Agency Information Collection Activities: Proposed Request and Comment Request, 64801-64803 [E9-29119]
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Federal Register / Vol. 74, No. 234 / Tuesday, December 8, 2009 / Notices
post all comments on the Commission’s
Internet Web site (https://www.sec.gov/
rules/sro.shtml). Copies of the
submission, all subsequent
amendments, all written statements
with respect to the proposed rule
change that are filed with the
Commission, and all written
communications relating to the
proposed rule change between the
Commission and any person, other than
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
Section, 100 F Street, NE., Washington,
DC 20549, on official business days
between the hours of 10 a.m. and 3 p.m.
Copies of such filings also will be
available for inspection and copying at
the principal office of NSCC and on
NSCC’s Web site at https://
www.dtcc.com/legal/rule_filings/nscc/
2009.php. 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–NSCC–
2009–09 and should be submitted on or
before December 29, 2009.
For the Commission by the Division of
Trading and Markets, pursuant to delegated
authority.8
Florence E. Harmon,
Deputy Secretary.
[FR Doc. E9–29132 Filed 12–7–09; 8:45 am]
BILLING CODE 8011–01–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 to 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 February 8, 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 e-mail
address.
1. Farm Self-Employment
Questionnaire—20 CFR 404.1082(c) &
404.1095—0960–0061. Section 211(a) of
the Social Security Act requires the
existence of a trade or business as a
prerequisite for determining whether an
Number of
respondents
Form number
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
SSA–637 ..............................................................................
SSA–639 ..............................................................................
Totals ....................................................................................
3. Certification of Prisoner Identity
Information—20 CFR 422.107—0960–
0688. This regulation stipulates when a
valid agreement is in place, prison
officials verify the identity of certain
incarcerated U.S. citizens who need
8 17
2,001
9,341
11,342
individual or partnership may have net
earnings from self-employment. During
a personal interview, the requesting
Social Security field office uses Form
SSA–7165 to elicit the information
necessary to determine the existence of
an agricultural trade or business and
subsequent covered earnings for Social
Security entitlement purposes. The
respondents are applicants for Social
Security benefits, whose entitlement
depends on whether the worker has
covered earnings from self-employment
as a farmer.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 47,500.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 7,917
hours.
2. Site Review Questionnaire for
Volume and Fee-for-Service Payees and
Beneficiary Interview Form—20 CFR
404.2035, 404.2065, 416.665, 416.701,
and 416.708—0960–0633. SSA uses the
SSA–637, Site Review Questionnaire for
Volume and Fee-for-Service Payees, to
obtain information from the payee about
how the organization operates and
carries out its representative payee
responsibilities, including how it
manages beneficiary funds. We then use
the SSA–639, Beneficiary Interview
Form, to obtain information from the
beneficiaries to help corroborate the
payee’s statements. Due to the
sensitivity of the information, SSA
employees always complete the forms
based on the answers respondents give
during the interview. The respondents
are individuals, State and local
governments, non-profit and for-profit
organizations that serve as
representative payees and the
beneficiaries they serve.
Type of Request: Extension of an
OMB-approved information collection.
Frequency
of response
Average burden
per response
(minutes)
1
1
........................
2 hours ......................................
10 minutes ................................
...................................................
replacement Social Security cards.
Information the prison officials provide
will come from the official prison files,
sent on prison letterhead. SSA uses this
information to establish the applicant’s
identity in the replacement Social
15:16 Dec 07, 2009
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Fmt 4703
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Total annual
burden
(hours)
4,002
1,557
5,559
Security card process. The respondents
are prison officials who certify the
identity of prisoners applying for
replacement Social Security cards.
Type of Request: Extension of an
OMB-approved information collection.
CFR 200.30–3(a)(12).
VerDate Nov<24>2008
64801
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Federal Register / Vol. 74, No. 234 / Tuesday, December 8, 2009 / Notices
Number of Respondents: 1,000.
Frequency of Response: 200.
Average Burden Per Response: 3
minutes.
Estimated Annual Burden: 10,000
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
SSA uses the information it collects on
the SSA–10–BK to determine whether
the applicant meets the statutory and
regulatory conditions for entitlement to
widow’s or widower’s Social Security
Title II benefits. The respondents are
applicants for widow’s or widower’s
insurance benefits.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 341,560.
within 30 days from the date of this
publication. To be sure we consider
your comments, we must receive them
no later than January 7, 2010. 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. Application for Widow’s or
Widower’s Insurance Benefits—20 CFR
404.335–404.338, 404.603—0960–0004.
Number of
respondents
Collection method
Estimated completion
time
Burden hours
MCS .................................................................................................................................
MCS/Signature Proxy ......................................................................................................
Paper ................................................................................................................................
162,241
162,241
17,078
15 minutes .................
14 minutes .................
15 minutes .................
40,560
37,856
4,270
Totals: .......................................................................................................................
341,560
....................................
82,686
Estimated Annual Burden: 82,686
hours.
2. Employment Relationship
Questionnaire—20 CFR 404.1007—
0960–0040. SSA obtains information on
Form SSA–7160–F4 to determine a
worker’s employment status; i.e.,
whether, under the definition of an
employee found in Section 210(j)(2) of
the Act and 20 CFR 404.1007 of the
Code of Federal Regulations, a worker is
an employee under the ‘‘usual common
law rules’’ applicable in determining the
existence of an employer-employee
relationship. We use the information to
develop the employment relationship
Number of
respondents
Respondent type
and to determine whether a beneficiary
is self-employed or an employee. The
respondents are individuals questioning
their status as employees and their
alleged employers.
Type of Request: Extension of an
OMB-approved information collection.
Frequency of
response
Average burden per response
(minutes)
Estimated annual burden
(hours)
8,000
7,200
800
1
1
1
25
25
25
3,333
3,000
333
Totals: .......................................................................................................
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
Individuals ........................................................................................................
Businesses .......................................................................................................
State/Local Government ..................................................................................
16,000
........................
........................
6,666
3. Substitution of Party upon Death of
Claimant—20 CFR 404.957(c)(4) and
416.1457(c)(4)—0960–0288. SSA
collects information on Form HA–539
when a claimant for Social Security or
Supplemental Security Income (SSI)
payments dies while his or her request
for a hearing is pending. The
information SSA collects establishes a
written record of the request of any
individual who asks to be made a
substitute party for a deceased claimant.
It also facilitates a decision by SSA on
who, if anyone, should become a
substitute party for the deceased. The
Administrative Law Judge and the
hearing office support staff use this
information to: (1) Establish the
relationship of the requester to the
deceased claimant; (2) determine the
substituted individual’s wishes
regarding an oral hearing or decision on
the record; and (3) admit the data into
the claimant’s official record as an
exhibit. The respondents are individuals
requesting to be made a substitute party
for a deceased claimant.
VerDate Nov<24>2008
15:16 Dec 07, 2009
Jkt 220001
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 4,000.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 333 hours.
4. Response to Notice of Revised
Determination—20 CFR 404.913–.914,
404.992(b), 416.1413–.1414 and
416.1492(d)—0960–0347. When SSA
determines that: (1) A claimant for
initial disability benefits does not
actually have a disability; or (2) the
current recipient’s disability ceased, the
agency must notify the disability
claimants/recipients of this decision. In
response to this notice, the affected
claimant and disability recipient has the
following recourse: (1) May request a
disability hearing to contest SSA’s
decision; and (2) may submit additional
information or evidence for SSA to
consider. Disability claimants,
recipients, and their representatives use
form SSA–765 to accomplish these two
actions. The respondents are disability
PO 00000
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Fmt 4703
Sfmt 4703
claimants, current disability recipients,
or their representatives.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 1,925.
Frequency of Response: 1.
Average Burden per Response: 30
minutes.
Estimated Annual Burden: 963 hours.
5. Statement of Household Expenses
and Contributions—20 CFR 416.1130–
416.1148—0960–0456. SSA uses the
information from Form SSA–8011–F3,
to determine whether the claimant or
recipient receives in-kind support and
maintenance. This is necessary to
determine the claimant’s or recipient’s
eligibility for SSI and the payment
amount. SSA does not use this form for
all claims and post eligibility
determinations. SSA uses this form only
in cases where SSA needs the
householder’s (head of household)
corroboration of in-kind support and
maintenance. Respondents are
householders where an SSI applicant or
recipient resides.
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Federal Register / Vol. 74, No. 234 / Tuesday, December 8, 2009 / Notices
Note: This is a correction notice. SSA
published this information collection as an
extension on October 06, 2009 at 74 FR
51353. 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: 400,000.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 100,000
hours.
6. Privacy and Disclosure of Official
Records and Information; Availability of
Information and Records to the Public—
20 CFR 401.40(b)&(c), 401.55(b),
401.100(a), 402.130, 402.185—0960–
0566. Under the Privacy and Disclosure
of Official Records and Information,
SSA established methods for the public
to: access their SSA records; disclose
SSA records to others; correct/amend
their SSA records; consent to release
their records; request records under the
Freedom of Information Act (FOIA); and
Number of
respondents
Type of request
request waiver/reduction of fees
normally charged for release of FOIA
records. SSA most often collects the
required information for these requests
through a written letter, with the
exception of the consent for release of
records for which there is Form SSA–
3288. Respondents are individuals
requesting access to, correction of, or
disclosure of SSA records.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average burden per response
(minutes)
Estimated annual burden
(hours)
Access to Records ...........................................................................................
Designating a Representative for Disclosure of Records ...............................
Amendment of Records ...................................................................................
Consent for Release of Records .....................................................................
FOIA Requests for Records ............................................................................
Waiver/Reduction of Fees ...............................................................................
10,000
3,000
100
3,000,000
15,000
400
1
1
1
1
1
1
11
2
10
3
5
5
1,833
6,000
17
150,000
1,250
33
Totals ........................................................................................................
3,028,500
........................
........................
159,133
7. Request for Reinstatement (Title
II)—20 CFR 404.1592b—404.1592f—
0960–0742. Through Form SSA–371,
SSA obtains a signed statement from
individuals stating a request for
Expedited Reinstatement (EXR) of their
Title II disability benefits and proof the
requestor meets the EXR requirements.
SSA maintains the form in the disability
folder of the applicant to demonstrate
the individual’s awareness of the EXR
requirements and his or her choice to
request EXR. Respondents are
individuals requesting expedited
reinstatement of their Title II disability
benefits.
WReier-Aviles on DSKGBLS3C1PROD with NOTICES
Note: This is a correction notice. SSA
published this information collection as an
extension on October 06, 2009 at 74 FR
51353. 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: 10,000.
Frequency of Response: 1.
Average Burden per Response: 2
minutes.
Estimated Annual Burden: 333 hours.
8. Request for Reinstatement (Title
XVI)—20 CFR 416.999—416.999d—
0960–0744. Through the SSA–372, SSA
obtains a signed statement from
individuals stating a request for EXR of
their Title XVI SSI payments and proof
the requestor meets the EXR
requirements. SSA maintains the form
in the disability folder of the applicant
to demonstrate the individual’s
awareness of the EXR requirements and
his or her choice to request EXR.
VerDate Nov<24>2008
15:16 Dec 07, 2009
Jkt 220001
Respondents are individuals requesting
expedited reinstatement of their Title
XVI SSI payments.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 2,000.
Frequency of Response: 1.
Average Burden per Response: 2
minutes.
Estimated Annual Burden: 67 hours.
Dated: December 2, 2009.
Elizabeth A. Davidson,
Director, Center for Reports Clearance, Social
Security Administration.
[FR Doc. E9–29119 Filed 12–7–09; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice 6832]
Town Hall Meeting To Consider the
Establishment of a U.S. Commission
on Cultural Materials Displaced During
World War II, and the Implementation
of the Art Restitution Provisions of the
June 30, 2009 Terezin Declaration
The Department of State’s Special
Envoy for Holocaust Issues is calling a
Town Hall Meeting January 7, 2010
from 1 p.m. to 4 p.m. at the Department
to get the views of interested
individuals and organizations on the
establishment of a U.S. commission on
cultural materials displaced during
World War II. The meeting will also
discuss the June 30, 2009 Terezin
Declaration, the text of which is at
PO 00000
Frm 00144
Fmt 4703
Sfmt 4703
https://www.state.gov/p/eur/rls/or/
126162.htm.
Individuals wishing to attend this
Town Hall Meeting should register no
later than January 5, 2010 by emailing
the following information to Ms.
Carolyn Jones-Johnson (JonesJohnsonCD@state.gov):
Full Name
Date of Birth
Number of Government-issued Picture
ID (Driver’s License Number,
including State of Issuance, U.S.
Passport or Alternate GovernmentIssued Picture ID)
Organization which you represent, and
its Address and Phone Number
Home Address (only if attending as an
individual)
Those who register are urged to arrive
at the Department by 12:45 p.m. to
allow time for security screening. Upon
arrival, show a valid government-issued
identification (a U.S. state driver’s
license or a U.S. passport.) The official
address of the State Department is 2201
C Street, NW., Washington, DC.
Attendees should use the ‘‘23rd Street
Entrance’’ on the West Side of the State
Department’s Harry S. Truman Building,
located on 23rd Street between C Street
and D Street, NW., Washington, DC.
Written comments on the above
subjects may also be provided to the
same e-mail address for Ms. JonesJohnson cited above.
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]]>Agencies
[Federal Register Volume 74, Number 234 (Tuesday, December 8, 2009)]
[Notices]
[Pages 64801-64803]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-29119]
=======================================================================
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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 to 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
February 8, 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 e-mail address.
1. Farm Self-Employment Questionnaire--20 CFR 404.1082(c) &
404.1095--0960-0061. Section 211(a) of the Social Security Act requires
the existence of a trade or business as a prerequisite for determining
whether an individual or partnership may have net earnings from self-
employment. During a personal interview, the requesting Social Security
field office uses Form SSA-7165 to elicit the information necessary to
determine the existence of an agricultural trade or business and
subsequent covered earnings for Social Security entitlement purposes.
The respondents are applicants for Social Security benefits, whose
entitlement depends on whether the worker has covered earnings from
self-employment as a farmer.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 47,500.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 7,917 hours.
2. Site Review Questionnaire for Volume and Fee-for-Service Payees
and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665,
416.701, and 416.708--0960-0633. SSA uses the SSA-637, Site Review
Questionnaire for Volume and Fee-for-Service Payees, to obtain
information from the payee about how the organization operates and
carries out its representative payee responsibilities, including how it
manages beneficiary funds. We then use the SSA-639, Beneficiary
Interview Form, to obtain information from the beneficiaries to help
corroborate the payee's statements. Due to the sensitivity of the
information, SSA employees always complete the forms based on the
answers respondents give during the interview. The respondents are
individuals, State and local governments, non-profit and for-profit
organizations that serve as representative payees and the beneficiaries
they serve.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Number of Frequency of Average burden per Total annual
Form number respondents response response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-637............................... 2,001 1 2 hours................. 4,002
SSA-639............................... 9,341 1 10 minutes.............. 1,557
Totals................................ 11,342 .............. ........................ 5,559
----------------------------------------------------------------------------------------------------------------
3. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. This regulation stipulates when a valid agreement is in
place, prison officials verify the identity of certain incarcerated
U.S. citizens who need replacement Social Security cards. Information
the prison officials provide will come from the official prison files,
sent on prison letterhead. SSA uses this information to establish the
applicant's identity in the replacement Social Security card process.
The respondents are prison officials who certify the identity of
prisoners applying for replacement Social Security cards.
Type of Request: Extension of an OMB-approved information
collection.
[[Page 64802]]
Number of Respondents: 1,000.
Frequency of Response: 200.
Average Burden Per Response: 3 minutes.
Estimated Annual Burden: 10,000 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 January 7, 2010. 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. Application for Widow's or Widower's Insurance Benefits--20 CFR
404.335-404.338, 404.603--0960-0004. SSA uses the information it
collects on the SSA-10-BK to determine whether the applicant meets the
statutory and regulatory conditions for entitlement to widow's or
widower's Social Security Title II benefits. The respondents are
applicants for widow's or widower's insurance benefits.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 341,560.
----------------------------------------------------------------------------------------------------------------
Number of
Collection method respondents Estimated completion time Burden hours
----------------------------------------------------------------------------------------------------------------
MCS........................................... 162,241 15 minutes...................... 40,560
MCS/Signature Proxy........................... 162,241 14 minutes...................... 37,856
Paper......................................... 17,078 15 minutes...................... 4,270
-----------------------------------------------------------------
Totals:................................... 341,560 ................................ 82,686
----------------------------------------------------------------------------------------------------------------
Estimated Annual Burden: 82,686 hours.
2. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. SSA obtains information on Form SSA-7160-F4 to determine a
worker's employment status; i.e., whether, under the definition of an
employee found in Section 210(j)(2) of the Act and 20 CFR 404.1007 of
the Code of Federal Regulations, a worker is an employee under the
``usual common law rules'' applicable in determining the existence of
an employer-employee relationship. We use the information to develop
the employment relationship and to determine whether a beneficiary is
self-employed or an employee. The respondents are individuals
questioning their status as employees and their alleged employers.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Respondent type Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Individuals..................................... 8,000 1 25 3,333
Businesses...................................... 7,200 1 25 3,000
State/Local Government.......................... 800 1 25 333
---------------------------------------------------------------
Totals:..................................... 16,000 .............. .............. 6,666
----------------------------------------------------------------------------------------------------------------
3. Substitution of Party upon Death of Claimant--20 CFR
404.957(c)(4) and 416.1457(c)(4)--0960-0288. SSA collects information
on Form HA-539 when a claimant for Social Security or Supplemental
Security Income (SSI) payments dies while his or her request for a
hearing is pending. The information SSA collects establishes a written
record of the request of any individual who asks to be made a
substitute party for a deceased claimant. It also facilitates a
decision by SSA on who, if anyone, should become a substitute party for
the deceased. The Administrative Law Judge and the hearing office
support staff use this information to: (1) Establish the relationship
of the requester to the deceased claimant; (2) determine the
substituted individual's wishes regarding an oral hearing or decision
on the record; and (3) admit the data into the claimant's official
record as an exhibit. The respondents are individuals requesting to be
made a substitute party for a deceased claimant.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 4,000.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 333 hours.
4. Response to Notice of Revised Determination--20 CFR
404.913-.914, 404.992(b), 416.1413-.1414 and 416.1492(d)--0960-0347.
When SSA determines that: (1) A claimant for initial disability
benefits does not actually have a disability; or (2) the current
recipient's disability ceased, the agency must notify the disability
claimants/recipients of this decision. In response to this notice, the
affected claimant and disability recipient has the following recourse:
(1) May request a disability hearing to contest SSA's decision; and (2)
may submit additional information or evidence for SSA to consider.
Disability claimants, recipients, and their representatives use form
SSA-765 to accomplish these two actions. The respondents are disability
claimants, current disability recipients, or their representatives.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 1,925.
Frequency of Response: 1.
Average Burden per Response: 30 minutes.
Estimated Annual Burden: 963 hours.
5. Statement of Household Expenses and Contributions--20 CFR
416.1130-416.1148--0960-0456. SSA uses the information from Form SSA-
8011-F3, to determine whether the claimant or recipient receives in-
kind support and maintenance. This is necessary to determine the
claimant's or recipient's eligibility for SSI and the payment amount.
SSA does not use this form for all claims and post eligibility
determinations. SSA uses this form only in cases where SSA needs the
householder's (head of household) corroboration of in-kind support and
maintenance. Respondents are householders where an SSI applicant or
recipient resides.
[[Page 64803]]
Note: This is a correction notice. SSA published this
information collection as an extension on October 06, 2009 at 74 FR
51353. 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: 400,000.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 100,000 hours.
6. Privacy and Disclosure of Official Records and Information;
Availability of Information and Records to the Public--20 CFR
401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185--0960-0566.
Under the Privacy and Disclosure of Official Records and Information,
SSA established methods for the public to: access their SSA records;
disclose SSA records to others; correct/amend their SSA records;
consent to release their records; request records under the Freedom of
Information Act (FOIA); and request waiver/reduction of fees normally
charged for release of FOIA records. SSA most often collects the
required information for these requests through a written letter, with
the exception of the consent for release of records for which there is
Form SSA-3288. Respondents are individuals requesting access to,
correction of, or disclosure of SSA records.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Type of request Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Access to Records............................... 10,000 1 11 1,833
Designating a Representative for Disclosure of 3,000 1 2 6,000
Records........................................
Amendment of Records............................ 100 1 10 17
Consent for Release of Records.................. 3,000,000 1 3 150,000
FOIA Requests for Records....................... 15,000 1 5 1,250
Waiver/Reduction of Fees........................ 400 1 5 33
---------------------------------------------------------------
Totals...................................... 3,028,500 .............. .............. 159,133
----------------------------------------------------------------------------------------------------------------
7. Request for Reinstatement (Title II)--20 CFR 404.1592b--
404.1592f--0960-0742. Through Form SSA-371, SSA obtains a signed
statement from individuals stating a request for Expedited
Reinstatement (EXR) of their Title II disability benefits and proof the
requestor meets the EXR requirements. SSA maintains the form in the
disability folder of the applicant to demonstrate the individual's
awareness of the EXR requirements and his or her choice to request EXR.
Respondents are individuals requesting expedited reinstatement of their
Title II disability benefits.
Note: This is a correction notice. SSA published this
information collection as an extension on October 06, 2009 at 74 FR
51353. 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: 10,000.
Frequency of Response: 1.
Average Burden per Response: 2 minutes.
Estimated Annual Burden: 333 hours.
8. Request for Reinstatement (Title XVI)--20 CFR 416.999--
416.999d--0960-0744. Through the SSA-372, SSA obtains a signed
statement from individuals stating a request for EXR of their Title XVI
SSI payments and proof the requestor meets the EXR requirements. SSA
maintains the form in the disability folder of the applicant to
demonstrate the individual's awareness of the EXR requirements and his
or her choice to request EXR. Respondents are individuals requesting
expedited reinstatement of their Title XVI SSI payments.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 2,000.
Frequency of Response: 1.
Average Burden per Response: 2 minutes.
Estimated Annual Burden: 67 hours.
Dated: December 2, 2009.
Elizabeth A. Davidson,
Director, Center for Reports Clearance, Social Security Administration.
[FR Doc. E9-29119 Filed 12-7-09; 8:45 am]
BILLING CODE 4191-02-P
