Agency Information Collection Activities: Proposed Request and Comment Request, 9992-9997 [2010-4448]
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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 No.
SR–NASDAQ–2010–022 and should be
submitted on or before March 25, 2010.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.11
Florence E. Harmon,
Deputy Secretary.
[FR Doc. 2010–4452 Filed 3–3–10; 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
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 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.
(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 May 3, 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. Application for Lump Sum Death
Payment—20 CFR 404.390–404.392—
0960–0013. SSA uses Form SSA–8–F4
to collect information needed to
authorize payment of the lump sum
death payment (LSDP) to a widow,
widower, or children as defined in
section 202(i) of the Social Security Act.
Respondents complete the application
for this one-time payment via paper
form, telephone, or an in-person
interview with SSA employees.
Respondents are applicants for the
LSDP.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Collection method
Estimated completion time
(minutes)
Burden hours
278,825
278,825
29,350
10
9
10
46,471
41,824
4,892
Totals: .................................................................................................................
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MCS ...........................................................................................................................
MCS/Signature Proxy ................................................................................................
Paper .........................................................................................................................
587,000
..............................
93,187
2. Certificate of Responsibility for
Welfare and Care of Child Not in
Applicant’s Custody—20 CFR 404.330,
404.339–341, and 404.348–404.349—
0960–0019. SSA uses Form SSA–781 to
determine if non-custodial parents who
are filing for spouse’s or mother’s and
father’s benefits based on having a child
in their care meet the in-care
requirements. Respondents are
applicants for spouse’s and/or mother’s
and father’s benefits.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 14,000.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 2,333
hours.
3. Supplemental Statement Regarding
Farming Activities of Person Living
Outside the U.S.A.—0960–0103. SSA
uses Form SSA–7163A to document
beneficiary or claimant reports of
11 17
working on a farm outside the United
States (U.S.). Specifically, the
information provided on this form helps
us to determine if we should apply
foreign work deductions to the
recipient’s benefits. We collect the
information either annually or every
other year, depending on the
respondent’s country of residence.
Respondents are Social Security
recipients engaged in farming activities
outside the U.S.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 1,000.
Frequency of Response: 1.
Average Burden Per Response: 1 hour.
Estimated Annual Burden: 1,000
hours.
4. Disability Report—Appeal—20 CFR
404.1512, 416.912, 404.916(c),
416.1416(c), 405 Subpart C, 422.140—
0960–0144. SSA requires disability
claimants who are appealing an
unfavorable disability determination to
complete Form SSA–3441–BK. This
form allows claimants to disclose any
changes to their disability or resources
that might influence SSA’s unfavorable
determination. SSA may use the
information to: (1) Reconsider and
review an initial disability
determination; (2) review a continuing
disability; and (3) evaluate a request for
a hearing. This information assists the
State Disability Determination Services
and administrative law judges (ALJ) in:
(1) Preparing for the appeals and
hearings; and (2) issuing a
determination or decision on an
individual’s entitlement (initial or
continuing) to disability benefits.
Respondents are individuals who
appeal denial, reduction, or cessation of
Social Security disability income and
Supplemental Security Income (SSI)
payments, or who are requesting a
hearing before an ALJ.
Type of Request: Revision of an OMBapproved information collection.
CFR 200.30–3(a)(12).
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Number of
respondents
Collection method
Average burden
per response
(minutes)
Frequency of
response
Estimated annual
burden
(hours)
SSA–3441 (Paper Form) .................................................................
Electronic Disability Collect System (EDCS) ...................................
I3441 (Internet Form) .......................................................................
12,604
843,090
417,268
1
1
1
45
45
120
9,453
632,318
834,536
Totals ........................................................................................
1,272,962
............................
............................
1,476,307
5. Request for Hearing by
Administrative Law Judge—20 CFR
404.929, 404.933, 416.1429, 404.1433,
405.722, 418.1350—0960–0269. When
SSA denies applicants’ or beneficiaries’
requests for new or continuing benefits,
those applicants/beneficiaries are
entitled to request a hearing to appeal
the decision. SSA uses Form HA–501 to
document such requests. Although SSA
collects this information, the actual
hearings take place before ALJs
employed by the Department of Health
and Human Services (HHS). The
respondents are: (1) Applicants for or
current recipients of various Social
Security benefits who want to appeal
SSA’s denial of their requests for new or
continued benefits; and (2) Medicare
Part B recipients whom SSA has
determined must pay the Medicare Part
B Income-Related Monthly Adjustment
Amount, both of whom wish to appeal
this decision at a hearing before an HHS
ALJ.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 669,469.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 111,578
hours.
6. Information about Joint Checking/
Savings Accounts—20 CFR 416.120,
416.1208—0960–0461. SSA considers a
person’s resources when evaluating
eligibility for SSI payments. Generally,
we consider funds in checking and
savings accounts to be resources owned
by the individuals whose names appear
on the account. Individuals applying for
SSI, however, may rebut an assumption
of ownership in a joint account if they
submit certain evidence establishing the
funds do not belong to them. SSA uses
Form SSA–2574 to collect information
from SSI applicants/recipients who
object to the assumption they own all or
part of the funds in a joint checking or
savings account bearing their names.
SSA collects information about the
account from both the SSI applicant/
recipient and other account holder(s).
After receiving the completed form, SSA
can determine if we should consider the
account to be a resource for the SSI
payments applicant/recipient. The
Number of respondents
Modality
respondents are applicants and
recipients of SSI and individuals who
list themselves as joint owners of
financial accounts with SSI applicants/
recipients.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 200,000.
Frequency of Response: 1.
Average Burden per Response: 7
minutes.
Estimated Annual Burden: 23,333
hours.
7. Request for Earnings and Benefit
Estimate Statement—20 CFR 404.810—
0960–0466. SSA uses the information
collected by Form SSA–7004 to identify
respondents’ Social Security earnings
records, extract posted earnings
information, calculate potential benefit
estimates, produce the resulting Social
Security statements, and mail them to
the requesters. The respondents are
Social Security number holders
requesting information about their
Social Security earnings records and
estimates of their potential benefits.
Type of Request: Revision of an OMBapproved information collection.
Average burden
per response
(minutes)
Frequency of
response
Total annual
burden
(hours)
127,000
426,000
1
1
5
5
10,583
35,500
Totals ........................................................................................
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Paper Version ..................................................................................
Internet Version ...............................................................................
553,000
............................
............................
46,083
8. Beneficiary Recontact Form—20
CFR 404.703, 404.705—0960–0502. SSA
must ensure that recipients of disability
payments continue to be eligible for
their payments. Research has indicated
benefit recipients may fail to report
circumstances that affect their benefits.
Two such cases are: (1) When parents
receiving disability benefits for their
child marry; and (2) the removal of an
entitled child from parents’ care. SSA
uses Form SSA–1588–OCR–SM to ask
mothers/fathers about their marital
status and children in care to detect
overpayments and avoid continuing
payment to those are no longer entitled.
Respondents are recipients of mother/
father Social Security benefits.
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Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 133,400.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 11,117
hours.
9. Complaint Form for Allegations of
Discrimination in Programs or Activities
Conducted by the Social Security
Administration—0960–0585. SSA uses
Form SSA–437 to investigate and
formally resolve complaints of
discrimination based on disability, race,
color, national origin (including limited
English proficiency), sex, sexual
orientation, age, religion, or retaliation
for having participated in a proceeding
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under this administrative complaint
process in connection with an SSA
program or activity. SSA also uses this
form to review, investigate, and resolve
complaints alleging discrimination
based on status as a parent in education,
training programs, or activities
conducted by SSA. Individuals who
believe SSA discriminated against them
on any of the above bases may file a
written complaint of discrimination.
SSA uses the information to identify the
complainant; identify the alleged
discriminatory act; ascertain the date of
such alleged act; obtain the identity of
any individual(s) with information
about the alleged discrimination; and
ascertain other relevant information that
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would assist in the investigation and
resolution of the complaint.
Respondents are individuals who
believe SSA or SSA employees,
contractors, or agents in programs or
activities conducted by SSA
discriminated against them.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 140.
Frequency of Response: 1.
Average Burden per Response: 1 hour.
Estimated Annual Burden: 140 hours.
10. Social Security Benefits
Application—20 CFR 404.310–404.311,
404.315–404.322, 404.330–404.333,
404.601–404.603, and 404.1501–
404.1512—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
Number of
respondents
Collection method
Claims System (MCS) screens for inperson field office interview
applications, and the Internet-based
iClaim application. This information
collection request (ICR) is for additions
and revisions to the information
collection.
Type of Request: Revision of an OMBapproved information collection.
Paper Forms/Accompanying MCS
Screens Burden Information:
Average
burden
per response
(minutes)
Frequency of
response
Estimated
annual burden
(hours)
Form SSA–1
MCS .................................................................................................
MCS/Signature Proxy ......................................................................
Paper ...............................................................................................
Medicare-only MCS .........................................................................
Medicare-only Paper ........................................................................
172,200
1,250,800
20,000
299,000
1,000
1
1
1
1
1
11
10
11
7
7
31,570
208,467
3,667
34,883
117
Totals ........................................................................................
1,743,000
............................
............................
278,704
Form SSA–2
MCS .................................................................................................
MCS/Signature Proxy ......................................................................
Paper ...............................................................................................
36,860
331,740
3,800
1
1
1
15
14
15
9,215
77,406
950
Totals ........................................................................................
372,400
............................
............................
87,571
Form SSA–16
MCS .................................................................................................
MCS/Signature Proxy ......................................................................
Paper ...............................................................................................
218,657
1,967,913
24,161
1
1
1
20
19
20
72,886
623,172
8,054
Totals ........................................................................................
2,210,731
............................
............................
704,112
iClaim 3rd Party ...............................................................................
iClaim Applicant after 3rd Party Completion ...................................
First Party iClaim .............................................................................
Medicare-only iClaim .......................................................................
28,118
28,118
541,851
200,000
1
1
1
1
15
5
15
10
7,030
2,343
135,463
33,333
Totals ........................................................................................
798,087
............................
............................
178,169
iClaim
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Aggregate Public Reporting Burden:
1,248,556 hours.
11. SSI Telephone Wage Reporting
System (SSITWR)—20 CFR 416.701–
0732—0960–0715. SSA requires SSI
recipients to report changes that could
affect their eligibility for and the
amount of their SSI payments, such as
changes in income, resources, and living
arrangements. The SSITWR, formerly
the Statement for SSI Monthly Wage
Reporting (Telephone), enables SSI
recipients to meet these requirements by
providing them with a fully automated
mechanism to report their monthly
wages by telephone, instead of
contacting their local field offices. The
SSITWR allows callers to report their
wages either by speaking their responses
through voice recognition technology, or
by keying in responses using the
telephone key pad. To ensure the
Collection
method
Frequency of
reporting
Training/Instruction ..........................................................................
SSITWR ...........................................................................................
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Number of
respondents
1
12
Sfmt 4703
security of the information provided,
SSITWR asks callers to provide
information SSA can compare against
its records for authentication purposes.
Once the system authenticates the
identity of the callers, the callers can
speak or key in their wage data. The
respondents are SSI recipients, deemors,
and representative payees of recipients.
Type of Request: Revision of an OMBapproved information collection.
Estimated completion time
(minutes)
85,000
85,000
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5
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Burden
(hours)
49,584
85,000
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Collection
method
Frequency of
reporting
Total ..........................................................................................
Estimated completion time
(minutes)
Number of
respondents
............................
*85,000
............................
Burden
(hours)
134,584
Note: * The same 85,000 respondents are completing both activities, so the actual total number of respondents is only 85,000.
12. Treating Physician Consultative
Examination Interest Form—20 CFR
404.1519g—20 CFR 404.1519i—0960–
0751. When an applicant for Social
Security disability benefits has not
consulted a physician for a specified
period preceding the application, SSA
will ask the applicant to complete a
consultative examination (CE). If the
applicant has a treating physician (TP),
SSA sends a medical evidence of record
request letter and Form SSA–84 to the
applicant’s TP; the TP completes the
latter form and returns it to SSA to
indicate interest in conducting the CE.
If the TP does not return the form, SSA
assumes the TP is not interested in
performing the CE. Respondents are
disability benefits applicants’ treating
physicians.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 168.
Frequency of Response: 1.
Average Burden Per Response: 5
minutes.
Estimated Annual Burden: 14 hours.
13. Claimant Travel Reimbursement
Request—20 CFR 404.999a–20 CFR
404.99c—0960–0752. SSA sends Form
SSA–104 to Social Security benefits
recipients with a CE appointment
notice. To receive reimbursement for
their travel expenses to the CE,
recipients must: (1) Submit an itemized
list of expenditures for their round trip;
and (2) complete, sign, and return the
SSA–104 to SSA. SSA collects this
information to determine the amount of
reimbursement. Respondents are
applicants for disability claims applying
for reimbursement of travel expenses to
a CE.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 11,092.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 1,849
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 April 5, 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. 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 if an
individual or partnership can claim 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 establish the existence of
an agricultural trade or business and
subsequent covered earnings for Social
Number of
respondents
Form No.
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: Revision of an OMBapproved information collection.
Number of Respondents: 47,500.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 7,917
hours.
2. Statement for Determining
Continuing Eligibility Supplemental
Security Income Payment—20 CFR
416.204—0960–0145. SSA uses the
information from Form SSA–8202–BK
to conduct low- and middle-errorprofile (LEP–MEP) telephone or face-toface redetermination (RZ) interviews
with SSI recipients and representative
payees. The information SSA collects
during the interview is needed 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.
Note: SSA published this information
collection with the incorrect burden
information on December 28, 2009 at 74 FR
68655. The correct information is below.
Type of Request: Revision of an OMBapproved information collection.
Average burden
per response
(minutes)
Frequency
of response
Total annual
burden
(hours)
235,390
333,408
1
1
21
20
82,387
111,136
Totals ........................................................................................
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SSA–8202–BK .................................................................................
MSSICS ...........................................................................................
568,798
............................
............................
193,523
3. Claimant Statement About Loan of
Food or Shelter; Statement About Food
or Shelter Provided to Another—20 CFR
416.1130–416.1148—0960–0529. SSA
uses Forms SSA–5062 and SSA–L5063
to obtain statements about food and/or
shelter provided to SSI claimants or
recipients. SSA uses this information to
determine whether food and/or shelter
are bona fide loans or if SSA should
count them as income for SSI purposes.
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This determination can affect a claimant
or recipient’s eligibility for SSI and the
amount of SSI payments. The
respondents are claimants and
recipients for SSI payments and
individuals who provide loans of food
or shelter to them.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 131,080.
Frequency of Response: 1.
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Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 21,847
hours.
4. Request To Resolve Questionable
Quarters of Coverage (QC); Request for
QC History Based on Relationship—
0960–0575. The Personal Responsibility
and Work Opportunity Reconciliation
Act states that aliens admitted for lawful
residence who have worked and earned
40 qualifying QCs for Social Security
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purposes can generally receive State
benefits. States complete Form SSA–512
to request clarification from SSA on
questionable QC information.
Specifically, States use this form to
request QC information for an alien’s
spouse or child in cases where the alien
does not sign a consent form giving
permission to access his/her Social
Security records. We can allocate QCs to
a spouse and/or to a child under age 18,
if needed, to obtain 40 qualifying QCs
for the alien. The respondents are State
agencies that require QC information to
determine eligibility for benefits.
Number of
respondents
Form No.
Note: This is a correction notice. SSA
published this information collection with
the incorrect burden information on
December 28, 2009 at 74 FR 68655. In
addition, 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 OMBapproved information collection.
Average burden
per response
(minutes)
Frequency of
response
Total annual
burden
(hours)
SSA–512 ..........................................................................................
SSA–513 ..........................................................................................
25,000
25,000
1
1
2
2
833
833
Totals ........................................................................................
50,000
............................
............................
1,666
5. 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 asks
organizational representative payees to
complete Form SSA–637, Site Review
Questionnaire for Volume and Fee-forService Payees, to provide information
on how they carry out their
representative payee responsibilities,
including how they manage beneficiary
funds. SSA then obtains information
from the beneficiaries these
organizations represent via the SSA–
639, Beneficiary Interview Form, to
corroborate the payees’ 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, and non-profit and
for-profit organizations that serve as
Number of
respondents
Form No.
representative payees and the
beneficiaries they serve.
Note: This is a correction notice. SSA
published this information collection as an
extension on December 08, 2009 at 74 FR
64801. 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.
Average burden
per response
(minutes)
Frequency of
response
Total annual
burden
(hours)
2,001
9,341
1
1
120
10
4,002
1,557
Totals ........................................................................................
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SSA–637 ..........................................................................................
SSA–639 ..........................................................................................
11,342
............................
............................
5,559
6. Direct Deposit Sign-Up Form
(Country)—31 CFR 210—0960–0686.
SSA’s International Direct Deposit
Program allows beneficiaries living
abroad to receive their payments via
direct deposit to an account at a
financial institution outside the United
States. SSA uses Form SSA–1199 to
obtain the direct deposit information for
such foreign accounts. Routing account
number information varies slightly for
each foreign country, so we use a
variation of the Treasury Department’s
Form SF–1199A for each country. The
respondents are Social Security
beneficiaries residing abroad who want
SSA to deposit their benefits payments
directly to a foreign financial
institution.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 5,000.
Frequency of Response: 1.
Average Burden per Response: 5
minutes.
Estimated Annual Burden: 417 hours.
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7. Certification of Prisoner Identity
Information—20 CFR 422.107—0960–
0688. This regulation stipulates that
when a valid agreement is in place,
prison officials may 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
identities of prisoners applying for
replacement Social Security cards.
Note: This is a correction notice. SSA
published this information collection as an
extension on December 08, 2009 at 74 FR
64801. 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: 1,000.
Frequency of Response: 200.
PO 00000
Frm 00130
Fmt 4703
Sfmt 4703
Average Burden per Response: 3
minutes.
Estimated Annual Burden: 10,000
hours.
8. Temporary Extension of Attorney
Fee Payment System to Title XVI; 5–
Year Demonstration Project Extending
Fee Withholding and Payment
Procedures to Eligible Non-Attorney
Representatives; Definition of Past-Due
Benefits; and Assessment for Fee
Payment Services—20 CFR 404.1717,
404.1730(c)(1), 404.1730(c)(2)(i),
404.1730(c)(2)(ii), 416.1517,
416.1528(a), 416.1530(c)(1),
416.1530(c)(2)(i), 416.1530(c)(2)(i)—
0960–0745. Section 302 of the Social
Security Protection Act of 2004 (SSPA),
Public Law 108–203, amended section
1631(d)(2) of the Social Security Act to
temporarily extend the Title II attorney
fee withholding and direct payment
process to Title XVI. Section 303 of the
SSPA directed SSA to develop and
conduct a 5-year nationwide
demonstration project to allow
qualifying non-attorneys the option of
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Federal Register / Vol. 75, No. 42 / Thursday, March 4, 2010 / Notices
fee withholding and direct payment of
fees under both Titles II and XVI. SSA
uses the information obtained through
this demonstration project to administer
fee withholding and direct payment to
certain non-attorney representatives.
Respondents are non-attorneys who are
Number of
respondents
Regulation section
eligible to receive direct payment of fees
for representing individuals before SSA.
Type of Request: Extension of an
OMB-approved information collection.
Frequency of
response
Average burden
per response
(minutes)
Estimated
annual burden
(hours)
404.1730(c)(2)(i) .................................................................................
404.1730(c)(2)(ii) ................................................................................
416.1530(c)(2)(i) .................................................................................
416.1530(c)(2)(ii) ................................................................................
841
600
561
400
10/year ............
1 ......................
10/year ............
1 ......................
30
3
30
3
4,205
30
2,805
20
Totals ...........................................................................................
2,402
.........................
............................
7,060
Dated: February 26, 2010.
Faye I. Lipsky,
Acting Reports Clearance Officer, Social
Security Administration.
DEPARTMENT OF STATE
[Public Notice 6911]
Bureau of Educational and Cultural
Affairs (ECA) Request for Grant
Proposals (RFGP): One-time
Competitive Grants Program—
Competition A—Academic Programs
[FR Doc. 2010–4448 Filed 3–3–10; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice 6913]
Determination and Waiver Regarding
the Sixth Proviso under the Heading
‘‘Economic Support Funds’’ in the
Department of State, Foreign
Operations, and Related Programs
Appropriations Act, 2009 (Div. H, Pub.
L. 111–8) Relating to Assistance for
Afghanistan
mstockstill on DSKH9S0YB1PROD with NOTICES
Pursuant to the authority vested in me
as Secretary of State, including by
Presidential Delegation No. 2007–29 of
August 27, 2007, I hereby determine
that it is in the national security
interests of the United States to make
available $200,000,000 appropriated
under the heading Economic Support
Funds in the Department of State,
Foreign Operations, and Related
Programs Appropriations Act, 2009
(Div. H, Pub. L. 111–8), without regard
to the restriction in the sixth proviso
under that heading.
This determination shall be reported
to the Congress promptly and published
in the Federal Register.
Dated: October 15, 2009.
Hillary Rodham Clinton,
Secretary of State.
[FR Doc. 2010–4604 Filed 3–3–10; 8:45 am]
BILLING CODE 4710–17–P
VerDate Nov<24>2008
16:39 Mar 03, 2010
Jkt 220001
Announcement Type: New Grant
Funding Opportunity Number: ECA/
A–10–One-time-Comp–A
Catalog of Federal Domestic
Assistance Number: 19.014
Key Dates:
Application Deadline: April 12, 2010
Executive Summary: This competition
is one of two competitions that the
Bureau of Educational and Cultural
Affairs is conducting in accordance with
the Conference Report (House Report
111–366) accompanying the
Consolidated Appropriations Act, 2010
(Pub. L. 111–117) under Division F of
the Department of State, Foreign
Operations and Related Programs
Appropriation Act 2010, ‘‘Educational
and Cultural Exchange Programs’’ in
support of an $8 million ‘‘One-Time
Competitive Grants Program.’’ All
applications must be submitted by
public or private non-profit
organizations, meeting the provisions
described in Internal Revenue code
section 26 U.S.C. 501(c)(3). Total
funding for this ‘‘One-Time Competitive
Grants Program’’ is $8 million. Four
million dollars will be dedicated to
Competition A—Academic Programs
One-time Grants Program—reference
number ECA/A–10–One-time-Comp-A,
and $4 million will be dedicated to and
announced simultaneously in a separate
RFGP Competition B—Professional,
Cultural and Youth One-time Grants
Program—reference number ECA/PE/C–
10–One-time-Comp-B. Please note: The
Bureau reserves the right to reallocate
funds it has initially allocated to each of
these two competitions, based upon
factors such as the number of
applications received and
PO 00000
Frm 00131
Fmt 4703
Sfmt 4703
responsiveness to the review criteria
outlined in each of the solicitations.
Applicants may submit only one
proposal (total) to one of the two
competitions referenced above. In
addition, applicants under this
competition (ECA/A–10–One-timeComp-A) may apply to administer only
one of the listed activities (total). If
multiple proposals are received from the
same applicant, all submissions will be
declared technically ineligible and will
be given no further consideration in the
review process. Eligible applicants are
strongly encouraged to read both RFGPs
thoroughly, prior to developing and
submitting proposals, to ensure that
proposed activities are appropriate and
responsive to the goals, objectives and
criteria outlined in the solicitations.
As further directed by the Congress,
‘‘The program shall be only for the
actual exchange of people and should
benefit a population that is not being
addressed through existing authorized
exchanges.’’
The Bureau of Educational and
Cultural Affairs announces a
competition for grants that support
international exchanges in order to
increase mutual understanding and
build relationships, through individuals
and organizations, between the people
of the United States and their
counterparts in other countries. The
Bureau welcomes proposals from
organizations that have not received a
previous grant from the Bureau as well
as from those which have; see eligibility
information below and in section III.
I. Funding Opportunity Description
Authority
Overall grant making authority for
this program is contained in the Mutual
Educational and Cultural Exchange Act
of 1961, Public Law 87–256, as
amended, also known as the FulbrightHays Act. The purpose of the Act is ‘‘to
enable the Government of the United
States to increase mutual understanding
between the people of the United States
E:\FR\FM\04MRN1.SGM
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]]>Agencies
[Federal Register Volume 75, Number 42 (Thursday, March 4, 2010)]
[Notices]
[Pages 9992-9997]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-4448]
=======================================================================
-----------------------------------------------------------------------
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 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.
(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 May
3, 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. Application for Lump Sum Death Payment--20 CFR 404.390-404.392--
0960-0013. SSA uses Form SSA-8-F4 to collect information needed to
authorize payment of the lump sum death payment (LSDP) to a widow,
widower, or children as defined in section 202(i) of the Social
Security Act. Respondents complete the application for this one-time
payment via paper form, telephone, or an in-person interview with SSA
employees. Respondents are applicants for the LSDP.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated
Collection method Number of completion time Burden hours
respondents (minutes)
----------------------------------------------------------------------------------------------------------------
MCS.................................................... 278,825 10 46,471
MCS/Signature Proxy.................................... 278,825 9 41,824
Paper.................................................. 29,350 10 4,892
--------------------------------------------------------
Totals:............................................ 587,000 ................. 93,187
----------------------------------------------------------------------------------------------------------------
2. Certificate of Responsibility for Welfare and Care of Child Not
in Applicant's Custody--20 CFR 404.330, 404.339-341, and 404.348-
404.349--0960-0019. SSA uses Form SSA-781 to determine if non-custodial
parents who are filing for spouse's or mother's and father's benefits
based on having a child in their care meet the in-care requirements.
Respondents are applicants for spouse's and/or mother's and father's
benefits.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 14,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 2,333 hours.
3. Supplemental Statement Regarding Farming Activities of Person
Living Outside the U.S.A.--0960-0103. SSA uses Form SSA-7163A to
document beneficiary or claimant reports of working on a farm outside
the United States (U.S.). Specifically, the information provided on
this form helps us to determine if we should apply foreign work
deductions to the recipient's benefits. We collect the information
either annually or every other year, depending on the respondent's
country of residence. Respondents are Social Security recipients
engaged in farming activities outside the U.S.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 1,000.
Frequency of Response: 1.
Average Burden Per Response: 1 hour.
Estimated Annual Burden: 1,000 hours.
4. Disability Report--Appeal--20 CFR 404.1512, 416.912, 404.916(c),
416.1416(c), 405 Subpart C, 422.140--0960-0144. SSA requires disability
claimants who are appealing an unfavorable disability determination to
complete Form SSA-3441-BK. This form allows claimants to disclose any
changes to their disability or resources that might influence SSA's
unfavorable determination. SSA may use the information to: (1)
Reconsider and review an initial disability determination; (2) review a
continuing disability; and (3) evaluate a request for a hearing. This
information assists the State Disability Determination Services and
administrative law judges (ALJ) in: (1) Preparing for the appeals and
hearings; and (2) issuing a determination or decision on an
individual's entitlement (initial or continuing) to disability
benefits. Respondents are individuals who appeal denial, reduction, or
cessation of Social Security disability income and Supplemental
Security Income (SSI) payments, or who are requesting a hearing before
an ALJ.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 9993]]
----------------------------------------------------------------------------------------------------------------
Average burden
Collection method Number of Frequency of per response Estimated annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3441 (Paper Form)................... 12,604 1 45 9,453
Electronic Disability Collect System 843,090 1 45 632,318
(EDCS).................................
I3441 (Internet Form)................... 417,268 1 120 834,536
-----------------------------------------------------------------------
Totals.............................. 1,272,962 ................ ................ 1,476,307
----------------------------------------------------------------------------------------------------------------
5. Request for Hearing by Administrative Law Judge--20 CFR 404.929,
404.933, 416.1429, 404.1433, 405.722, 418.1350--0960-0269. When SSA
denies applicants' or beneficiaries' requests for new or continuing
benefits, those applicants/beneficiaries are entitled to request a
hearing to appeal the decision. SSA uses Form HA-501 to document such
requests. Although SSA collects this information, the actual hearings
take place before ALJs employed by the Department of Health and Human
Services (HHS). The respondents are: (1) Applicants for or current
recipients of various Social Security benefits who want to appeal SSA's
denial of their requests for new or continued benefits; and (2)
Medicare Part B recipients whom SSA has determined must pay the
Medicare Part B Income-Related Monthly Adjustment Amount, both of whom
wish to appeal this decision at a hearing before an HHS ALJ.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 669,469.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 111,578 hours.
6. Information about Joint Checking/Savings Accounts--20 CFR
416.120, 416.1208--0960-0461. SSA considers a person's resources when
evaluating eligibility for SSI payments. Generally, we consider funds
in checking and savings accounts to be resources owned by the
individuals whose names appear on the account. Individuals applying for
SSI, however, may rebut an assumption of ownership in a joint account
if they submit certain evidence establishing the funds do not belong to
them. SSA uses Form SSA-2574 to collect information from SSI
applicants/recipients who object to the assumption they own all or part
of the funds in a joint checking or savings account bearing their
names. SSA collects information about the account from both the SSI
applicant/recipient and other account holder(s). After receiving the
completed form, SSA can determine if we should consider the account to
be a resource for the SSI payments applicant/recipient. The respondents
are applicants and recipients of SSI and individuals who list
themselves as joint owners of financial accounts with SSI applicants/
recipients.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 200,000.
Frequency of Response: 1.
Average Burden per Response: 7 minutes.
Estimated Annual Burden: 23,333 hours.
7. Request for Earnings and Benefit Estimate Statement--20 CFR
404.810--0960-0466. SSA uses the information collected by Form SSA-7004
to identify respondents' Social Security earnings records, extract
posted earnings information, calculate potential benefit estimates,
produce the resulting Social Security statements, and mail them to the
requesters. The respondents are Social Security number holders
requesting information about their Social Security earnings records and
estimates of their potential benefits.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden
Modality Number of Frequency of per response Total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Paper Version........................... 127,000 1 5 10,583
Internet Version........................ 426,000 1 5 35,500
-----------------------------------------------------------------------
Totals.............................. 553,000 ................ ................ 46,083
----------------------------------------------------------------------------------------------------------------
8. Beneficiary Recontact Form--20 CFR 404.703, 404.705--0960-0502.
SSA must ensure that recipients of disability payments continue to be
eligible for their payments. Research has indicated benefit recipients
may fail to report circumstances that affect their benefits. Two such
cases are: (1) When parents receiving disability benefits for their
child marry; and (2) the removal of an entitled child from parents'
care. SSA uses Form SSA-1588-OCR-SM to ask mothers/fathers about their
marital status and children in care to detect overpayments and avoid
continuing payment to those are no longer entitled. Respondents are
recipients of mother/father Social Security benefits.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 133,400.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 11,117 hours.
9. Complaint Form for Allegations of Discrimination in Programs or
Activities Conducted by the Social Security Administration--0960-0585.
SSA uses Form SSA-437 to investigate and formally resolve complaints of
discrimination based on disability, race, color, national origin
(including limited English proficiency), sex, sexual orientation, age,
religion, or retaliation for having participated in a proceeding under
this administrative complaint process in connection with an SSA program
or activity. SSA also uses this form to review, investigate, and
resolve complaints alleging discrimination based on status as a parent
in education, training programs, or activities conducted by SSA.
Individuals who believe SSA discriminated against them on any of the
above bases may file a written complaint of discrimination. SSA uses
the information to identify the complainant; identify the alleged
discriminatory act; ascertain the date of such alleged act; obtain the
identity of any individual(s) with information about the alleged
discrimination; and ascertain other relevant information that
[[Page 9994]]
would assist in the investigation and resolution of the complaint.
Respondents are individuals who believe SSA or SSA employees,
contractors, or agents in programs or activities conducted by SSA
discriminated against them.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 140.
Frequency of Response: 1.
Average Burden per Response: 1 hour.
Estimated Annual Burden: 140 hours.
10. Social Security Benefits Application--20 CFR 404.310-404.311,
404.315-404.322, 404.330-404.333, 404.601-404.603, and 404.1501-
404.1512--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) is for additions and revisions to
the information collection.
Type of Request: Revision of an OMB-approved information
collection.
Paper Forms/Accompanying MCS Screens Burden Information:
----------------------------------------------------------------------------------------------------------------
Average burden
Collection method Number of Frequency of per response Estimated annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Form SSA-1
----------------------------------------------------------------------------------------------------------------
MCS..................................... 172,200 1 11 31,570
MCS/Signature Proxy..................... 1,250,800 1 10 208,467
Paper................................... 20,000 1 11 3,667
Medicare-only MCS....................... 299,000 1 7 34,883
Medicare-only Paper..................... 1,000 1 7 117
-----------------------------------------------------------------------
Totals.............................. 1,743,000 ................ ................ 278,704
----------------------------------------------------------------------------------------------------------------
Form SSA-2
----------------------------------------------------------------------------------------------------------------
MCS..................................... 36,860 1 15 9,215
MCS/Signature Proxy..................... 331,740 1 14 77,406
Paper................................... 3,800 1 15 950
-----------------------------------------------------------------------
Totals.............................. 372,400 ................ ................ 87,571
----------------------------------------------------------------------------------------------------------------
Form SSA-16
----------------------------------------------------------------------------------------------------------------
MCS..................................... 218,657 1 20 72,886
MCS/Signature Proxy..................... 1,967,913 1 19 623,172
Paper................................... 24,161 1 20 8,054
-----------------------------------------------------------------------
Totals.............................. 2,210,731 ................ ................ 704,112
----------------------------------------------------------------------------------------------------------------
iClaim
----------------------------------------------------------------------------------------------------------------
iClaim 3rd Party........................ 28,118 1 15 7,030
iClaim Applicant after 3rd Party 28,118 1 5 2,343
Completion.............................
First Party iClaim...................... 541,851 1 15 135,463
Medicare-only iClaim.................... 200,000 1 10 33,333
-----------------------------------------------------------------------
Totals.............................. 798,087 ................ ................ 178,169
----------------------------------------------------------------------------------------------------------------
Aggregate Public Reporting Burden: 1,248,556 hours.
11. SSI Telephone Wage Reporting System (SSITWR)--20 CFR 416.701-
0732--0960-0715. SSA requires SSI recipients to report changes that
could affect their eligibility for and the amount of their SSI
payments, such as changes in income, resources, and living
arrangements. The SSITWR, formerly the Statement for SSI Monthly Wage
Reporting (Telephone), enables SSI recipients to meet these
requirements by providing them with a fully automated mechanism to
report their monthly wages by telephone, instead of contacting their
local field offices. The SSITWR allows callers to report their wages
either by speaking their responses through voice recognition
technology, or by keying in responses using the telephone key pad. To
ensure the security of the information provided, SSITWR asks callers to
provide information SSA can compare against its records for
authentication purposes. Once the system authenticates the identity of
the callers, the callers can speak or key in their wage data. The
respondents are SSI recipients, deemors, and representative payees of
recipients.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated
Collection method Frequency of Number of completion time Burden (hours)
reporting respondents (minutes)
----------------------------------------------------------------------------------------------------------------
Training/Instruction.................... 1 85,000 35 49,584
SSITWR.................................. 12 85,000 5 85,000
-----------------------------------------------------------------------
[[Page 9995]]
Total............................... ................ *85,000 ................ 134,584
----------------------------------------------------------------------------------------------------------------
Note: * The same 85,000 respondents are completing both activities, so the actual total number of respondents is
only 85,000.
12. Treating Physician Consultative Examination Interest Form--20
CFR 404.1519g--20 CFR 404.1519i--0960-0751. When an applicant for
Social Security disability benefits has not consulted a physician for a
specified period preceding the application, SSA will ask the applicant
to complete a consultative examination (CE). If the applicant has a
treating physician (TP), SSA sends a medical evidence of record request
letter and Form SSA-84 to the applicant's TP; the TP completes the
latter form and returns it to SSA to indicate interest in conducting
the CE. If the TP does not return the form, SSA assumes the TP is not
interested in performing the CE. Respondents are disability benefits
applicants' treating physicians.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 168.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 14 hours.
13. Claimant Travel Reimbursement Request--20 CFR 404.999a-20 CFR
404.99c--0960-0752. SSA sends Form SSA-104 to Social Security benefits
recipients with a CE appointment notice. To receive reimbursement for
their travel expenses to the CE, recipients must: (1) Submit an
itemized list of expenditures for their round trip; and (2) complete,
sign, and return the SSA-104 to SSA. SSA collects this information to
determine the amount of reimbursement. Respondents are applicants for
disability claims applying for reimbursement of travel expenses to a
CE.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 11,092.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 1,849 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 April 5, 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. 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
if an individual or partnership can claim 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
establish 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: Revision 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. Statement for Determining Continuing Eligibility Supplemental
Security Income Payment--20 CFR 416.204--0960-0145. SSA uses the
information from Form SSA-8202-BK to conduct low- and middle-error-
profile (LEP-MEP) telephone or face-to-face redetermination (RZ)
interviews with SSI recipients and representative payees. The
information SSA collects during the interview is needed 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.
Note: SSA published this information collection with the
incorrect burden information on December 28, 2009 at 74 FR 68655.
The correct information is below.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden
Form No. Number of Frequency of per response Total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8202-BK............................. 235,390 1 21 82,387
MSSICS.................................. 333,408 1 20 111,136
-----------------------------------------------------------------------
Totals.............................. 568,798 ................ ................ 193,523
----------------------------------------------------------------------------------------------------------------
3. Claimant Statement About Loan of Food or Shelter; Statement
About Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. SSA uses Forms SSA-5062 and SSA-L5063 to obtain statements
about food and/or shelter provided to SSI claimants or recipients. SSA
uses this information to determine whether food and/or shelter are bona
fide loans or if SSA should count them as income for SSI purposes. This
determination can affect a claimant or recipient's eligibility for SSI
and the amount of SSI payments. The respondents are claimants and
recipients for SSI payments and individuals who provide loans of food
or shelter to them.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 131,080.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 21,847 hours.
4. Request To Resolve Questionable Quarters of Coverage (QC);
Request for QC History Based on Relationship--0960-0575. The Personal
Responsibility and Work Opportunity Reconciliation Act states that
aliens admitted for lawful residence who have worked and earned 40
qualifying QCs for Social Security
[[Page 9996]]
purposes can generally receive State benefits. States complete Form
SSA-512 to request clarification from SSA on questionable QC
information. Specifically, States use this form to request QC
information for an alien's spouse or child in cases where the alien
does not sign a consent form giving permission to access his/her Social
Security records. We can allocate QCs to a spouse and/or to a child
under age 18, if needed, to obtain 40 qualifying QCs for the alien. The
respondents are State agencies that require QC information to determine
eligibility for benefits.
Note: This is a correction notice. SSA published this
information collection with the incorrect burden information on
December 28, 2009 at 74 FR 68655. In addition, 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.
----------------------------------------------------------------------------------------------------------------
Average burden
Form No. Number of Frequency of per response Total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-512................................. 25,000 1 2 833
SSA-513................................. 25,000 1 2 833
-----------------------------------------------------------------------
Totals.............................. 50,000 ................ ................ 1,666
----------------------------------------------------------------------------------------------------------------
5. 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 asks organizational representative
payees to complete Form SSA-637, Site Review Questionnaire for Volume
and Fee-for-Service Payees, to provide information on how they carry
out their representative payee responsibilities, including how they
manage beneficiary funds. SSA then obtains information from the
beneficiaries these organizations represent via the SSA-639,
Beneficiary Interview Form, to corroborate the payees' 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, and non-
profit and for-profit organizations that serve as representative payees
and the beneficiaries they serve.
Note: This is a correction notice. SSA published this
information collection as an extension on December 08, 2009 at 74 FR
64801. 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.
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Average burden
Form No. Number of Frequency of per response Total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-637................................. 2,001 1 120 4,002
SSA-639................................. 9,341 1 10 1,557
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Totals.............................. 11,342 ................ ................ 5,559
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6. Direct Deposit Sign-Up Form (Country)--31 CFR 210--0960-0686.
SSA's International Direct Deposit Program allows beneficiaries living
abroad to receive their payments via direct deposit to an account at a
financial institution outside the United States. SSA uses Form SSA-1199
to obtain the direct deposit information for such foreign accounts.
Routing account number information varies slightly for each foreign
country, so we use a variation of the Treasury Department's Form SF-
1199A for each country. The respondents are Social Security
beneficiaries residing abroad who want SSA to deposit their benefits
payments directly to a foreign financial institution.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 5,000.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 417 hours.
7. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. This regulation stipulates that when a valid agreement is in
place, prison officials may 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 identities of
prisoners applying for replacement Social Security cards.
Note: This is a correction notice. SSA published this
information collection as an extension on December 08, 2009 at 74 FR
64801. 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: 1,000.
Frequency of Response: 200.
Average Burden per Response: 3 minutes.
Estimated Annual Burden: 10,000 hours.
8. Temporary Extension of Attorney Fee Payment System to Title XVI;
5-Year Demonstration Project Extending Fee Withholding and Payment
Procedures to Eligible Non-Attorney Representatives; Definition of
Past-Due Benefits; and Assessment for Fee Payment Services--20 CFR
404.1717, 404.1730(c)(1), 404.1730(c)(2)(i), 404.1730(c)(2)(ii),
416.1517, 416.1528(a), 416.1530(c)(1), 416.1530(c)(2)(i),
416.1530(c)(2)(i)--0960-0745. Section 302 of the Social Security
Protection Act of 2004 (SSPA), Public Law 108-203, amended section
1631(d)(2) of the Social Security Act to temporarily extend the Title
II attorney fee withholding and direct payment process to Title XVI.
Section 303 of the SSPA directed SSA to develop and conduct a 5-year
nationwide demonstration project to allow qualifying non-attorneys the
option of
[[Page 9997]]
fee withholding and direct payment of fees under both Titles II and
XVI. SSA uses the information obtained through this demonstration
project to administer fee withholding and direct payment to certain
non-attorney representatives. Respondents are non-attorneys who are
eligible to receive direct payment of fees for representing individuals
before SSA.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden
Regulation section Number of Frequency of response per response Estimated annual
respondents (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
404.1730(c)(2)(i)................ 841 10/year................ 30 4,205
404.1730(c)(2)(ii)............... 600 1...................... 3 30
416.1530(c)(2)(i)................ 561 10/year................ 30 2,805
416.1530(c)(2)(ii)............... 400 1...................... 3 20
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Totals....................... 2,402 ....................... ................ 7,060
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Dated: February 26, 2010.
Faye I. Lipsky,
Acting Reports Clearance Officer, Social Security Administration.
[FR Doc. 2010-4448 Filed 3-3-10; 8:45 am]
BILLING CODE 4191-02-P
