Agency Information Collection Activities: Proposed Request and Comment Request, 3778-3781 [2010-1115]
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3778
Federal Register / Vol. 75, No. 14 / Friday, January 22, 2010 / Notices
This filing addresses NASDAQ Rule
2342, which sets forth requirements for
providing information regarding the
Securities Investor Protection
Corporation (‘‘SIPC’’) to customers, and
which formerly corresponded to NASD
2342. In SR–FINRA–2009–016,4 FINRA
re-designated NASD Rule 2342 as
FINRA Rule 2266, with no material
changes. FINRA Rule 2266 requires
members, with certain exceptions, to
advise all new customers that they may
obtain information about SIPC by
contacting SIPC, and to provide SIPC’s
web site address and telephone
numbers.
NASDAQ is adopting the new FINRA
rule in full and is re-designating the rule
as NASDAQ Rule 2266, to correspond to
the new FINRA rule number.
2. Statutory Basis
The Exchange believes that the
proposed rule change is consistent with
the provisions of Section 6 of the Act,5
in general, and with Sections 6(b)(5) of
the Act,6 in particular, in that the
proposal is designed to prevent
fraudulent and manipulative acts and
practices, to promote just and equitable
principles of trade, to foster cooperation
and coordination with persons engaged
in regulating, clearing, settling,
processing information with respect to,
and facilitating transactions in
securities, to remove impediments to
and perfect the mechanism of a free and
open market and a national market
system, and, in general, to protect
investors and the public interest. The
proposed changes will conform
NASDAQ Rule 2342 to recent changes
made to a corresponding FINRA rule, to
promote application of consistent
regulatory standards.
B. Self-Regulatory Organization’s
Statement on Burden on Competition
The Exchange does not believe that
the proposed rule change will result in
any burden on competition that is not
necessary or appropriate in furtherance
of the purposes of the Act, as amended.
erowe on DSK5CLS3C1PROD with NOTICES
C. Self-Regulatory Organization’s
Statement on Comments on the
Proposed Rule Change Received From
Members, Participants, or Others
Written comments were neither
solicited nor received.
4 Securities Exchange Act Release No. 59987 (May
27, 2009), 74 FR 106 [sic] (June 4, 2009) (SR–
FINRA–2009–016).
5 15 U.S.C. 78f.
6 15 U.S.C. 78f(b)(5).
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14:43 Jan 21, 2010
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III. Date of Effectiveness of the
Proposed Rule Change and Timing for
Commission Action
Because the foregoing proposed rule
change does not: (i) Significantly affect
the protection of investors or the public
interest; (ii) impose any significant
burden on competition; and (iii) become
operative for 30 days from the date on
which it was filed, or such shorter time
as the Commission may designate, it has
become effective pursuant to Section
19(b)(3)(A) of the Act 7 and Rule 19b–
4(f)(6) thereunder.8
At any time within 60 days of the
filing of the proposed rule change, the
Commission may summarily abrogate
such rule change if it appears to the
Commission that such action is
necessary or appropriate in the public
interest, for the protection of investors,
or otherwise in furtherance of the
purposes of the Act.
IV. Solicitation of Comments
Interested persons are invited to
submit written data, views, and
arguments concerning the foregoing,
including whether the proposed rule
change is consistent with the Act.
Comments may be submitted by any of
the following methods:
Electronic Comments
• Use the Commission’s Internet
comment form (https://www.sec.gov/
rules/sro.shtml); or
• Send an e-mail to rulecomments@sec.gov. Please include File
Number SR–NASDAQ–2010–001 on the
subject line.
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 NASDAQ. 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–
NASDAQ–2010–001 and should be
submitted on or before February 12,
2010.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.9
Florence E. Harmon,
Deputy Secretary.
[FR Doc. 2010–1138 Filed 1–21–10; 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
Paper Comments
Paperwork Reduction Act of 1995,
effective October 1, 1995. This notice
• Send paper comments in triplicate
includes revisions and extensions of
to Elizabeth M. Murphy, Secretary,
OMB-approved information collections,
Securities and Exchange Commission,
a collection in use without an OMB
Station Place, 100 F Street, NE.,
number, and new information
Washington, DC 20549–1090.
collections.
All submissions should refer to File
SSA is soliciting comments on the
Number SR–NASDAQ–2010–001. This
accuracy of the agency’s burden
file number should be included on the
subject line if e-mail is used. To help the estimate; the need for the information;
its practical utility; ways to enhance its
Commission process and review your
quality, utility, and clarity; and ways to
comments more efficiently, please use
only one method. The Commission will minimize burden on respondents,
post all comments on the Commission’s including the use of automated
collection techniques or other forms of
Internet Web site (https://www.sec.gov/
information technology. Mail, e-mail, or
rules/sro.shtml). Copies of the
fax your comments and
submission, all subsequent
recommendations on the information
amendments, all written statements
collection(s) to the OMB Desk Officer
with respect to the proposed rule
and SSA Reports Clearance Director to
change that are filed with the
the following addresses or fax numbers.
Commission, and all written
(OMB), Office of Management and
communications relating to the
Budget, Attn: Desk Officer for SSA,
proposed rule change between the
Fax: 202–395–6974, E-mail address:
Commission and any person, other than
OIRA_Submission@omb.eop.gov.
7 15
8 17
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U.S.C. 78s(b)(3)(A).
CFR 240.19b–4(f)(6).
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CFR 200.30–3(a)(12).
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Federal Register / Vol. 75, No. 14 / Friday, January 22, 2010 / Notices
(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 collections below
are pending at SSA. SSA will submit
them 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 March 23,
2010. Individuals can obtain copies of
the collection instruments by calling the
SSA Director for Reports Clearance at
410–965–0454 or by writing to the
above e-mail address.
1. Waiver of Supplemental Security
Income (SSI) Payment Continuation—20
CFR 416.1400–416.1422—0960–NEW.
SSA collects the information on Form
SSA 263–U2 to determine whether an
individual meets the provisions of the
Social Security Act regarding waiver of
payment continuation. Recipients must
use Form SSA 263–U2 when they are
awaiting a determination on their
appeal and have decided to stop their
payment continuation. SSA needs the
information on the form as proof
respondents no longer want their
payments to continue. Respondents are
recipients of SSI payments who wish to
discontinue receipt of payment while
awaiting a determination on their
appeal.
Type of Request: Existing information
collection in use without an OMB
number.
Number of Respondents: 3,000.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 250 hours.
2. Notice Regarding Substitution of
Party upon Death of Claimant—
Reconsideration of Disability
Cessation—20 CFR 404.917–404.921
and 416.1407–416.1421—0960–0351.
When a claimant dies before we make
a determination on that person’s request
for reconsideration of their disability
cessation, SSA seeks a qualified
substitute party to pursue the appeal. If
SSA locates a qualified substitute party,
the agency will use Form SSA–770 to
collect information about whether to
pursue or withdraw the reconsideration
request. The information Form SSA–770
collects is the basis of the decision to
continue or discontinue the appeals
process. Respondents are substitute
applicants who are pursuing a
reconsideration request for a deceased
claimant.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 1,200.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 100 hours.
3. Application for Benefits under the
Italy-U.S. International Social Security
Agreement—20 CFR 404.1925—0960–
0445. SSA collects information using
Form SSA–2582 based on the United
States-Italy agreement effective
November 1, 1978. Article 19.2 of that
agreement provides that an applicant for
benefits can file an application with
either country. Article 4.3 of the
Protocol to the Agreement dictates the
country receiving the application will
forward agreed-upon forms and
applications to the other country. As
agreed upon by the United States and
Italian Social Security agencies,
individuals filing an application for U.S.
benefits directly with one of the Italian
Social Security agencies must complete
Form SSA–2528. The SSA–2528 is
mandatory for respondents living in
Italy who wish to file an application for
U.S. benefits. SSA uses the SSA–2528 to
establish age, relationship, citizenship,
marriage, death, military service, or to
evaluate a family bible or other family
record when determining eligibility for
benefits. The Italian Social Security
agencies assist applicants in completing
Form SSA–2528 and then forward the
application to SSA for processing. The
respondents are individuals living in
Italy who wish to file for U.S. Social
Security benefits.
Type of Request: Revision of an OMBapproved information collection.
Number of
annual
responses
Respondent
Number of Respondents: 250.
Frequency of Response: 1.
Average Burden per Response: 20
minutes.
Estimated Annual Burden: 83 hours.
4. Earnings Record Information—20
CFR 404.801–404.803 and 404.821–
404.822—0960–0505. SSA discovered
that as many as 70 percent of the wage
reports it receives for children under age
7 are actually the earnings of someone
other than the child. To ensure we
credit the correct person with the
reported earnings, SSA decided we
should verify wage reports for children
under age 7 with the children’s
employers before posting to the earnings
record. SSA uses Form SSA–L3231–C1
for this purpose. The respondents are
employers who report earnings for
children under age 7.
Type of Information Collection:
Revision of an OMB-approved
information collection.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 3,333
hours.
5. Work Incentives Planning and
Assistance Program—0960–0629. The
Work Incentives Planning and
Assistance (WIPA) program collects
identifying information from project
sites and Community Work Incentives
Coordinators (CWIC). In addition, the
program collects data from beneficiaries
on background employment, training,
benefits, and work incentives. SSA is
interested in identifying beneficiary
outcomes under the WIPA program to
determine the extent to which
beneficiaries with disabilities achieve
their employment, financial, and health
care goals. SSA will also use the data in
its analysis and future planning for
Social Security Disability Insurance and
SSI programs.
Type of Request: Extension of an
OMB-approved information collection.
Estimated Annual Burden: 5,019
hours.
Average burden
per response
(minutes)
Frequency of
response
Estimated annual
burden hours
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Project Site ......................................................................................
CWIC ...............................................................................................
Beneficiary .......................................................................................
147
422
60,000
1
1
1
2
2
5
5
14
5,000
Totals ........................................................................................
60,569
............................
............................
5,019
6. Beneficiary Interview and Auditor’s
Observations Form—0960–0630. SSA’s
Office of the Inspector General (OIG)
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will use the information collected
through Form SSA–322, the Beneficiary
Interview and Auditor’s Observation
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form, to interview beneficiaries and/or
their payees to determine if they are
complying with their duties and
E:\FR\FM\22JAN1.SGM
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Federal Register / Vol. 75, No. 14 / Friday, January 22, 2010 / Notices
responsibilities. SSA will randomly
select SSI recipients and Social Security
beneficiaries who have representative
payees as respondents for this
collection.
Type of Request: Extension of a
previously-approved OMB information
collection.
Number of Respondents: 200.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 50 hours.
7. Certification of Contents of
Document(s) or Record(s)—20 CFR
404.715f—0960–0689. SSA must secure
evidence necessary for individuals to
establish rights to benefits. Some of the
required evidence categories include
evidence of age, relationship,
citizenship, marriage, death, and
military service. Form SSA–704 allows
SSA employees, State record
custodians, and other custodians of
evidentiary documents to record
information from documents and
records to establish these types of
evidence. State record custodians and
other custodians of evidentiary
documents are the respondents.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 4,800.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 800 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 February 22, 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 email address.
1. 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 who
ask SSA to mail confirmation of their
application or the SSN to their
employers.
Type of Request: New information
collection.
Number of Respondents: 375,000.
Frequency of Response: 1.
Average Burden per Response: 2
minutes.
Estimated Annual Burden: 12,500
hours.
2. Important Information about Your
Appeal, Waiver Rights, and Repayment
Options—20 CFR 404.502–521—0960–
NEW. When SSA accidentally overpays
beneficiaries, the agency uses Form
SSA–3105 to inform those beneficiaries
about their rights to reconsideration,
waiver, or a different repayment rate.
Beneficiaries use Form SSA–3105 to
inform SSA if they do not agree with
SSA’s initial overpayment
determination, if they are unable to
repay the overpayment, or to request a
waiver for repayment to SSA. The
respondents are individuals who are
overpaid claimants and who are
requesting a waiver of recovery for the
overpayment, reconsideration of the
overpayment determination, or a lesser
rate of withholding of the overpayment.
Type of Request: New information
collection.
Number of Respondents: 800,000.
Frequency of Response: 1.
Number of
respondents
Collection method
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 200,000
hours.
3. Physician’s/Medical Officer’s
Statement of Patient’s Capability to
Manage Benefits—20 CFR 404.2015 and
416.615—0960–0024. SSA collects
information on Form SSA–787 to
determine beneficiaries’ ability to
handle their own benefits. This
information assists SSA in determining
the need for a representative payee. The
respondents are the beneficiary’s
physicians or medical officers of the
institution in which the beneficiary
resides.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 120,000.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 20,000
hours.
4. Statement for Determining
Continuing Eligibility, Supplemental
Security Income Payment(s)—20 CFR
416.204—0960–0416. SSA uses the
information from the SSA–8203–BK for
high-error-profile (HEP)
redeterminations of disability to
determine whether 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. Typically,
beneficiaries complete this collection 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 ........................................................................................
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MSSICS ...........................................................................................
MSSICS/Signature Proxy ................................................................
Paper ...............................................................................................
157,612
............................
............................
52,012
5. 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
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14:43 Jan 21, 2010
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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
PO 00000
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effects of symptoms on functionality to
help make a disability determination.
The respondents are applicants for SSI
payments.
E:\FR\FM\22JAN1.SGM
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Federal Register / Vol. 75, No. 14 / Friday, January 22, 2010 / Notices
Note: This is a correction notice. SSA
published this information collection as an
extension on November 17, 2009, at 74 FR
59336. 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: 250,000.
Frequency of Response: 1.
Average Burden Per Response: 15
minutes.
Estimated Annual Burden: 62,500
hours.
6. 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.
Note: This is a correction notice. SSA
published this information collection as an
extension on November 17, 2009, at 74 FR
59336. Since we are revising the Privacy Act
Statement, this is now a revision of an OMBapproved information collection.
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Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 90,000.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 15,000
hours.
7. Certificate of Support—20 CFR
404.370, 404.750, 404.408a—0960–
0001. A parent of a deceased, fully
insured worker may be entitled to Title
II benefits on the earnings record of the
deceased worker under certain
conditions. One of the conditions is the
parent must have received at least onehalf support from the deceased worker.
The one-half support requirement also
applies to a spouse applicant in
determining whether Title II benefits are
subject to Government Pension Offset
(GPO). SSA uses the information from
Form SSA–760–F4 to determine
whether the parent of a deceased worker
or a spouse applicant meets the one-half
support requirement. Respondents are
parents of deceased workers or spouses
who may be exempt from GPO.
Note: This is a correction notice. SSA
published this information collection as an
extension on October 26, 2009, at 74 FR
55080. 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: 18,000.
Frequency of Response: 1.
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14:43 Jan 21, 2010
Jkt 220001
Average Burden Per Response: 15
minutes.
Estimated Annual Burden: 4,500
hours.
Dated: January 15, 2010.
Elizabeth A. Davidson,
Director, Center for Reports Clearance, Social
Security Administration.
[FR Doc. 2010–1115 Filed 1–21–10; 8:45 am]
3781
Dated: January 14, 2010.
Maura M. Pally,
Deputy Assistant Secretary for Professional
and Cultural Exchanges, Bureau of
Educational and Cultural Affairs, Department
of State.
[FR Doc. 2010–1215 Filed 1–21–10; 8:45 am]
BILLING CODE 4710–05–P
DEPARTMENT OF STATE
BILLING CODE 4191–02–P
[Public Notice 6883]
Culturally Significant Objects Imported
for Exhibition Determinations: ‘‘The
Mourners: Tomb Sculptures From the
Court of Burgundy’’
DEPARTMENT OF STATE
[Public Notice 6884]
Culturally Significant Object Imported
for Exhibition; Determinations:
‘‘Projects 92: Yin Xiuzhen’’
SUMMARY: Notice is hereby given of the
following determinations: Pursuant to
the authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, Delegation of Authority
No. 236 of October 19, 1999, as
amended, and Delegation of Authority
No. 257 of April 15, 2003 [68 FR 19875],
I hereby determine that the object to be
included in the exhibition ‘‘Projects 92:
Yin Xiuzhen,’’ imported from abroad for
temporary exhibition within the United
States, is of cultural significance. The
object is imported pursuant to a loan
agreement with the foreign owner or
custodian. I also determine that the
exhibition or display of the exhibit
object at the Museum of Modern Art,
New York, New York, from on or about
February 24, 2010, until on or about
May 24, 2010, and at possible additional
exhibitions or venues yet to be
determined, is in the national interest.
I have ordered that Public Notice of
these Determinations be published in
the Federal Register.
FOR FURTHER INFORMATION CONTACT: For
further information, including a
description of the exhibit object, contact
Paul W. Manning, Attorney-Adviser,
Office of the Legal Adviser, U.S.
Department of State (telephone: 202–
632–6469). The mailing address is U.S.
Department of State, SA–5, L/PD, Fifth
Floor (Suite 5H03), Washington, DC
20522–0505.
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SUMMARY: Notice is hereby given of the
following determinations: Pursuant to
the authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, Delegation of Authority
No. 236 of October 19, 1999, as
amended, and Delegation of Authority
No. 257 of April 15, 2003 [68 FR 19875],
I hereby determine that the objects to be
included in the exhibition ‘‘The
Mourners: Tomb Sculptures from the
Court of Burgundy,’’ imported from
abroad for temporary exhibition within
the United States, are of cultural
significance. The objects are imported
pursuant to loan agreements with the
foreign owners or custodians. I also
determine that the exhibition or display
of the exhibit objects at the Metropolitan
Museum of Art, New York, NY, from on
or about March 1, 2010, until on or
about May 23, 2010; the St. Louis Art
Museum, St. Louis, MO, from on or
about June 20, 2010, until on or about
September 6, 2010; the Dallas Museum
of Art, Dallas, TX, from on or about
October 3, 2010 until on or about
January 2, 2011; the Minneapolis
Institute of Arts, Minneapolis, MN, from
on or about January 23, 2011, until on
or about April 17, 2011; the Los Angeles
County Museum of Art, Los Angeles,
CA, from on or about May 8, 2011, until
on or about July 31, 2011; the Fine Arts
Museums of San Francisco, San
Francisco, CA, from on or about August
21, 2011, until on or about January 1,
2012; the Virginia Museum of Fine Arts,
Richmond, VA, from on or about
January 20, 2012, until on or about April
15, 2012; and at possible additional
exhibitions or venues yet to be
determined, is in the national interest.
Public Notice of these Determinations is
ordered to be published in the Federal
Register.
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]]>Agencies
[Federal Register Volume 75, Number 14 (Friday, January 22, 2010)]
[Notices]
[Pages 3778-3781]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-1115]
=======================================================================
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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, a collection in use without an OMB number, and
new 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 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 SSA Reports Clearance Director to the following
addresses or fax numbers.
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974, E-mail address: OIRA_Submission@omb.eop.gov.
[[Page 3779]]
(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 collections below are pending at SSA. SSA will
submit them 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
March 23, 2010. Individuals can obtain copies of the collection
instruments by calling the SSA Director for Reports Clearance at 410-
965-0454 or by writing to the above e-mail address.
1. Waiver of Supplemental Security Income (SSI) Payment
Continuation--20 CFR 416.1400-416.1422--0960-NEW. SSA collects the
information on Form SSA 263-U2 to determine whether an individual meets
the provisions of the Social Security Act regarding waiver of payment
continuation. Recipients must use Form SSA 263-U2 when they are
awaiting a determination on their appeal and have decided to stop their
payment continuation. SSA needs the information on the form as proof
respondents no longer want their payments to continue. Respondents are
recipients of SSI payments who wish to discontinue receipt of payment
while awaiting a determination on their appeal.
Type of Request: Existing information collection in use without an
OMB number.
Number of Respondents: 3,000.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 250 hours.
2. Notice Regarding Substitution of Party upon Death of Claimant--
Reconsideration of Disability Cessation--20 CFR 404.917-404.921 and
416.1407-416.1421--0960-0351. When a claimant dies before we make a
determination on that person's request for reconsideration of their
disability cessation, SSA seeks a qualified substitute party to pursue
the appeal. If SSA locates a qualified substitute party, the agency
will use Form SSA-770 to collect information about whether to pursue or
withdraw the reconsideration request. The information Form SSA-770
collects is the basis of the decision to continue or discontinue the
appeals process. Respondents are substitute applicants who are pursuing
a reconsideration request for a deceased claimant.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 1,200.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 100 hours.
3. Application for Benefits under the Italy-U.S. International
Social Security Agreement--20 CFR 404.1925--0960-0445. SSA collects
information using Form SSA-2582 based on the United States-Italy
agreement effective November 1, 1978. Article 19.2 of that agreement
provides that an applicant for benefits can file an application with
either country. Article 4.3 of the Protocol to the Agreement dictates
the country receiving the application will forward agreed-upon forms
and applications to the other country. As agreed upon by the United
States and Italian Social Security agencies, individuals filing an
application for U.S. benefits directly with one of the Italian Social
Security agencies must complete Form SSA-2528. The SSA-2528 is
mandatory for respondents living in Italy who wish to file an
application for U.S. benefits. SSA uses the SSA-2528 to establish age,
relationship, citizenship, marriage, death, military service, or to
evaluate a family bible or other family record when determining
eligibility for benefits. The Italian Social Security agencies assist
applicants in completing Form SSA-2528 and then forward the application
to SSA for processing. The respondents are individuals living in Italy
who wish to file for U.S. Social Security benefits.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 250.
Frequency of Response: 1.
Average Burden per Response: 20 minutes.
Estimated Annual Burden: 83 hours.
4. Earnings Record Information--20 CFR 404.801-404.803 and 404.821-
404.822--0960-0505. SSA discovered that as many as 70 percent of the
wage reports it receives for children under age 7 are actually the
earnings of someone other than the child. To ensure we credit the
correct person with the reported earnings, SSA decided we should verify
wage reports for children under age 7 with the children's employers
before posting to the earnings record. SSA uses Form SSA-L3231-C1 for
this purpose. The respondents are employers who report earnings for
children under age 7.
Type of Information Collection: Revision of an OMB-approved
information collection.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 3,333 hours.
5. Work Incentives Planning and Assistance Program--0960-0629. The
Work Incentives Planning and Assistance (WIPA) program collects
identifying information from project sites and Community Work
Incentives Coordinators (CWIC). In addition, the program collects data
from beneficiaries on background employment, training, benefits, and
work incentives. SSA is interested in identifying beneficiary outcomes
under the WIPA program to determine the extent to which beneficiaries
with disabilities achieve their employment, financial, and health care
goals. SSA will also use the data in its analysis and future planning
for Social Security Disability Insurance and SSI programs.
Type of Request: Extension of an OMB-approved information
collection.
Estimated Annual Burden: 5,019 hours.
----------------------------------------------------------------------------------------------------------------
Average burden
Respondent Number of Frequency of per response Estimated annual
annual responses response (minutes) burden hours
----------------------------------------------------------------------------------------------------------------
Project Site............................ 147 1 2 5
CWIC.................................... 422 1 2 14
Beneficiary............................. 60,000 1 5 5,000
-----------------------------------------------------------------------
Totals.............................. 60,569 ................ ................ 5,019
----------------------------------------------------------------------------------------------------------------
6. Beneficiary Interview and Auditor's Observations Form--0960-
0630. SSA's Office of the Inspector General (OIG) will use the
information collected through Form SSA-322, the Beneficiary Interview
and Auditor's Observation form, to interview beneficiaries and/or their
payees to determine if they are complying with their duties and
[[Page 3780]]
responsibilities. SSA will randomly select SSI recipients and Social
Security beneficiaries who have representative payees as respondents
for this collection.
Type of Request: Extension of a previously-approved OMB information
collection.
Number of Respondents: 200.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 50 hours.
7. Certification of Contents of Document(s) or Record(s)--20 CFR
404.715f--0960-0689. SSA must secure evidence necessary for individuals
to establish rights to benefits. Some of the required evidence
categories include evidence of age, relationship, citizenship,
marriage, death, and military service. Form SSA-704 allows SSA
employees, State record custodians, and other custodians of evidentiary
documents to record information from documents and records to establish
these types of evidence. State record custodians and other custodians
of evidentiary documents are the respondents.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 4,800.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 800 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 February 22, 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 email address.
1. 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 who ask SSA to mail confirmation of
their application or the SSN to their employers.
Type of Request: New information collection.
Number of Respondents: 375,000.
Frequency of Response: 1.
Average Burden per Response: 2 minutes.
Estimated Annual Burden: 12,500 hours.
2. Important Information about Your Appeal, Waiver Rights, and
Repayment Options--20 CFR 404.502-521--0960-NEW. When SSA accidentally
overpays beneficiaries, the agency uses Form SSA-3105 to inform those
beneficiaries about their rights to reconsideration, waiver, or a
different repayment rate. Beneficiaries use Form SSA-3105 to inform SSA
if they do not agree with SSA's initial overpayment determination, if
they are unable to repay the overpayment, or to request a waiver for
repayment to SSA. The respondents are individuals who are overpaid
claimants and who are requesting a waiver of recovery for the
overpayment, reconsideration of the overpayment determination, 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.
3. Physician's/Medical Officer's Statement of Patient's Capability
to Manage Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA
collects information on Form SSA-787 to determine beneficiaries'
ability to handle their own benefits. This information assists SSA in
determining the need for a representative payee. The respondents are
the beneficiary's physicians or medical officers of the institution in
which the beneficiary resides.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 120,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 20,000 hours.
4. Statement for Determining Continuing Eligibility, Supplemental
Security Income Payment(s)--20 CFR 416.204--0960-0416. SSA uses the
information from the SSA-8203-BK for high-error-profile (HEP)
redeterminations of disability to determine whether 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. Typically, beneficiaries
complete this collection 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 burden
Collection method Number of Frequency of per response Estimated annual
respondents response (minutes) burden (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
----------------------------------------------------------------------------------------------------------------
5. 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.
[[Page 3781]]
Note: This is a correction notice. SSA published this
information collection as an extension on November 17, 2009, at 74
FR 59336. 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: 250,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 62,500 hours.
6. 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.
Note: This is a correction notice. SSA published this
information collection as an extension on November 17, 2009, at 74
FR 59336. 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: 90,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 15,000 hours.
7. Certificate of Support--20 CFR 404.370, 404.750, 404.408a--0960-
0001. A parent of a deceased, fully insured worker may be entitled to
Title II benefits on the earnings record of the deceased worker under
certain conditions. One of the conditions is the parent must have
received at least one-half support from the deceased worker. The one-
half support requirement also applies to a spouse applicant in
determining whether Title II benefits are subject to Government Pension
Offset (GPO). SSA uses the information from Form SSA-760-F4 to
determine whether the parent of a deceased worker or a spouse applicant
meets the one-half support requirement. Respondents are parents of
deceased workers or spouses who may be exempt from GPO.
Note: This is a correction notice. SSA published this
information collection as an extension on October 26, 2009, at 74 FR
55080. 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: 18,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 4,500 hours.
Dated: January 15, 2010.
Elizabeth A. Davidson,
Director, Center for Reports Clearance, Social Security Administration.
[FR Doc. 2010-1115 Filed 1-21-10; 8:45 am]
BILLING CODE 4191-02-P
