Agency Information Collection Activities: Proposed Request and Comment Request, 65315-65317 [2011-27222]

Download as PDF 65315 Federal Register / Vol. 76, No. 203 / Thursday, October 20, 2011 / Notices Securities and Exchange Commission, 100 F Street, NE., Washington DC 20549–1090. All submissions should refer to File Number SR–FINRA–2011–056. 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 the filing will also be available for inspection and copying at the principal office of FINRA. All comments received will be posted without change; the Commission does not edit personal identifying information from submissions. You should submit only information that you wish to make available publicly. All submissions should refer to File No. SR–FINRA–2011–056 and should be submitted on or before November 10, 2011. For the Commission, by the Division of Trading and Markets, pursuant to delegated authority.17 Elizabeth M. Murphy, Secretary. [FR Doc. 2011–27132 Filed 10–19–11; 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 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. Number of responses Collection instrument (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, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD 21235. Fax No.: 410–966–2830. 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 December 19, 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 email address. 1. Medical Report on Adult with Allegation of Human Immunodeficiency Virus Infection; Medical Report on Child with Allegation of Human Immunodeficiency Virus Infection—20 CFR 416.933–20; CFR 416.934 —0960– 0500. SSA uses Forms SSA–4814–F5 and SSA–4815–F6 to collect information necessary to determine if an individual with human immunodeficiency virus infection, who is applying for Supplemental Security Income (SSI) disability benefits, meets the requirements for presumptive disability payments. The respondents are the medical sources of the applicants for SSI disability payments. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) SSA–4814–F5 .......................................................................... SSA–4815–F6 .......................................................................... 46,200 12,900 1 1 10 10 7,700 2,150 Totals ................................................................................ 59,100 .............................. .............................. 9,850 sroberts on DSK5SPTVN1PROD with NOTICES 2. Supplement to Claim of Person Outside the United States—20 CFR 404.463, 20 CFR 422.505(b) and 20 CFR 407.27(c)—0960–0051. Claimants or beneficiaries (both United States (U.S.) citizens and aliens entitled to benefits) living outside the U.S. complete Form SSA–21 as a supplement to an application for benefits. SSA collects the information to determine eligibility for U.S. Social Security benefits for those months a beneficiary or claimant is outside the U.S., and to determine if tax withholding applies. In addition, SSA uses the information to terminate Supplemental Medical Insurance coverage for recipients who request it, because they are or will be out of the Number of responses Collection instrument SSA–21 (non-residents) .......................................................... 17 17 36,874 U.S. The respondents are individuals entitled to Social Security benefits who are, will be, or have been residing outside the U.S. for three months or longer. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response 1 5 CFR 200.30–3(a)(12). VerDate Mar<15>2010 18:59 Oct 19, 2011 Jkt 226001 PO 00000 Frm 00158 Fmt 4703 Sfmt 4703 E:\FR\FM\20OCN1.SGM Estimated total annual burden (hours) 20OCN1 3,073 65316 Federal Register / Vol. 76, No. 203 / Thursday, October 20, 2011 / Notices Number of responses Collection instrument Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) SSA–21 (U.S. citizens and residents) ..................................... 1,941 1 15 485 Totals ................................................................................ 38,815 .............................. .............................. 3,559 3. Credit Card Payment Form—0960– 0648. SSA uses form SSA–1414 to process: (1) Credit card payments from former employees and vendors with outstanding debts to the agency; (2) advance payments for reimbursable agreements; and (3) credit card payments for all Freedom of Information Act (FOIA) requests requiring payment. The respondents are former employees and vendors who have outstanding debts to the agency, entities who have Number of responses Collection instrument SSA–1414 ................................................................................ 4. Benefit Offset National Demonstration—0960–0785. In an effort to produce strong evidence about the effectiveness of potential solutions that would improve the historically very low rate of return to work among SSDI beneficiaries, SSA is currently conducting the Benefit Offset National Demonstration (BOND) project. The demonstration project will evaluate the result of policy changes and services on the Social Security Disability Insurance (SSDI) program. Under current law, Social Security beneficiaries lose their SSDI benefit if they have earnings and/or work activity above the threshold of substantial gainful activity (SGA) after completing the trial work period and two-month grace period. The benefit-offset component of this demonstration reduces benefits by $1 for each $2 in Average burden per response (minutes) Frequency of response 6,000 1 earnings above the BOND threshold, resulting in a gradual reduction in benefits as earnings increase. BOND tests a benefit offset alone and in conjunction with enhanced work incentives counseling. The central research questions include: • What is the effect of the benefit offset alone on employment and other outcomes? • What is the effect of the benefit offset in combination with enhanced work incentives counseling on employment and other outcomes? The public survey data collections for BOND have four components—an impact study, a cost-benefit analysis, a participation analysis, and a process study. The data collections are a primary source for data to measure the effects of a more generous benefit offset and the provision of enhanced work incentives counseling on SSDI Number of respondents Survey reimbursable agreements with SSA, and individuals who request information through FOIA. Type of Request: Revision of an OMBapproved information collection. Frequency of response Estimated total annual burden (hours) 2 200 beneficiaries’ work efforts and earnings. Ultimately, these data will benefit researchers, policy analysts, policy makers, and the United States Congress in a wide range of program areas. The effects of BOND on the well-being of SSDI beneficiaries could manifest themselves in many dimensions and could be relevant to an array of other public programs. This project offers the opportunity to obtain reliable measures of these effects based upon a nationally representative sample. The long-term indirect benefits of this research are likely to be substantial. Respondents are SSDI beneficiaries and concurrent SSDI and SSI recipients who we randomly assign to the study (Stage 1), and SSDI beneficiaries who agree to participate in the study (Stage 2). Type of Request: Revision of an OMBapproved information collection. Number of responses Average burden per response (minutes) Estimated total annual burden (hours) 12,600 12,600 10,080 8,000 10,080 3,000 100 600 500 1 1 1 1 1 1 7 1 1 12,600 12,600 10,080 8,000 10,080 3,000 700 600 500 20 41 29 49 60 35 60 90 3 4200 8,610 4,872 6,533 10,080 1,750 700 900 25 Totals ........................................................ sroberts on DSK5SPTVN1PROD with NOTICES Participation Agreement ................................... Baseline Survey ............................................... Interim Survey .................................................. Stage 1 36-month Survey ................................ Stage 2 36-month Survey ................................ Enhanced Work Incentives Assessment ......... Key Informant Interviews ................................. Stage 2 Participant Focus Groups .................. Stage 1 First Contact Letter Survey ................ 57,560 ............................ 58,160 ............................ 37,670 II. SSA submitted the information collection below to OMB for clearance. Your comments regarding the information collection would be most useful if OMB and SSA receive them VerDate Mar<15>2010 18:59 Oct 19, 2011 Jkt 226001 within 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than November 21, 2011. Individuals can obtain copies of the PO 00000 Frm 00159 Fmt 4703 Sfmt 4703 OMB clearance package by calling the SSA Reports Clearance Officer at 410– 965–8783 or by writing to the above email address. E:\FR\FM\20OCN1.SGM 20OCN1 65317 Federal Register / Vol. 76, No. 203 / Thursday, October 20, 2011 / Notices Claimant’s Work Background—20 CFR 404.1565(b) and 20 CFR 416.965(b)—0960–0300. Sections 205(a) and 1631(e) of the Social Security Act provide the Commissioner of Social Security with the authority to establish procedures for determining if a claimant is entitled to disability benefits. The administrative law judge (ALJ) may ask individuals to provide background information on Form HA–4633 about work they performed in the past 15 years. The ALJ uses the information to assess an individual’s disability based on an updated summary of the individual’s relevant work history. The HA–4633 becomes part of the documentary evidence of record. The respondents are claimants for disability benefits under title II or title XVI who requested a hearing before an ALJ. Type of Request: Revision of an OMBapproved information collection. Collection instrument Number of responses Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) HA–4633 .................................................................................. 200,000 1 15 50,000 Dated: October 17, 2011. Faye Lipsky, Reports Clearance Officer, Center for Reports Clearance, Social Security Administration. [FR Doc. 2011–27222 Filed 10–19–11; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice 7662] 60-Day Notice of Proposed Information Collection: DS–4184, Risk Management and Analysis (RAM) 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: Risk Analysis and Management. • OMB Control Number: None. • Type of Request: New. • Originating Office: Bureau of Administration, Office of Logistics Management (A/LM). • Form Number: DS–4184. • Respondents: Potential contractors and grantees. • Estimated Number of Respondents: 1250. • Estimated Number of Responses: 6250. • Average Hours per Response: 1 hour 15 minutes. • Total Estimated Burden: 7813 hours. • Frequency: On occasion. • Obligation to Respond: Voluntary. DATES: The Department will accept comments from the public up to 60 days from October 20, 2011. ADDRESSES You may submit comments by any of the following methods: sroberts on DSK5SPTVN1PROD with NOTICES SUMMARY: VerDate Mar<15>2010 18:59 Oct 19, 2011 Jkt 226001 • E-mail: Vazquezeh@State.gov. • Mail (paper, disk, or CD–ROM submissions): U.S. Department of State, 2201 C St., NW., SA–15 Room 3200, Washington, DC 20520. • Fax: 703–812–2307. 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 Edward H. Vazquez, U.S. Department of State who may be reached by the following methods: Mail: U.S. Department of State, 2201 C St., NW., SA–15 Room 3200, Washington, DC 20520; Tel: 703–812–2308 or e-mail: Vazquezeh@State.gov. If you have access to the internet you may submit comments online by going to: https://www.regulations.gov/search/ Regs/home.html#home. 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 information collected from individuals and organizations is specifically used to conduct screening to ensure that State funded activities do not provide support to entities or individuals deemed to be a risk to national security. PO 00000 Frm 00160 Fmt 4703 Sfmt 4703 Methodology: The State Department, is implementing a Risk Analysis and Management Program to vet potential contractors and grantees seeking funding from the Department of State to mitigate the risk that such funds might benefit terrorists or their supporters. To conduct this vetting program the Department envisions collecting information from contractors, subcontractors, grantees and sub-grantees regarding their directors, officers or key employees. The information collected will be compared to information gathered from commercial, public, and U.S. government databases to determine the risk that the applying organization, entity or individual might use Department funds or programs to benefit terrorist entities. This program will initially be conducted as a pilot program as directed by Congress in the FY 2010 Department of State, Foreign Operations, and Related Programs Appropriations Act, as carried forward in the FY 2011 Full-Year Continuing Appropriations Act. Methodology: We will collect this information either through mail, fax or electronic submission. Dated: October 14, 2011. Catherine I. Ebert-Gray, Deputy Assistant Secretary, Bureau of Administration, Department of State. [FR Doc. 2011–27191 Filed 10–19–11; 8:45 am] BILLING CODE 4710–24–P DEPARTMENT OF STATE [Public Notice 7661] Determination Under the Foreign Assistance Act and the Department of State, Foreign Operations, and Related Programs Appropriations Acts Pursuant to Section 654(c) of the Foreign Assistance Act of 1961, as amended (FAA), notice is hereby given that the Deputy Secretary of State has made a determination pursuant to Section 620H of the FAA, and Section E:\FR\FM\20OCN1.SGM 20OCN1

Agencies

[Federal Register Volume 76, Number 203 (Thursday, October 20, 2011)]
[Notices]
[Pages 65315-65317]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-27222]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law (Pub. L.) 
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. 
This notice includes revisions 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, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD 
21235. Fax No.: 410-966-2830. 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 
December 19, 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. Medical Report on Adult with Allegation of Human 
Immunodeficiency Virus Infection; Medical Report on Child with 
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.933-
20; CFR 416.934 --0960-0500. SSA uses Forms SSA-4814-F5 and SSA-4815-F6 
to collect information necessary to determine if an individual with 
human immunodeficiency virus infection, who is applying for 
Supplemental Security Income (SSI) disability benefits, meets the 
requirements for presumptive disability payments. The respondents are 
the medical sources of the applicants for SSI disability payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                              Average burden    Estimated total
        Collection instrument             Number of         Frequency of       per response      annual burden
                                          responses           response          (minutes)           (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4814-F5.........................             46,200                  1                 10              7,700
SSA-4815-F6.........................             12,900                  1                 10              2,150
                                     ---------------------------------------------------------------------------
    Totals..........................             59,100  .................  .................              9,850
----------------------------------------------------------------------------------------------------------------

    2. Supplement to Claim of Person Outside the United States--20 CFR 
404.463, 20 CFR 422.505(b) and 20 CFR 407.27(c)--0960-0051. Claimants 
or beneficiaries (both United States (U.S.) citizens and aliens 
entitled to benefits) living outside the U.S. complete Form SSA-21 as a 
supplement to an application for benefits. SSA collects the information 
to determine eligibility for U.S. Social Security benefits for those 
months a beneficiary or claimant is outside the U.S., and to determine 
if tax withholding applies. In addition, SSA uses the information to 
terminate Supplemental Medical Insurance coverage for recipients who 
request it, because they are or will be out of the U.S. The respondents 
are individuals entitled to Social Security benefits who are, will be, 
or have been residing outside the U.S. for three months or longer.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                              Average burden    Estimated total
        Collection instrument             Number of         Frequency of       per response      annual burden
                                          responses           response          (minutes)           (hours)
----------------------------------------------------------------------------------------------------------------
SSA-21 (non-residents)..............             36,874                  1                  5              3,073

[[Page 65316]]

 
SSA-21 (U.S. citizens and residents)              1,941                  1                 15                485
                                     ---------------------------------------------------------------------------
    Totals..........................             38,815  .................  .................              3,559
----------------------------------------------------------------------------------------------------------------

    3. Credit Card Payment Form--0960-0648. SSA uses form SSA-1414 to 
process: (1) Credit card payments from former employees and vendors 
with outstanding debts to the agency; (2) advance payments for 
reimbursable agreements; and (3) credit card payments for all Freedom 
of Information Act (FOIA) requests requiring payment. The respondents 
are former employees and vendors who have outstanding debts to the 
agency, entities who have reimbursable agreements with SSA, and 
individuals who request information through FOIA.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                             Average  burden    Estimated total
        Collection instrument             Number of         Frequency of       per response      annual burden
                                          responses           response          (minutes)           (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1414............................              6,000                  1                  2                200
----------------------------------------------------------------------------------------------------------------

    4. Benefit Offset National Demonstration--0960-0785. In an effort 
to produce strong evidence about the effectiveness of potential 
solutions that would improve the historically very low rate of return 
to work among SSDI beneficiaries, SSA is currently conducting the 
Benefit Offset National Demonstration (BOND) project. The demonstration 
project will evaluate the result of policy changes and services on the 
Social Security Disability Insurance (SSDI) program.
    Under current law, Social Security beneficiaries lose their SSDI 
benefit if they have earnings and/or work activity above the threshold 
of substantial gainful activity (SGA) after completing the trial work 
period and two-month grace period. The benefit-offset component of this 
demonstration reduces benefits by $1 for each $2 in earnings above the 
BOND threshold, resulting in a gradual reduction in benefits as 
earnings increase.
    BOND tests a benefit offset alone and in conjunction with enhanced 
work incentives counseling. The central research questions include:
     What is the effect of the benefit offset alone on 
employment and other outcomes?
     What is the effect of the benefit offset in combination 
with enhanced work incentives counseling on employment and other 
outcomes?
    The public survey data collections for BOND have four components--
an impact study, a cost-benefit analysis, a participation analysis, and 
a process study. The data collections are a primary source for data to 
measure the effects of a more generous benefit offset and the provision 
of enhanced work incentives counseling on SSDI beneficiaries' work 
efforts and earnings. Ultimately, these data will benefit researchers, 
policy analysts, policy makers, and the United States Congress in a 
wide range of program areas.
    The effects of BOND on the well-being of SSDI beneficiaries could 
manifest themselves in many dimensions and could be relevant to an 
array of other public programs. This project offers the opportunity to 
obtain reliable measures of these effects based upon a nationally 
representative sample. The long-term indirect benefits of this research 
are likely to be substantial. Respondents are SSDI beneficiaries and 
concurrent SSDI and SSI recipients who we randomly assign to the study 
(Stage 1), and SSDI beneficiaries who agree to participate in the study 
(Stage 2).
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                       Average burden    Estimated total
                            Survey                                  Number of       Frequency of        Number of       per response      annual burden
                                                                   respondents        response          responses         (minutes)          (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Participation Agreement.......................................            12,600                 1            12,600                20              4200
Baseline Survey...............................................            12,600                 1            12,600                41             8,610
Interim Survey................................................            10,080                 1            10,080                29             4,872
Stage 1 36-month Survey.......................................             8,000                 1             8,000                49             6,533
Stage 2 36-month Survey.......................................            10,080                 1            10,080                60            10,080
Enhanced Work Incentives Assessment...........................             3,000                 1             3,000                35             1,750
Key Informant Interviews......................................               100                 7               700                60               700
Stage 2 Participant Focus Groups..............................               600                 1               600                90               900
Stage 1 First Contact Letter Survey...........................               500                 1               500                 3                25
                                                               -----------------------------------------------------------------------------------------
    Totals....................................................            57,560  ................            58,160  ................            37,670
--------------------------------------------------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collection below to OMB for 
clearance. Your comments regarding the information collection 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 November 21, 2011. Individuals can obtain copies 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.

[[Page 65317]]

    Claimant's Work Background--20 CFR 404.1565(b) and 20 CFR 
416.965(b)--0960-0300. Sections 205(a) and 1631(e) of the Social 
Security Act provide the Commissioner of Social Security with the 
authority to establish procedures for determining if a claimant is 
entitled to disability benefits. The administrative law judge (ALJ) may 
ask individuals to provide background information on Form HA-4633 about 
work they performed in the past 15 years. The ALJ uses the information 
to assess an individual's disability based on an updated summary of the 
individual's relevant work history. The HA-4633 becomes part of the 
documentary evidence of record. The respondents are claimants for 
disability benefits under title II or title XVI who requested a hearing 
before an ALJ.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                Estimated total
      Collection instrument            Number of         Frequency of     Average burden per     annual burden
                                       responses           response       response (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
HA-4633.........................            200,000                   1                  15              50,000
----------------------------------------------------------------------------------------------------------------


    Dated: October 17, 2011.
Faye Lipsky,
Reports Clearance Officer, Center for Reports Clearance, Social 
Security Administration.
[FR Doc. 2011-27222 Filed 10-19-11; 8:45 am]
BILLING CODE 4191-02-P
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