Agency Information Collection Activities: Proposed Request and Comment Request, 53703-53704 [2011-22007]
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53703
Federal Register / Vol. 76, No. 167 / Monday, August 29, 2011 / Notices
Fax: 410–965–6400, E-mail address:
OPLM.RCO@ssa.gov.
SSA submitted the information
collection listed below to OMB for
clearance. Your comments on the
information collection would be most
useful if OMB and SSA receive them
within 30 days from the date of this
publication. To consider your
comments, we must receive them no
later than September 28, 2011. You can
obtain a copy of the OMB clearance
package by calling the SSA Reports
Clearance Officer at 410–965–8783 or by
writing to the above e-mail address.
costs. This law requires SSA to make
eligibility determinations and to provide
a process for appealing SSA’s
determinations. Regulation sections
418.3625(c), 418.3645, 418.3665(a), and
418.3670 contain public reporting
requirements pertaining to
administrative review hearings.
Respondents are applicants for the
Medicare Part D subsidies who request
an administrative review hearing.
Type of Request: Extension of an
OMB-approved information collection.
Medicare Part D Subsidies
Regulations—20 CFR 418.3625,
418.3645, 418.3665(a), and 418.3670—
0960–0702. The Medicare Prescription
Drug Improvement and Modernization
Act (MMA) of 2003 established the
Medicare Part D program for voluntary
prescription drug coverage of premium,
deductible, and co-payment costs for
certain low-income individuals. The
MMA also mandated the provision of
subsidies for those individuals who
qualify for the program and who meet
eligibility criteria for help with
premium, deductible, or co-payment
Number of
respondents
Section
Frequency of
response
Average
burden per
response
(minutes)
Total annual
burden
(hours)
418.3625(c) ......................................................................................................
418.3645 ..........................................................................................................
418.3665(a) ......................................................................................................
418.3670 ..........................................................................................................
2,500
10
1,000
5
1
1
1
1
5
20
5
10
208
3
83
1
Total ..........................................................................................................
3,515
........................
........................
295
Dated: August 24, 2011.
Faye Lipsky,
Reports Clearance Officer, Center for Reports
Clearance, Social Security Administration.
[FR Doc. 2011–21956 Filed 8–26–11; 8:45 am]
BILLING CODE 4191–02–P
SOCIAL SECURITY ADMINISTRATION
Emcdonald on DSK2BSOYB1PROD with NOTICES
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 a request
for a new information collection, and
revisions 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, email, 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,
VerDate Mar<15>2010
16:45 Aug 26, 2011
Jkt 223001
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 Collection Below Is
Pending at SSA
SSA will submit it to OMB within 60
days from the date of this notice. To be
sure we consider your comments, we
must receive them no later than October
28, 2011. Individuals can obtain copies
of the collection instrument by calling
the SSA Reports Clearance Officer at
410–965–8783 or by writing to the
above e-mail address.
Screen Pop—20 CFR 401.45—0960–
New. Section 205(a) of the Social
Security Act (Act) requires SSA to verify
the identity of individuals who request
a record or information pertaining to
themselves, and to establish procedures
for disclosing personal information.
SSA has established Screen Pop, an
automated telephone process, to speed
up verification for such individuals.
Accessing Screen Pop, callers enter their
Social Security number (SSN) using
their telephone keypad or speech
technology prior to speaking with a
National 800 Number Network (N8NN)
agent. The automated Screen Pop
application collects the SSN and routes
it to the ‘‘Start New Call’’ Customer
Help and Information (CHIP) screen.
Functionality for the Screen Pop
application ends once the SSN connects
PO 00000
Frm 00041
Fmt 4703
Sfmt 4703
to the CHIP screen and the SSN routes
to the agent’s screen. When the call
connects to the SSA agent, the agent can
use the SSN to access the caller’s record
as needed.
The respondents for this collection
are individuals who contact SSA’s
N8NN to speak with an agent.
Type of Request: Request for a new
information collection.
Number of Respondents: 34,000,000.
Frequency of Response: 1.
Average Burden per Response: 1
minute.
Estimated Annual Burden: 566,667
hours.
II. SSA Submitted the Information
Collections Below to OMB for
Clearance
Your comments regarding 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 September 28, 2011.
Individuals can obtain copies of the
OMB clearance packages by calling the
SSA Reports Clearance Officer at 410–
965–8783 or by writing to the above email address.
1. Application for Benefits Under a U.S.
International Social Security
Agreement—20 CFR 404.1925–0960–
0448
Section 233(a) of the Act authorizes
the President to broker international
Social Security agreements (totalization
agreements) between the United States
E:\FR\FM\29AUN1.SGM
29AUN1
53704
Federal Register / Vol. 76, No. 167 / Monday, August 29, 2011 / Notices
and foreign countries. SSA collects
information using Form SSA–2490–BK
to determine entitlement to Social
Security benefits from the United States,
or from a country that enters into a
totalization agreement with the United
States. The respondents are individuals
applying for Old Age Survivors and
Disability Insurance benefits from the
Number of
respondents
Form No.
United States or from a totalization
agreement country.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency of
response
Total annual
burden
(hours)
SSA–2490–BK (MCS) .....................................................................
SSA–2490–BK (paper) ....................................................................
14,000
2,000
1
1
30
30
7,000
1,000
Totals ........................................................................................
16,000
............................
............................
8,000
2. Plan for Achieving Self-Support
(PASS)—20 CFR 416.110(e), 416.1180–
1182, 416.1225–1227–0960–0559
The Supplemental Security Income
(SSI) program encourages disability
payment recipients to return to work.
One of the program objectives is to
provide incentives and opportunities
that help recipients do this. The PASS
provision allows individuals to use
available income or resources (such as
business equipment, education, or
specialized training) to enter or re-enter
the workforce and become selfsupporting. In turn, SSA does not count
the income or resources recipients use
to fund a PASS when determining an
individual’s SSI eligibility or payment
amount. An SSI recipient, who wants to
use available income and resources to
obtain education or training to become
self-supporting, completes the SSA–545.
SSA uses the information from the
SSA–545 to evaluate the recipient’s
PASS, and to determine eligibility
under the provisions of the SSI program.
The respondents are SSI recipients
who are blind or disabled and want to
develop a plan to work.
Note: This is a correction notice. SSA
published this information collection as an
extension on June 15, 2011 at 76 FR 35067.
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: 7,000.
Frequency of Response: 1.
Average Burden Per Response:
2 hours.
Estimated Annual Burden:
14,000 hours.
3. Authorization To Disclose
Information to SSA—20 CFR 404.1512
and 416.912, 45 CFR 160 and 164–
0960–0623
SSA must obtain sufficient evidence
to make eligibility determinations for
Number of
respondents
Modaility
Title II and Title XVI payments.
Therefore, the applicant must authorize
the release of information from various
sources to SSA. The applicant uses the
SSA–827 to provide consent for the
release of medical records, education
records, and other information related to
his or her ability to perform tasks. Once
the applicant completes the SSA–827,
SSA or the State Disability
Determination Service sends the form to
the designated source(s) to obtain
pertinent records. The respondents are
applicants for Title II benefits and Title
XVI payments.
Type of Request: Revision of an OMBapproved information collection.
Note: This is a correction notice: SSA
published incorrect burden information for
this collection at 76 FR 23640, on April 27,
2011. We are correcting the error here.
Average
burden per
response
(minutes)
Frequency of
response
Total annual
burden
(hours)
SSA–827 with electronic signature (adult first person only) ...........
SSA–827 with wet signature ...........................................................
Reading the Internet Instructions ....................................................
2,530,000
1,591,551
708,100
1
1
1
9
10
3
379,500
265,258
35,405
Totals ........................................................................................
4,829,651
............................
............................
680,163
Dated: August 24, 2011.
Faye Lipsky,
Reports Clearance Officer, Center for Reports
Clearance, Social Security Administration.
[FR Doc. 2011–22007 Filed 8–26–11; 8:45 am]
Emcdonald on DSK2BSOYB1PROD with NOTICES
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice 7570]
30-Day Notice of Proposed Information
Collection: Passport Demand
Forecasting Study Phase III, OMB
Number 1405–0177
Notice of request for public
comment and submission to OMB of
proposed collection of information.
ACTION:
The Department of State has
submitted the following information
collection request to the Office of
SUMMARY:
VerDate Mar<15>2010
16:45 Aug 26, 2011
Jkt 223001
PO 00000
Frm 00042
Fmt 4703
Sfmt 4703
Management and Budget (OMB) for
approval in accordance with the
Paperwork Reduction Act of 1995.
• Title of Information Collection:
Passport Demand Forecasting Study
Phase III.
• OMB Control Number: OMB
Number 1405–0177.
• Type of Request: Revision of a
Currently Approved Collection.
• Originating Office: Bureau of
Consular Affairs, Office of Passport
Services CA/PPT.
• Form Number: SV2011–0010.
E:\FR\FM\29AUN1.SGM
29AUN1
]]>Agencies
[Federal Register Volume 76, Number 167 (Monday, August 29, 2011)]
[Notices]
[Pages 53703-53704]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-22007]
-----------------------------------------------------------------------
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 a request for a new information collection, and revisions 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, email, 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 Collection Below Is Pending at SSA
SSA will submit it to OMB within 60 days from the date of this
notice. To be sure we consider your comments, we must receive them no
later than October 28, 2011. Individuals can obtain copies of the
collection instrument by calling the SSA Reports Clearance Officer at
410-965-8783 or by writing to the above e-mail address.
Screen Pop--20 CFR 401.45--0960-New. Section 205(a) of the Social
Security Act (Act) requires SSA to verify the identity of individuals
who request a record or information pertaining to themselves, and to
establish procedures for disclosing personal information. SSA has
established Screen Pop, an automated telephone process, to speed up
verification for such individuals. Accessing Screen Pop, callers enter
their Social Security number (SSN) using their telephone keypad or
speech technology prior to speaking with a National 800 Number Network
(N8NN) agent. The automated Screen Pop application collects the SSN and
routes it to the ``Start New Call'' Customer Help and Information
(CHIP) screen. Functionality for the Screen Pop application ends once
the SSN connects to the CHIP screen and the SSN routes to the agent's
screen. When the call connects to the SSA agent, the agent can use the
SSN to access the caller's record as needed.
The respondents for this collection are individuals who contact
SSA's N8NN to speak with an agent.
Type of Request: Request for a new information collection.
Number of Respondents: 34,000,000.
Frequency of Response: 1.
Average Burden per Response: 1 minute.
Estimated Annual Burden: 566,667 hours.
II. SSA Submitted the Information Collections Below to OMB for
Clearance
Your comments regarding 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 September 28, 2011. Individuals can obtain copies 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. Application for Benefits Under a U.S. International Social Security
Agreement--20 CFR 404.1925-0960-0448
Section 233(a) of the Act authorizes the President to broker
international Social Security agreements (totalization agreements)
between the United States
[[Page 53704]]
and foreign countries. SSA collects information using Form SSA-2490-BK
to determine entitlement to Social Security benefits from the United
States, or from a country that enters into a totalization agreement
with the United States. The respondents are individuals applying for
Old Age Survivors and Disability Insurance benefits from the United
States or from a totalization agreement country.
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-2490-BK (MCS)....................... 14,000 1 30 7,000
SSA-2490-BK (paper)..................... 2,000 1 30 1,000
-----------------------------------------------------------------------
Totals.............................. 16,000 ................ ................ 8,000
----------------------------------------------------------------------------------------------------------------
2. Plan for Achieving Self-Support (PASS)--20 CFR 416.110(e), 416.1180-
1182, 416.1225-1227-0960-0559
The Supplemental Security Income (SSI) program encourages
disability payment recipients to return to work. One of the program
objectives is to provide incentives and opportunities that help
recipients do this. The PASS provision allows individuals to use
available income or resources (such as business equipment, education,
or specialized training) to enter or re-enter the workforce and become
self-supporting. In turn, SSA does not count the income or resources
recipients use to fund a PASS when determining an individual's SSI
eligibility or payment amount. An SSI recipient, who wants to use
available income and resources to obtain education or training to
become self-supporting, completes the SSA-545. SSA uses the information
from the SSA-545 to evaluate the recipient's PASS, and to determine
eligibility under the provisions of the SSI program.
The respondents are SSI recipients who are blind or disabled and
want to develop a plan to work.
Note: This is a correction notice. SSA published this
information collection as an extension on June 15, 2011 at 76 FR
35067. 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: 7,000.
Frequency of Response: 1.
Average Burden Per Response: 2 hours.
Estimated Annual Burden: 14,000 hours.
3. Authorization To Disclose Information to SSA--20 CFR 404.1512 and
416.912, 45 CFR 160 and 164-0960-0623
SSA must obtain sufficient evidence to make eligibility
determinations for Title II and Title XVI payments. Therefore, the
applicant must authorize the release of information from various
sources to SSA. The applicant uses the SSA-827 to provide consent for
the release of medical records, education records, and other
information related to his or her ability to perform tasks. Once the
applicant completes the SSA-827, SSA or the State Disability
Determination Service sends the form to the designated source(s) to
obtain pertinent records. The respondents are applicants for Title II
benefits and Title XVI payments.
Type of Request: Revision of an OMB-approved information
collection.
Note: This is a correction notice: SSA published incorrect
burden information for this collection at 76 FR 23640, on April 27,
2011. We are correcting the error here.
----------------------------------------------------------------------------------------------------------------
Average burden
Modaility Number of Frequency of per response Total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-827 with electronic signature (adult 2,530,000 1 9 379,500
first person only).....................
SSA-827 with wet signature.............. 1,591,551 1 10 265,258
Reading the Internet Instructions....... 708,100 1 3 35,405
-----------------------------------------------------------------------
Totals.............................. 4,829,651 ................ ................ 680,163
----------------------------------------------------------------------------------------------------------------
Dated: August 24, 2011.
Faye Lipsky,
Reports Clearance Officer, Center for Reports Clearance, Social
Security Administration.
[FR Doc. 2011-22007 Filed 8-26-11; 8:45 am]
BILLING CODE 4191-02-P
