Agency Information Collection Activities: Proposed Request and Comment Request, 3688-3690 [2011-1028]
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<![CDATA[
3688
Federal Register / Vol. 76, No. 13 / Thursday, January 20, 2011 / Notices
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–NYSEAmex–2011–03 on
the subject line.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.15
Elizabeth M. Murphy,
Secretary.
[FR Doc. 2011–1077 Filed 1–19–11; 8:45 am]
BILLING CODE 8011–01–P
Paper Comments
SOCIAL SECURITY ADMINISTRATION
• Send paper comments in triplicate
to Elizabeth M. Murphy, Secretary,
Securities and Exchange Commission,
100 F Street, NE., Washington, DC
20549–1090.
Agency Information Collection
Activities: Proposed Request and
Comment Request
mstockstill on DSKH9S0YB1PROD with NOTICES
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
All submissions should refer to File
by the Office of Management and
Number SR–NYSEAmex–2011–03. This
Budget (OMB) in compliance with
file number should be included on the
Public Law 104–13, the Paperwork
subject line if e-mail is used. To help the Reduction Act of 1995, effective October
Commission process and review your
1, 1995. This notice includes revisions
comments more efficiently, please use
to OMB-approved information
only one method. The Commission will collections.
post all comments on the Commission’s
SSA is soliciting comments on the
Internet Web site (https://www.sec.gov/
accuracy of the agency’s burden
rules/sro.shtml). Copies of the
estimate; the need for the information;
submission, all subsequent
its practical utility; ways to enhance its
amendments, all written statements
quality, utility, and clarity; and ways to
with respect to the proposed rule
minimize burden on respondents,
change that are filed with the
including the use of automated
collection techniques or other forms of
Commission, and all written
information technology. Mail, e-mail, or
communications relating to the
fax your comments and
proposed rule change between the
Commission and any person, other than recommendations on the information
collection(s) to the OMB Desk Officer
those that may be withheld from the
and SSA Reports Clearance Officer at
public in accordance with the
the following addresses or fax numbers.
provisions of 5 U.S.C. 552, will be
(OMB), Office of Management and
available for Web site viewing and
Budget, Attn: Desk Officer for SSA,
printing in the Commission’s Public
Fax: 202–395–6974, E-mail address:
Reference Room, 100 F Street, NE.,
OIRA_Submission@omb.eop.gov;
Washington, DC 20549, on official
(SSA), Social Security Administration,
business days between the hours of 10
DCBFM, Attn: Reports Clearance
a.m. and 3 p.m. Copies of the filing also
Officer, 1333 Annex Building, 6401
will be available for inspection and
Security Blvd., Baltimore, MD 21235,
copying at the principal office of the
Fax: 410–965–6400, E-mail address:
Exchange. All comments received will
OPLM.RCO@ssa.gov.
be posted without change; the
I. The information collections below
Commission does not edit personal
are pending at SSA. SSA will submit
identifying information from
them to OMB within 60 days from the
submissions. You should submit only
date of this notice. To be sure we
information that you wish to make
consider your comments, we must
available publicly. All submissions
receive them no later than March 21,
should refer to File Number SR–
2011. Individuals can obtain copies of
NYSEAmex–2011–03 and should be
the collection instruments by calling the
submitted on or before February 10,
SSA Reports Clearance Officer at 410–
2011.
965–8783 or by writing to the above
e-mail address.
15 17
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CFR 200.30–3(a)(12).
Frm 00090
Fmt 4703
Sfmt 4703
1. Petition to Obtain Approval of a
Fee for Representing a Claimant before
the Social Security Administration—20
CFR 404.1720 and 404.1725; 20 CFR
416.1520 and 416.1525–0960–0104. A
Social Security claimant’s
representative, whether an attorney or a
non-attorney, uses Form SSA–1560–U4
to petition SSA for authorization to
charge and collect a fee. A claimant may
also use the form to agree or disagree
with the requested fee amount or other
information the representative provides
on the form. The SSA official
responsible for setting the fee uses the
information from the form to determine
a reasonable fee amount representatives
may charge for their services. Primary
respondents are attorneys and nonattorneys who represent Social Security
claimants.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 48,110.
Frequency of Response: 1.
Average Burden per Response: 30
minutes.
Estimated Annual Burden: 24,055
hours.
2. Annual Earnings Test Direct Mail
Follow-Up Program Notices—20 CFR
404.452–404.455—0960–0369. SSA
developed the Annual Earnings Test
Direct Mail Follow-up Program to
improve beneficiary reporting on work
and earnings during the year, and
earnings information at the end of the
year. SSA may reduce benefits payable
under the Social Security Act when an
individual has wages or selfemployment income exceeding the
annual exempt amount. SSA identifies
beneficiaries likely to receive more than
the annual exempt amount, and requests
more frequent estimates of earnings
from them. When applicable, SSA also
requests a future year estimate to reduce
overpayments due to earnings. SSA
sends letters (SSA–L9778, L9779,
L9781, L9784, L9785, and L9790) to
beneficiaries requesting earnings
information the month prior to reaching
full retirement age. We send each
beneficiary a tailored letter, which
includes relevant earnings data from
SSA records. The Annual Earnings Test
Direct Mail Follow-up Program helps to
ensure Social Security payments are
correct. The respondents are working
Social Security beneficiaries.
Type of Request: Revision of an OMBapproved information collection.
E:\FR\FM\20JAN1.SGM
20JAN1
3689
Federal Register / Vol. 76, No. 13 / Thursday, January 20, 2011 / Notices
Number of
respondents
Frequency
of response
Estimated
burden per
response
(minutes)
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
42,630
158,865
472,437
1,270
15,870
45,000
1
1
1
1
1
1
10
10
10
10
10
10
7,105
26,478
78,740
212
2,645
7,500
Totals ........................................................................................................................
736,072
....................
....................
122,680
Collection instrument
Form
Form
Form
Form
Form
Form
SSA–L9778
SSA–L9779
SSA–L9781
SSA–L9784
SSA–L9785
SSA–L9790
II. SSA has submitted the information
collections listed below to OMB for
clearance. Your comments on the
information collections would be most
useful if OMB and SSA receive them
within 30 days from the date of this
publication. To be sure we consider
your comments, we must receive them
no later than February 22, 2011. You
can obtain a copy of the OMB clearance
packages by calling the SSA Reports
Clearance Officer at 410–965–8783 or by
writing to the above e-mail address.
1. Request for Review of Hearing
Decision/Order—20 CFR 404.967–
404.981, 416.1467–416.1481—0960–
0277. Claimants have a statutory right
under the Social Security Act and
current regulations to request review of
an administrative law judge’s (ALJ)
hearing decision or dismissal of a
hearing request on Title II and Title XVI
claims. Claimants may request Appeals
Council review by filing a written
request using Form HA–520. SSA uses
the information to establish the claimant
filed her or his request for review within
the prescribed time and to ensure the
claimant completed the requisite steps
permitting the Appeals Council review.
The Appeals Council uses the
information to: (1) Document the
claimant’s reason(s) for disagreeing with
the ALJ’s decision or dismissal; (2)
determine whether the claimant has
additional evidence to submit; and (3)
determine whether the claimant has a
representative or wants to appoint one.
The respondents are claimants
requesting review of an ALJ’s decision
or dismissal of hearing.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 145,000.
Frequency of Response: 1.
Average Burden per Response: 10
minutes.
Estimated Annual Burden: 24,167
hours.
2. Development for Participation in a
Vocational Rehabilitation or Similar
Program—20 CFR 404.316(c),
404.337(c), 404.352(d), 404.1586(g),
404.1596, 404.1597(a), 404.327, 404.328,
416.1338(c)(d), 416.1320(d),
416.1331(a)–(b), and 416.1338—0960–
0282. State Disability Determination
Services (DDS) must determine if Social
Security disability payment recipients,
whose disability ceased and who
participate in vocational rehabilitation
programs, may continue to receive
disability payments. To do this, DDSs
need information about the recipients,
the types of program participation, and
the services they receive under the
rehabilitation program. SSA uses Form
SSA–4290 to collect this information.
The respondents are State employment
Total
annual
burden
(hours)
networks, vocational rehabilitation
agencies, or other providers of
educational or job training services.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 3,000.
Frequency of Response: 1.
Average Burden per Response: 15
minutes.
Estimated Annual Burden: 750 hours.
3. Acknowledgement of Receipt
(Notice of Hearing)—20 CFR 404.938 &
416.1438—0960–0671. SSA uses Forms
HA–504 and HA–504–OP1 to inform
claimants of a scheduled hearing.
Claimants complete the form to
acknowledge they will attend the
hearing or to ask the ALJ to reschedule
the hearing. The ALJ uses the
information to prepare for the scheduled
hearing or to reschedule the hearing to
a different date or location. The only
difference between the two forms is the
exclusion of the video teleconferencing
option on the HA–504–OP1. We exclude
video teleconferencing when it is not
feasible, based on certain circumstances,
for the ALJ’s use. The respondents are
applicants for Social Security benefits
who request a hearing to appeal an
unfavorable entitlement or continued
eligibility determination.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
HA–504 (with teleconferencing) ......................................................................................
HA–504–OP1 ...................................................................................................................
70,000
630,000
1
1
30
30
35,000
315,000
Total ..........................................................................................................................
700,000
....................
....................
350,000
mstockstill on DSKH9S0YB1PROD with NOTICES
Version of the HA–504
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E:\FR\FM\20JAN1.SGM
20JAN1
Total
annual
burden
(hours)
3690
Federal Register / Vol. 76, No. 13 / Thursday, January 20, 2011 / Notices
Dated: January 13, 2011.
Elizabeth A. Davidson,
Center Director, Center for Reports Clearance
Office of Documents Management, OPLM,
BFM.
[FR Doc. 2011–1028 Filed 1–19–11; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice: 7303]
60-Day Notice of Proposed Information
Collection: DS–60, Affidavit Regarding
a Change of Name, OMB Control
Number 1405–0133
Notice of request for public
comments.
ACTION:
The Department of State is
seeking Office of Management and
Budget (OMB) approval for the
information collection described below.
The purpose of this notice is to allow 60
days for public comment in the Federal
Register preceding submission to OMB.
We are conducting this process in
accordance with the Paperwork
Reduction Act of 1995.
• Title of Information Collection:
Affidavit Regarding a Change of Name.
• OMB Control Number: 1405–0133.
• Type of Request: Extension of a
Currently Approved Collection.
• Originating Office: Bureau of
Consular Affairs, CA/PPT.
• Form Number: DS–60.
• Respondents: Individuals or
Households.
• Estimated Number of Respondents:
202,920 per year.
• Estimated Number of Responses:
202,920 per year.
• Average Hours per Response: 15
minutes.
• Total Estimated Burden: 50,730
hours.
• Frequency: On Occasion.
• Obligation to Respond: Required to
Obtain or Retain a Benefit.
DATES: The Department will accept
comments from the public up to 60 days
from January 20, 2011.
ADDRESSES: You may submit comments
by any of the following methods:
• E-mail: PPTFormsOfficer@state.gov.
• Mail (paper, disk, or CD–ROM
submissions): Passport Forms
Management Officer, U.S. Department of
State, Office of Program Management
and Operational Support, 2100
Pennsylvania Avenue, NW., Room 3031,
Washington, DC 20037.
You must include the DS form
number (if applicable), information
collection title, and OMB control
number in any correspondence.
mstockstill on DSKH9S0YB1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
18:24 Jan 19, 2011
Jkt 223001
FOR FURTHER INFORMATION CONTACT:
Direct requests for additional
information regarding the collection
listed in this notice, including requests
for copies of the proposed information
collection and supporting documents, to
Passport Forms Management Officer,
U.S. Department of State, Office of
Program Management and Operational
Support, 2100 Pennsylvania Avenue,
NW., Room 3031, Washington, DC
20037, who may be reached on 202–
663–2457 or at
PPTFormsOfficer@state.gov.
SUPPLEMENTARY INFORMATION: We are
soliciting public comments to permit
the Department to:
• Evaluate whether the proposed
information collection is necessary for
the proper performance of our
functions.
• Evaluate the accuracy of our
estimate of the burden of the proposed
collection, including the validity of the
methodology and assumptions used.
• Enhance the quality, utility, and
clarity of the information to be
collected.
• Minimize the reporting burden on
those who are to respond, including the
use of automated collection techniques
or other forms of technology.
Abstract of proposed collection: The
Affidavit Regarding a Change of Name is
submitted in conjunction with an
application for a U.S. passport. It is used
by Passport Services to collect
information for the purpose of
establishing that a passport applicant
has adopted a new name without formal
court proceedings or by marriage and
has publicly and exclusively used the
adopted name over a period of time (at
least five years).
Methodology: When needed, the
Affidavit Regarding a Change of Name is
completed at the time a U.S. citizen
applies for a U.S. passport.
Dated: January 11, 2011.
Brenda Sprague,
Deputy Assistant Secretary for Passport
Services, Bureau of Consular Affairs,
Department of State.
[FR Doc. 2011–1186 Filed 1–19–11; 8:45 am]
BILLING CODE 4710–06–P
DEPARTMENT OF STATE
[Public Notice: 7304]
60-Day Notice of Proposed Information
Collection: DS–10, Birth Affidavit, OMB
Control Number 1405–0132
Notice of request for public
comments.
ACTION:
The Department of State is
seeking Office of Management and
SUMMARY:
PO 00000
Frm 00092
Fmt 4703
Sfmt 4703
Budget (OMB) approval for the
information collection described below.
The purpose of this notice is to allow 60
days for public comment in the Federal
Register preceding submission to OMB.
We are conducting this process in
accordance with the Paperwork
Reduction Act of 1995.
• Title of Information Collection:
Birth Affidavit.
• OMB Control Number: 1405–0132.
• Type of Request: Extension of a
Currently Approved Collection.
• Originating Office: Bureau of
Consular Affairs, CA/PPT/FO/FC.
• Form Number: DS–10.
• Respondents: Individuals or
Households.
• Estimated Number of Respondents:
154,850 per year.
• Estimated Number of Responses:
154,850 per year.
• Average Hours per Response: 15
minutes.
• Total Estimated Burden: 38,713
hours.
• Frequency: On Occasion.
• Obligation to Respond: Required to
Obtain or Retain a Benefit.
DATES: The Department will accept
comments from the public up to 60 days
from January 20, 2011.
ADDRESSES: You may submit comments
by any of the following methods:
• E-mail: PPTFormsOfficer@state.gov.
• Mail (paper, disk, or CD–ROM
submissions): Passport Forms
Management Officer, U.S. Department of
State, Office of Program Management
and Operational Support, 2100
Pennsylvania Avenue, NW., Room 3031,
Washington, DC 20037.
You must include the DS form
number (if applicable), information
collection title, and OMB control
number in any correspondence.
FOR FURTHER INFORMATION CONTACT:
Direct requests for additional
information regarding the collection
listed in this notice, including requests
for copies of the proposed information
collection and supporting documents, to
Passport Forms Management Officer,
U.S. Department of State, Office of
Program Management and Operational
Support, 2100 Pennsylvania Avenue,
NW., Room 3031, Washington, DC
20037, who may be reached on 202–
663–2457 or at
PPTFormsOfficer@state.gov.
SUPPLEMENTARY INFORMATION: We are
soliciting public comments to permit
the Department to:
• Evaluate whether the proposed
information collection is necessary for
the proper performance of our
functions.
• Evaluate the accuracy of our
estimate of the burden of the proposed
E:\FR\FM\20JAN1.SGM
20JAN1
]]>Agencies
[Federal Register Volume 76, Number 13 (Thursday, January 20, 2011)]
[Notices]
[Pages 3688-3690]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-1028]
=======================================================================
-----------------------------------------------------------------------
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 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions to 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 Officer at 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: Reports Clearance
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235,
Fax: 410-965-6400, E-mail address: OPLM.RCO@ssa.gov.
I. The information collections below are pending at SSA. SSA will
submit them to OMB within 60 days from the date of this notice. To be
sure we consider your comments, we must receive them no later than
March 21, 2011. Individuals can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
8783 or by writing to the above e-mail address.
1. Petition to Obtain Approval of a Fee for Representing a Claimant
before the Social Security Administration--20 CFR 404.1720 and
404.1725; 20 CFR 416.1520 and 416.1525-0960-0104. A Social Security
claimant's representative, whether an attorney or a non-attorney, uses
Form SSA-1560-U4 to petition SSA for authorization to charge and
collect a fee. A claimant may also use the form to agree or disagree
with the requested fee amount or other information the representative
provides on the form. The SSA official responsible for setting the fee
uses the information from the form to determine a reasonable fee amount
representatives may charge for their services. Primary respondents are
attorneys and non-attorneys who represent Social Security claimants.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 48,110.
Frequency of Response: 1.
Average Burden per Response: 30 minutes.
Estimated Annual Burden: 24,055 hours.
2. Annual Earnings Test Direct Mail Follow-Up Program Notices--20
CFR 404.452-404.455--0960-0369. SSA developed the Annual Earnings Test
Direct Mail Follow-up Program to improve beneficiary reporting on work
and earnings during the year, and earnings information at the end of
the year. SSA may reduce benefits payable under the Social Security Act
when an individual has wages or self-employment income exceeding the
annual exempt amount. SSA identifies beneficiaries likely to receive
more than the annual exempt amount, and requests more frequent
estimates of earnings from them. When applicable, SSA also requests a
future year estimate to reduce overpayments due to earnings. SSA sends
letters (SSA-L9778, L9779, L9781, L9784, L9785, and L9790) to
beneficiaries requesting earnings information the month prior to
reaching full retirement age. We send each beneficiary a tailored
letter, which includes relevant earnings data from SSA records. The
Annual Earnings Test Direct Mail Follow-up Program helps to ensure
Social Security payments are correct. The respondents are working
Social Security beneficiaries.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 3689]]
----------------------------------------------------------------------------------------------------------------
Estimated Total
Number of Frequency burden per annual
Collection instrument respondents of response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Form SSA-L9778.............................................. 42,630 1 10 7,105
Form SSA-L9779.............................................. 158,865 1 10 26,478
Form SSA-L9781.............................................. 472,437 1 10 78,740
Form SSA-L9784.............................................. 1,270 1 10 212
Form SSA-L9785.............................................. 15,870 1 10 2,645
Form SSA-L9790.............................................. 45,000 1 10 7,500
---------------------------------------------------
Totals.................................................. 736,072 ........... ........... 122,680
----------------------------------------------------------------------------------------------------------------
II. SSA has submitted the information collections listed below to
OMB for clearance. Your comments on the information collections would
be most useful if OMB and SSA receive them within 30 days from the date
of this publication. To be sure we consider your comments, we must
receive them no later than February 22, 2011. You can obtain a copy of
the OMB clearance packages by calling the SSA Reports Clearance Officer
at 410-965-8783 or by writing to the above e-mail address.
1. Request for Review of Hearing Decision/Order--20 CFR 404.967-
404.981, 416.1467-416.1481--0960-0277. Claimants have a statutory right
under the Social Security Act and current regulations to request review
of an administrative law judge's (ALJ) hearing decision or dismissal of
a hearing request on Title II and Title XVI claims. Claimants may
request Appeals Council review by filing a written request using Form
HA-520. SSA uses the information to establish the claimant filed her or
his request for review within the prescribed time and to ensure the
claimant completed the requisite steps permitting the Appeals Council
review. The Appeals Council uses the information to: (1) Document the
claimant's reason(s) for disagreeing with the ALJ's decision or
dismissal; (2) determine whether the claimant has additional evidence
to submit; and (3) determine whether the claimant has a representative
or wants to appoint one. The respondents are claimants requesting
review of an ALJ's decision or dismissal of hearing.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 145,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 24,167 hours.
2. Development for Participation in a Vocational Rehabilitation or
Similar Program--20 CFR 404.316(c), 404.337(c), 404.352(d),
404.1586(g), 404.1596, 404.1597(a), 404.327, 404.328, 416.1338(c)(d),
416.1320(d), 416.1331(a)-(b), and 416.1338--0960-0282. State Disability
Determination Services (DDS) must determine if Social Security
disability payment recipients, whose disability ceased and who
participate in vocational rehabilitation programs, may continue to
receive disability payments. To do this, DDSs need information about
the recipients, the types of program participation, and the services
they receive under the rehabilitation program. SSA uses Form SSA-4290
to collect this information. The respondents are State employment
networks, vocational rehabilitation agencies, or other providers of
educational or job training services.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 3,000.
Frequency of Response: 1.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 750 hours.
3. Acknowledgement of Receipt (Notice of Hearing)--20 CFR 404.938 &
416.1438--0960-0671. SSA uses Forms HA-504 and HA-504-OP1 to inform
claimants of a scheduled hearing. Claimants complete the form to
acknowledge they will attend the hearing or to ask the ALJ to
reschedule the hearing. The ALJ uses the information to prepare for the
scheduled hearing or to reschedule the hearing to a different date or
location. The only difference between the two forms is the exclusion of
the video teleconferencing option on the HA-504-OP1. We exclude video
teleconferencing when it is not feasible, based on certain
circumstances, for the ALJ's use. The respondents are applicants for
Social Security benefits who request a hearing to appeal an unfavorable
entitlement or continued eligibility determination.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Total
Number of Frequency burden per annual
Version of the HA-504 respondents of response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
HA-504 (with teleconferencing).............................. 70,000 1 30 35,000
HA-504-OP1.................................................. 630,000 1 30 315,000
---------------------------------------------------
Total................................................... 700,000 ........... ........... 350,000
----------------------------------------------------------------------------------------------------------------
[[Page 3690]]
Dated: January 13, 2011.
Elizabeth A. Davidson,
Center Director, Center for Reports Clearance Office of Documents
Management, OPLM, BFM.
[FR Doc. 2011-1028 Filed 1-19-11; 8:45 am]
BILLING CODE 4191-02-P
