Agency Information Collection Activities: Proposed Request and Comment Request, 15761-15764 [2010-7016]
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15761
Federal Register / Vol. 75, No. 60 / Tuesday, March 30, 2010 / Notices
C. Self-Regulatory Organization’s
Statement on Comments on the
Proposed Rule Change Received From
Members, Participants, or Others
The Exchange neither solicited nor
received comments on the proposal.
III. Date of Effectiveness of the
Proposed Rule Change and Timing for
Commission Action
Because the foregoing rule 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 if consistent
with the protection of investors and the
public interest, provided that the selfregulatory organization has given the
Commission written notice of its intent
to file the proposed rule change at least
five business days prior to the date of
filing of the proposed rule change or
such shorter time as designated by the
Commission, the proposed rule change
has become effective pursuant to
Section 19(b)(3)(A) of the Act 8 and Rule
19b–4(f)(6) thereunder.9 At any time
within 60 days of the filing of such
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–CBOE–2010–029 on the
subject line.
jlentini on DSKJ8SOYB1PROD with NOTICES
Paper Comments
• Send paper comments in triplicate
to Elizabeth M. Murphy, Secretary,
Securities and Exchange Commission,
100 F Street, NE., Washington, DC
20549–1090.
All submissions should refer to File
Number SR–CBOE–2010–029. This file
number should be included on the
subject line if e-mail is used. To help the
Commission process and review your
comments more efficiently, please use
only one method. The Commission will
post all comments on the Commission’s
Internet Web site (https://www.sec.gov/
rules/sro.shtml). Copies of the
submission, all subsequent
amendments, all written statements
with respect to the proposed rule
change that are filed with the
Commission, and all written
communications relating to the
proposed rule change between the
Commission and any person, other than
those that may be withheld from the
public in accordance with the
provisions of 5 U.S.C. 552, will be
available for Web site viewing and
printing in the Commission’s Public
Reference Room, 100 F Street, NE.,
Washington, DC 20549, on official
business days between the hours of 10
a.m. and 3 p.m. Copies of such filing
also will be available for inspection and
copying at the principal office of the
Exchange. All comments received will
be posted without change; the
Commission does not edit personal
identifying information from
submissions. You should submit only
information that you wish to make
available publicly. All submissions
should refer to File Number SR–CBOE–
2010–029 and should be submitted on
or before April 20, 2010.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.10
Florence E. Harmon,
Deputy Secretary.
[FR Doc. 2010–6993 Filed 3–29–10; 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
and a collection in use without an OMB
number.
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 June 1, 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 Child’s Insurance
Benefits—20 CFR 404.350–404.368,
404.603, & 416.350—0960–0010
SSA uses Form SSA–4–BK to
determine if children of living and
deceased workers are entitled to their
parents’ monthly Social Security
payments. The respondents are
guardians completing the form on behalf
of the children of living or deceased
workers, or the children of living or
deceased workers.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Form of request
Life Claims (paper) ......................................................................................................................
8 15
U.S.C. 78s(b)(3)(A).
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9 17
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CFR 240.19b–4(f)(6).
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8,052
10 17
Sfmt 4703
Response time
(minutes)
E:\FR\FM\30MRN1.SGM
CFR 200.30–3(a)(12).
30MRN1
12
Burden
(hours)
1,610
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Federal Register / Vol. 75, No. 60 / Tuesday, March 30, 2010 / Notices
Number of
respondents
Form of request
Response time
(minutes)
Burden
(hours)
Life Claims (MCS) .......................................................................................................................
Life Claims-Signature Proxy ........................................................................................................
Death Claims (paper) ..................................................................................................................
Death Claims (MCS) ....................................................................................................................
Death Claims-Signature Proxy ....................................................................................................
152,983
152,983
19,061
362,150
362,150
12
11
12
12
11
30,597
28,047
3,812
72,430
66,394
Totals ....................................................................................................................................
1,057,379
........................
202,890
2. Report to United States Social
Security Administration by Person
Receiving Benefits for a Child or for an
Adult Unable To Handle Funds/Report
to the United States Social Security
Administration—0960–0049
SSA uses the information it collects
on Forms SSA–7161–OCR–SM and
SSA–7162–OCR–SM to: (1) Determine
continuing entitlement to Social
Security benefits; (2) correct benefit
amounts for beneficiaries outside the
United States; and (3) monitor the
performance of representative payees
outside the United States. The
respondents are individuals living
outside the United States who are
receiving benefits on their own (or for
someone else) under Title II of the
Social Security Act.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Form No.
Average
burden per
response
Frequency of
response
Estimated
annual burden
SSA–7161–OCR–SM ......................................................................................
SSA–7162–OCR–SM ......................................................................................
30,560
271,142
1
1
15
5
7,640
22,595
Totals ........................................................................................................
301,702
........................
........................
30,235
jlentini on DSKJ8SOYB1PROD with NOTICES
3. Real Property Current Market Value
Estimate—0960–0471
SSA considers a person’s resources
when evaluating eligibility for
Supplemental Security Income (SSI)
payments. The value of an individual’s
resources, including non-home real
property, is one of the eligibility
requirements for SSI payments. SSA
obtains current market value estimates
of real property owned by applicants
for, or recipients of, SSI through Form
SSA–L2794. The respondents are small
business operators in real estate, state
and local employees, and other
individuals knowledgeable about local
real estate values.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 5,438.
Frequency of Response: 1.
Average Burden per Response: 20
minutes.
Estimated Annual Burden: 1,813
hours.
4. Employer Verification of Earnings
After Death—20 CFR 404.821 and
404.822—0960–0472
When SSA records show a wage
earner is deceased and an employer
reported wages for the wage earner for
a year subsequent to death, SSA must
VerDate Nov<24>2008
16:22 Mar 29, 2010
Jkt 220001
contact the employer and verify the
reported wage and employee
information. The information SSA
obtains on Form SSA–L4112 verifies the
wage information previously received
from the employer is correct for the
employee and the year in question. The
respondents are employers who report
wages for employees who have died.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 8,333
hours.
5. Wage Reports and Pension
Information—20 CFR 422.122(b)—0960–
0547
Pension plan administrators annually
file plan information with the Internal
Revenue Service, who then forwards the
information to SSA. SSA maintains and
organizes this information by plan
numbers, plan participant’s name, and
Social Security number. Under Section
1131(a) of the Social Security Act,
pension plan participants are entitled to
request this information from SSA. The
Wage Reports and Pension Information
regulation, 20 CFR 422.122(b) of the
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Code of Federal Regulations, stipulates
that before SSA disseminates this
information, the requester must first
submit a written request with
identifying information to SSA. The
respondents are requestors of pension
plan information.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 600.
Frequency of Response: 1.
Average Burden per Response: 30
minutes.
Estimated Annual Burden: 300 hours.
6. Request for Reconsideration—20 CFR
404.907–404.921, 416.1407–416.1421,
408.1009—0960–0622
SSA uses Form SSA–561–U2 to
initiate and document the
reconsideration process for determining
an individual’s eligibility or entitlement
to Social Security benefits (Title II), SSI
payments (Title XVI), Special Veterans
Benefits (Title VIII), Medicare (Title
XVIII), and for initial determinations
regarding Medicare Part B incomerelated premium subsidy reductions.
The respondents are individuals filing
for reconsideration.
Type of Request: Revision of an OMBapproved information collection.
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Federal Register / Vol. 75, No. 60 / Tuesday, March 30, 2010 / Notices
Number of
respondents
Collection method
Average
burden per
response
(minutes)
Frequency of
response
Estimated
annual burden
(hours)
Paper form & Modernized Claims System ......................................................
Internet i561 .....................................................................................................
730,850
730,850
1
1
8
20
97,447
243,617
Totals ........................................................................................................
1,461,700
........................
........................
341,064
7. Identifying Information for Possible
Direct Payment of Authorized Fees—
0960–0730
SSA collects information from
claimants’ appointed representatives on
Form SSA–1695 to process and facilitate
direct payment of authorized fees to a
financial institution. SSA also needs
this information to issue a Form 1099–
MISC, if applicable. Finally, SSA uses
Form SSA–1695 to establish a link
between each claim for benefits and the
data that we collect on the SSA–1699
for our appointed representative
database. The respondents are attorneys
and other individuals who represent
claimants for benefits before SSA.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 10,000.
Frequency of Response: 40.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 66,667
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 29, 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.
jlentini on DSKJ8SOYB1PROD with NOTICES
1. Waiver of Supplemental Security
Income Payment Continuation—20 CFR
416.1400–416.1422—0960–NEW
SSA uses 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
VerDate Nov<24>2008
16:22 Mar 29, 2010
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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. Centenarian Project Development
Worksheets: Face-to-Face Interview;
Telephone Interview; Third Party
Contact; Unable To Locate—20 CFR
416.204(b) and 422.135—0960–NEW
SSA conducts interviews with
centenary beneficiaries age 103 and
older to assess: (1) If the beneficiaries
are still living; (2) to prevent fraud,
through either identity
misrepresentation or representative
payee misuse of funds; and (3) to assess
the well-being of the beneficiaries.
SSA’s San Francisco field offices
currently use this survey, and we intend
to expand its use to all other SSA field
offices. Field office personnel obtain the
information through one-time, in-person
interviews with centenarians. During
the interview, SSA employees will make
overall observations of the centenarian
and their representative payee (if
applicable). The interviewer will use the
appropriate Centenarian Development
Worksheet as a guide for the interview
and to document findings. SSA will
conduct the interview one time only at
the beneficiary’s residence or over the
phone if a site visit is not possible.
Refusal of the interview will not result
in the suspension of the centenarian’s
payments. Respondents are SSI
recipients or Social Security
beneficiaries 103 years old or older,
their representative payees, or
caregivers.
Type of Request: Existing information
collection in use without an OMB
number.
Number of Respondents: 14,000.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 3,500
hours.
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3. 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 collects information on Form
SSA–770 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.
4. 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 StatesItaly agreement effective November 1,
1978. Article 19.2 of the 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. 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
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Italy who wish to file for U.S. Social
Security benefits.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 250.
Frequency of Response: 1.
Average Burden per Response: 20
minutes.
Estimated Annual Burden: 83 hours.
5. 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
verifies 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 Request: Revision of an OMBapproved information collection.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 3,333
hours.
6. Work Incentives Planning and
Assistance Program—0960–0629
The Work Incentives Planning and
Assistance (WIPA) program collects
identifying information from project
Number of
responses
Respondents
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.
Average burden per
response
(minutes)
Frequency of
response
Estimated annual burden
(hours)
Project Site ......................................................................................................
CWIC ...............................................................................................................
Beneficiary .......................................................................................................
147
422
60,000
1
1
1
2
2
5
5
14
5,000
Totals ........................................................................................................
60,569
........................
........................
5,019
7. Beneficiary Interview and Auditor’s
Observations Form—0960–0630
SSA’s Office of the Inspector General
collects information 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
responsibilities. SSA randomly selects
SSI recipients and Social Security
beneficiaries who have representative
payees as respondents for this
collection.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 200.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 50 hours.
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.
Dated: March 25, 2010.
Elizabeth Davidson,
Center Director, Center for Reports Clearance,
Social Security Administration.
[FR Doc. 2010–7016 Filed 3–29–10; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice 6936]
jlentini on DSKJ8SOYB1PROD with NOTICES
8. Certification of Contents of
Document(s) or Record(s)—20 CFR
404.715f—0960–0689
Culturally Significant Objects Imported
for Exhibition Determinations: ‘‘Gods
of Angkor: Bronzes From the National
Museum of Cambodia’’
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
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
VerDate Nov<24>2008
16:22 Mar 29, 2010
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No. 257 of April 15, 2003 [68 FR 19875],
I hereby determine that the objects to be
included in the exhibition ‘‘Gods of
Angkor: Bronzes from the National
Museum of Cambodia,’’ imported from
abroad for temporary exhibition within
the United States, are of cultural
significance. The objects are imported
pursuant to a loan agreement with the
foreign owner or custodian. I also
determine that the exhibition or display
of the exhibit objects at the Arthur M.
Sackler Gallery, Smithsonian
Institution, Washington, DC, from on or
about May 15, 2010, until on or about
January 23, 2011, the J. Paul Getty
Museum, Los Angeles, California, from
on or about February 22, 2011, until on
or about August 14, 2011, 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 list of
the exhibit objects, 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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]]>Agencies
[Federal Register Volume 75, Number 60 (Tuesday, March 30, 2010)]
[Notices]
[Pages 15761-15764]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-7016]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law (Pub. L.)
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995.
This notice includes revisions and extensions of OMB-approved
information collections and a collection in use without an OMB number.
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 June
1, 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 Child's Insurance Benefits--20 CFR 404.350-404.368,
404.603, & 416.350--0960-0010
SSA uses Form SSA-4-BK to determine if children of living and
deceased workers are entitled to their parents' monthly Social Security
payments. The respondents are guardians completing the form on behalf
of the children of living or deceased workers, or the children of
living or deceased workers.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Number of Response time Burden
Form of request respondents (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Life Claims (paper)............................................. 8,052 12 1,610
[[Page 15762]]
Life Claims (MCS)............................................... 152,983 12 30,597
Life Claims-Signature Proxy..................................... 152,983 11 28,047
Death Claims (paper)............................................ 19,061 12 3,812
Death Claims (MCS).............................................. 362,150 12 72,430
Death Claims-Signature Proxy.................................... 362,150 11 66,394
-----------------------------------------------
Totals...................................................... 1,057,379 .............. 202,890
----------------------------------------------------------------------------------------------------------------
2. Report to United States Social Security Administration by Person
Receiving Benefits for a Child or for an Adult Unable To Handle Funds/
Report to the United States Social Security Administration--0960-0049
SSA uses the information it collects on Forms SSA-7161-OCR-SM and
SSA-7162-OCR-SM to: (1) Determine continuing entitlement to Social
Security benefits; (2) correct benefit amounts for beneficiaries
outside the United States; and (3) monitor the performance of
representative payees outside the United States. The respondents are
individuals living outside the United States who are receiving benefits
on their own (or for someone else) under Title II of the Social
Security Act.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Form No. Number of Frequency of burden per Estimated
respondents response response annual burden
----------------------------------------------------------------------------------------------------------------
SSA-7161-OCR-SM................................. 30,560 1 15 7,640
SSA-7162-OCR-SM................................. 271,142 1 5 22,595
---------------------------------------------------------------
Totals...................................... 301,702 .............. .............. 30,235
----------------------------------------------------------------------------------------------------------------
3. Real Property Current Market Value Estimate--0960-0471
SSA considers a person's resources when evaluating eligibility for
Supplemental Security Income (SSI) payments. The value of an
individual's resources, including non-home real property, is one of the
eligibility requirements for SSI payments. SSA obtains current market
value estimates of real property owned by applicants for, or recipients
of, SSI through Form SSA-L2794. The respondents are small business
operators in real estate, state and local employees, and other
individuals knowledgeable about local real estate values.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 5,438.
Frequency of Response: 1.
Average Burden per Response: 20 minutes.
Estimated Annual Burden: 1,813 hours.
4. Employer Verification of Earnings After Death--20 CFR 404.821 and
404.822--0960-0472
When SSA records show a wage earner is deceased and an employer
reported wages for the wage earner for a year subsequent to death, SSA
must contact the employer and verify the reported wage and employee
information. The information SSA obtains on Form SSA-L4112 verifies the
wage information previously received from the employer is correct for
the employee and the year in question. The respondents are employers
who report wages for employees who have died.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 8,333 hours.
5. Wage Reports and Pension Information--20 CFR 422.122(b)--0960-0547
Pension plan administrators annually file plan information with the
Internal Revenue Service, who then forwards the information to SSA. SSA
maintains and organizes this information by plan numbers, plan
participant's name, and Social Security number. Under Section 1131(a)
of the Social Security Act, pension plan participants are entitled to
request this information from SSA. The Wage Reports and Pension
Information regulation, 20 CFR 422.122(b) of the Code of Federal
Regulations, stipulates that before SSA disseminates this information,
the requester must first submit a written request with identifying
information to SSA. The respondents are requestors of pension plan
information.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 600.
Frequency of Response: 1.
Average Burden per Response: 30 minutes.
Estimated Annual Burden: 300 hours.
6. Request for Reconsideration--20 CFR 404.907-404.921, 416.1407-
416.1421, 408.1009--0960-0622
SSA uses Form SSA-561-U2 to initiate and document the
reconsideration process for determining an individual's eligibility or
entitlement to Social Security benefits (Title II), SSI payments (Title
XVI), Special Veterans Benefits (Title VIII), Medicare (Title XVIII),
and for initial determinations regarding Medicare Part B income-related
premium subsidy reductions. The respondents are individuals filing for
reconsideration.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 15763]]
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Collection method respondents response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Paper form & Modernized Claims System........... 730,850 1 8 97,447
Internet i561................................... 730,850 1 20 243,617
---------------------------------------------------------------
Totals...................................... 1,461,700 .............. .............. 341,064
----------------------------------------------------------------------------------------------------------------
7. Identifying Information for Possible Direct Payment of Authorized
Fees--0960-0730
SSA collects information from claimants' appointed representatives
on Form SSA-1695 to process and facilitate direct payment of authorized
fees to a financial institution. SSA also needs this information to
issue a Form 1099-MISC, if applicable. Finally, SSA uses Form SSA-1695
to establish a link between each claim for benefits and the data that
we collect on the SSA-1699 for our appointed representative database.
The respondents are attorneys and other individuals who represent
claimants for benefits before SSA.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 10,000.
Frequency of Response: 40.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 66,667 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 29, 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. Waiver of Supplemental Security Income Payment Continuation--20 CFR
416.1400-416.1422--0960-NEW
SSA uses 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. Centenarian Project Development Worksheets: Face-to-Face Interview;
Telephone Interview; Third Party Contact; Unable To Locate--20 CFR
416.204(b) and 422.135--0960-NEW
SSA conducts interviews with centenary beneficiaries age 103 and
older to assess: (1) If the beneficiaries are still living; (2) to
prevent fraud, through either identity misrepresentation or
representative payee misuse of funds; and (3) to assess the well-being
of the beneficiaries. SSA's San Francisco field offices currently use
this survey, and we intend to expand its use to all other SSA field
offices. Field office personnel obtain the information through one-
time, in-person interviews with centenarians. During the interview, SSA
employees will make overall observations of the centenarian and their
representative payee (if applicable). The interviewer will use the
appropriate Centenarian Development Worksheet as a guide for the
interview and to document findings. SSA will conduct the interview one
time only at the beneficiary's residence or over the phone if a site
visit is not possible. Refusal of the interview will not result in the
suspension of the centenarian's payments. Respondents are SSI
recipients or Social Security beneficiaries 103 years old or older,
their representative payees, or caregivers.
Type of Request: Existing information collection in use without an
OMB number.
Number of Respondents: 14,000.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 3,500 hours.
3. 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 collects information on Form
SSA-770 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.
4. 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 the
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. 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
[[Page 15764]]
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.
5. 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 verifies 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 Request: 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.
6. 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.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Respondents Number of Frequency of per response annual burden
responses response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Project Site.................................... 147 1 2 5
CWIC............................................ 422 1 2 14
Beneficiary..................................... 60,000 1 5 5,000
---------------------------------------------------------------
Totals...................................... 60,569 .............. .............. 5,019
----------------------------------------------------------------------------------------------------------------
7. Beneficiary Interview and Auditor's Observations Form--0960-0630
SSA's Office of the Inspector General collects information 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 responsibilities. SSA randomly selects
SSI recipients and Social Security beneficiaries who have
representative payees as respondents for this collection.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 200.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 50 hours.
8. 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.
Dated: March 25, 2010.
Elizabeth Davidson,
Center Director, Center for Reports Clearance, Social Security
Administration.
[FR Doc. 2010-7016 Filed 3-29-10; 8:45 am]
BILLING CODE 4191-02-P
