Social Security Number (SSN) to an Employer for Wage Reporting—20 CFR 422.103–0960– NEW. Individuals applying for employment must provide an SSN or indicate they have applied for one. The information SSA collects on Form SSA– 112 allows SSA to send, at the individual’s request, the individual’s SSN to his or her employer. Mailing this information to the employer ensures the employer has the correct SSN for the individual, allows SSA to receive correct earnings information for wage reporting purposes for the individual, and reduces the delay between the initial SSN assignment and delivery of the SSN information to the employer. The respondents are individuals who are applying for an initial SSN and request to have the information mailed to their employer. Type of Request: New information collection. Number of Respondents: 375,000. Frequency of Response: 1. Average Burden per Response: 2 minutes. E:\FR\FM\17NON1.SGM 17NON1 59337 Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices Estimated Annual Burden: 12,500 hours. 3. Statement for Determining Continuing Eligibility, Supplemental Security Income Payment(s)—416.204– 0960–0416. SSA uses the information from the SSA–8203–BK for high-errorprofile redeterminations of disability to determine whether Supplemental Security Income (SSI) recipients have met and continue to meet all statutory and regulatory requirements for SSI eligibility and whether they have been, and are still receiving, the correct payment amount. Periodic collection of this information is the only way SSA can make these determinations, and collection of this information is mandatory under the law. The Number of respondents Collection method information is normally completed in field offices by personal contact (face-toface or telephone interview) using the automated Modernized SSI Claim System (MSSICS). The respondents are SSI recipients or their representative payees. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated annual burden (hours) 94,568 31,522 31,522 1 1 1 20 19 20 31,523 9,982 10,507 Totals ........................................................................................................ mstockstill on DSKH9S0YB1PROD with NOTICES MSSICS ........................................................................................................... MSSICS/Signature Proxy ................................................................................ Paper ............................................................................................................... 157,612 ........................ ........................ 52,012 4. Pain Report Child—20 CFR 416.912 and 416.512—0960–0540. Disability interviewers and applicants/claimants in self-help situations use Form SSA– 3371–BK to record information about pain or other symptoms of a child who is claiming disability. The State Disability Determination Services adjudicators and administrative law judges use this information to assess the effects of symptoms on functionality to help make a disability determination. The respondents are applicants for SSI payments. Type of Request: Extension of an OMB-approved information collection. Number of Respondents: 250,000. Frequency of Response: 1. Average Burden per Response: 15 minutes. Estimated Annual Burden: 62,500 hours. 5. Internet Direct Deposit Application—31 CFR 210—0960–0634. SSA uses Direct Deposit/Electronic Funds Transfer (DD/EFT) enrollment information received from beneficiaries to facilitate DD/EFT of their Social Security benefits with a financial institution. Respondents are Social Security beneficiaries who use the Internet to enroll in DD/EFT. Type of Request: Extension of an OMB-approved information collection. Number of Respondents: 90,000. Frequency of Response: 1. Average Burden per Response: 10 minutes. Estimated Annual Burden: 15,000 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 OMB and SSA receive them within 30 days from the date of this VerDate Nov<24>2008 20:50 Nov 16, 2009 Jkt 220001 publication. To be sure we consider your comments, we must receive them no later than December 17, 2009. You can obtain a copy of the OMB clearance packages by calling the SSA Director for Reports Clearance at 410–965–0454 or by writing to the above e-mail address. 1. Blood Donor Locator Service (BDLS)—20 CFR 401.200—0960–0501. This regulation stipulates when blood donor facilities identify blood donations as Human Immunodeficiency Virus (HIV)-positive, the overseeing state agency must provide the names and SSNs of the affected donors to SSA’s BDLS. SSA uses this information to furnish the state agencies with the blood donors’ address information to notify the blood donors. Respondents are state agencies acting on behalf of blood donor facilities. Type of Request: Extension of an OMB-approved information collection. Number of Respondents: 10. Frequency of Response: 5. Average Burden per Response: 15 minutes. Estimated Annual Burden: 13 hours. 2. Representative Payee Report of Benefits and Dedicated Account—20 CFR 416.546, 416.635, 416.640, 416.665—0960–0576. SSA requires representative payees (RP) to submit a written report accounting for their use of money paid to Social Security and/ or SSI recipients and to establish and maintain a dedicated account for these payments. SSA uses Form SSA–6233 to ensure RPs are using the benefits received for the recipient’s current maintenance and personal needs, and the expenditures of funds from the dedicated account comply with the law. Respondents are RPs for SSI recipients. Note: This is a correction notice. SSA published this information collection as an PO 00000 Frm 00225 Fmt 4703 Sfmt 4703 extension on September 2, 2009, at 74 FR 4408. 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: 30,000. Frequency of Response: 1. Average Burden per Response: 20 minutes. Estimated Annual Burden: 10,000 hours. 3. Medical Consultant’s Review of Psychiatric Review Technique Form— 20 CFR 404.1520a, 404.1640, 404.1643, 404.1645, 416.920a—0960–0677. Form SSA–3023 is a program evaluation form SSA’s regional review component uses to facilitate the contract medical/ psychological consultant’s review of the Psychiatric Review Technique Form (PRTF). SSA–3023 records the reviewing medical/psychological consultant’s assessment of the PRTF. The medical/psychological consultant only completes Form SSA–3023 when an adjudicating component’s PRTF is in the file. Form SSA–3023 is required for each PRTF completed. The respondents are medical/psychological consultants who review the PRTF for quality purposes. Note: This is a correction notice. SSA published this information collection as an extension on September 2, 2009, at 74 FR 45508. 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: 344. Frequency of Response: 165. Average Burden per Response: 12 minutes. Estimated Annual Burden: 11,352 hours. E:\FR\FM\17NON1.SGM 17NON1 59338 Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices Dated: November 10, 2009. Elizabeth A. Davidson, Director, Center for Reports Clearance, Social Security Administration. [FR Doc. E9–27510 Filed 11–16–09; 8:45 am] BILLING CODE 4191–02–P SOCIAL SECURITY ADMINISTRATION Agency Information Collection Activities: 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 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, email, or fax your comments and recommendations on the information collection(s) to the OMB Desk Officer and the SSA Director for Clearance 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: Director, Center Clearance Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410–965– 6400, E-mail address: OPLM.RCO@ssa.gov. I. SSA has submitted the information collection we list below to OMB for clearance. Your comments on the information collection 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 December 17, 2009. You can obtain a copy of the OMB clearance package by calling the SSA Director for Reports Clearance at 410–965–0454 or by writing to the above email address. 1. Social Security Benefits Application—20 CFR 404.310–.311, .315–.322, .330–.333, 601–.603, and .1501–.1512—0960–0618. This collection comprises the various application modalities for retirement, survivors, and disability benefits. These modalities include paper forms (SSA Forms SSA–1, SSA–2, and SSA–16), Modernized Claims System (MCS) screens for in-person field office interview applications, and the Internet based iClaim application. This information collection request (ICR) will expand the potential user base for iClaim. Type of Collection: Revision to an existing Office of Management and Budget-approved information collection. Paper Forms/Accompanying MCS Screens/Burden Information: FORM SSA–1 Frequency of response Average burden per response (min) 172,200 1,549,800 21,000 299,000 1,000 2,043,000 1 1 1 1 1 ........................ 11 10 11 7 7 ........................ 31,570 258,300 3,850 34,883 117 328,720 36,860 331,740 3,800 372,400 1 1 1 ........................ 15 14 15 ........................ 9,215 77,406 950 87,571 218,657 1,967,913 24,161 2,210,731 1 1 1 ........................ 20 19 20 ........................ 72,886 623,172 8,054 704,112 1 1 1 1 ........................ 15 5 15 10 ........................ 7,030 2,343 135,463 33,333 178,169 Number of respondents Collection method MCS ................................................................................................................. MCS/Signature Proxy ...................................................................................... Paper ............................................................................................................... Medicare-only MCS ......................................................................................... Medicare-only Paper ........................................................................................ Totals ........................................................................................................ Estimated annual burden (hours) Form SSA–2: MCS ................................................................................................................. MCS/Signature Proxy ...................................................................................... Paper ............................................................................................................... Totals ........................................................................................................ Form SSA–16: MCS ................................................................................................................. MCS/Signature Proxy ...................................................................................... Paper ............................................................................................................... Totals ........................................................................................................ iClaim Burden Information: mstockstill on DSKH9S0YB1PROD with NOTICES iClaim 3rd Party ............................................................................................... iClaim Applicant after 3rd Party Completion ................................................... First Party iClaim ............................................................................................. Medicare-only iClaim (new to this ICR) ........................................................... Totals ........................................................................................................ VerDate Nov<24>2008 20:50 Nov 16, 2009 Jkt 220001 PO 00000 Frm 00226 Fmt 4703 Sfmt 4703 28,118 28,118 541,851 200,000 798,087 E:\FR\FM\17NON1.SGM 17NON1

Agencies

[Federal Register Volume 74, Number 220 (Tuesday, November 17, 2009)]
[Notices]
[Pages 59336-59338]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-27510]


-----------------------------------------------------------------------

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.
    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, email, or 
fax your comments and recommendations on the information collection(s) 
to the OMB Desk Officer and the SSA Director for Reports Clearance 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_Submion@omb.eop.gov.

(SSA)

Social Security Administration, DCBFM, Attn: Director, Center for 
Reports Clearance, 1333 Annex Building, 6401 Security Blvd., Baltimore, 
MD 21235, Fax: 410-965-0454, 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 
January 19, 2010. Individuals can obtain copies of the collection 
instrument by calling the SSA Director for Reports Clearance at 410-
965-0454 or by writing to the above email address.
    1. Important Information about Your Appeal, Waiver Rights and 
Repayment Options--20 CFR 404.502-521-0960-NEW. SSA uses Form SSA-3105 
in an overpayment situation to explain the claimant's rights to 
reconsideration, waiver, or a different repayment rate. Claimants use 
Form SSA-3105 to inform SSA they do not agree with SSA's initial 
overpayment determination, they are unable to repay the overpayment, or 
to request a waiver for repayment to SSA. The respondents are 
individuals who are overpaid claimants who are requesting a waiver of 
recovery for the overpayment, reconsideration of the fact of the 
overpayment, or a lesser rate of withholding of the overpayment.
    Type of Request: New information collection.
    Number of Respondents: 800,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 200,000 hours.
    2. Notification of a Social Security Number (SSN) to an Employer 
for Wage Reporting--20 CFR 422.103-0960-NEW. Individuals applying for 
employment must provide an SSN or indicate they have applied for one. 
The information SSA collects on Form SSA-112 allows SSA to send, at the 
individual's request, the individual's SSN to his or her employer. 
Mailing this information to the employer ensures the employer has the 
correct SSN for the individual, allows SSA to receive correct earnings 
information for wage reporting purposes for the individual, and reduces 
the delay between the initial SSN assignment and delivery of the SSN 
information to the employer. The respondents are individuals who are 
applying for an initial SSN and request to have the information mailed 
to their employer.
    Type of Request: New information collection.
    Number of Respondents: 375,000.
    Frequency of Response: 1.
    Average Burden per Response: 2 minutes.

[[Page 59337]]

    Estimated Annual Burden: 12,500 hours.
    3. Statement for Determining Continuing Eligibility, Supplemental 
Security Income Payment(s)--416.204-0960-0416. SSA uses the information 
from the SSA-8203-BK for high-error-profile redeterminations of 
disability to determine whether Supplemental Security Income (SSI) 
recipients have met and continue to meet all statutory and regulatory 
requirements for SSI eligibility and whether they have been, and are 
still receiving, the correct payment amount. Periodic collection of 
this information is the only way SSA can make these determinations, and 
collection of this information is mandatory under the law. The 
information is normally completed in field offices by personal contact 
(face-to-face or telephone interview) using the automated Modernized 
SSI Claim System (MSSICS). The respondents are SSI recipients or their 
representative payees.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                Collection method                   respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
MSSICS..........................................          94,568               1              20          31,523
MSSICS/Signature Proxy..........................          31,522               1              19           9,982
Paper...........................................          31,522               1              20          10,507
                                                 ---------------------------------------------------------------
    Totals......................................         157,612  ..............  ..............          52,012
�������������������������������������������������
----------------------------------------------------------------------------------------------------------------

    4. Pain Report Child--20 CFR 416.912 and 416.512--0960-0540. 
Disability interviewers and applicants/claimants in self-help 
situations use Form SSA-3371-BK to record information about pain or 
other symptoms of a child who is claiming disability. The State 
Disability Determination Services adjudicators and administrative law 
judges use this information to assess the effects of symptoms on 
functionality to help make a disability determination. The respondents 
are applicants for SSI payments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 250,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 62,500 hours.
    5. Internet Direct Deposit Application--31 CFR 210--0960-0634. SSA 
uses Direct Deposit/Electronic Funds Transfer (DD/EFT) enrollment 
information received from beneficiaries to facilitate DD/EFT of their 
Social Security benefits with a financial institution. Respondents are 
Social Security beneficiaries who use the Internet to enroll in DD/EFT.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 90,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 15,000 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 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 December 17, 2009. You can obtain a copy of 
the OMB clearance packages by calling the SSA Director for Reports 
Clearance at 410-965-0454 or by writing to the above e-mail address.
    1. Blood Donor Locator Service (BDLS)--20 CFR 401.200--0960-0501. 
This regulation stipulates when blood donor facilities identify blood 
donations as Human Immunodeficiency Virus (HIV)-positive, the 
overseeing state agency must provide the names and SSNs of the affected 
donors to SSA's BDLS. SSA uses this information to furnish the state 
agencies with the blood donors' address information to notify the blood 
donors. Respondents are state agencies acting on behalf of blood donor 
facilities.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 10.
    Frequency of Response: 5.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 13 hours.
    2. Representative Payee Report of Benefits and Dedicated Account--
20 CFR 416.546, 416.635, 416.640, 416.665--0960-0576. SSA requires 
representative payees (RP) to submit a written report accounting for 
their use of money paid to Social Security and/or SSI recipients and to 
establish and maintain a dedicated account for these payments. SSA uses 
Form SSA-6233 to ensure RPs are using the benefits received for the 
recipient's current maintenance and personal needs, and the 
expenditures of funds from the dedicated account comply with the law. 
Respondents are RPs for SSI recipients.

    Note: This is a correction notice. SSA published this 
information collection as an extension on September 2, 2009, at 74 
FR 4408. 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: 30,000.
    Frequency of Response: 1.
    Average Burden per Response: 20 minutes.
    Estimated Annual Burden: 10,000 hours.
    3. Medical Consultant's Review of Psychiatric Review Technique 
Form--20 CFR 404.1520a, 404.1640, 404.1643, 404.1645, 416.920a--0960-
0677. Form SSA-3023 is a program evaluation form SSA's regional review 
component uses to facilitate the contract medical/psychological 
consultant's review of the Psychiatric Review Technique Form (PRTF). 
SSA-3023 records the reviewing medical/psychological consultant's 
assessment of the PRTF. The medical/psychological consultant only 
completes Form SSA-3023 when an adjudicating component's PRTF is in the 
file. Form SSA-3023 is required for each PRTF completed. The 
respondents are medical/psychological consultants who review the PRTF 
for quality purposes.

    Note: This is a correction notice. SSA published this 
information collection as an extension on September 2, 2009, at 74 
FR 45508. 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: 344.
    Frequency of Response: 165.
    Average Burden per Response: 12 minutes.
    Estimated Annual Burden: 11,352 hours.


[[Page 59338]]


    Dated: November 10, 2009.
Elizabeth A. Davidson,
Director, Center for Reports Clearance, Social Security Administration.
[FR Doc. E9-27510 Filed 11-16-09; 8:45 am]
BILLING CODE 4191-02-P