Agency Information Collection Activities: Proposed Request and Comment Request, 21616-21618 [2012-8546]

Download as PDF 21616 Federal Register / Vol. 77, No. 69 / Tuesday, April 10, 2012 / Notices in a non-discriminatory manner with respect to the execution of complex orders. The Exchange also believes it is fair and equitable not to charge a taker fee, nor provide a maker rebate, to PMMs when they trade report a public customer order in compliance with their linkage obligations. The PMM neither receives a financial benefit in the form of a rebate from performing its obligations, nor is it subject to the burden of paying the taker fee. The Exchange believe this is the most fair way to approach the PMM trade report function under the maker/taker pricing model, as categorizing the PMM trade report as a maker or taker would either provide an inequitable benefit to PMMs or place an inequitable burden on PMMs. The proposal to codify the application of the maker/taker pricing model to PMM trade reports will add transparency to the Exchange’s Schedule of Fees. B. Self-Regulatory Organization’s Statement on Burden on Competition The proposed rule change does not impose any burden on competition that is not necessary or appropriate in furtherance of the purposes of the Act. srobinson on DSK4SPTVN1PROD with NOTICES C. Self-Regulatory Organization’s Statement on Comments on the Proposed Rule Change Received From Members, Participants, or Others The Exchange has not solicited, and does not intend to solicit, comments on this proposed rule change. The Exchange has not received any unsolicited written comments from members or other interested parties. III. Date of Effectiveness of the Proposed Rule Change and Timing for Commission Action The foregoing rule change has become effective pursuant to Section 19(b)(3)(A)(ii) of the Act.10 At any time within 60 days of the filing of such proposed rule change, the Commission summarily may temporarily suspend 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. If the Commission takes such action, the Commission shall institute proceedings to determine whether the proposed rule should be approved or disapproved. IV. Solicitation of Comments Interested persons are invited to submit written data, views, and 10 15 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: [FR Doc. 2012–8522 Filed 4–9–12; 8:45 am] Electronic Comments BILLING CODE 8011–01–P • Use the Commission’s Internet comment form (https://www.sec.gov/ rules/sro.shtml); or • Send an email to rulecomments@sec.gov. Please include File Number SR–ISE–2012–29 on the subject line. 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–ISE–2012–29. This file number should be included on the subject line if email 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 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–ISE– 2012–29 and should be submitted on or before May 1, 2012. U.S.C. 78s(b)(3)(A)(ii). VerDate Mar<15>2010 16:26 Apr 09, 2012 For the Commission, by the Division of Trading and Markets, pursuant to delegated authority.11 Kevin M. O’Neill, Deputy Secretary. 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 and one extension 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, Email address: OIRA_Submission@omb.eop.gov. (SSA), Social Security Administration, DCRDP, Attn: Reports Clearance Director, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410–966–2830, Email 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 11, 2012. 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. Request for Workers’ Compensation/Public Disability Benefit Information—20 CFR 404.408(e)—0960– 0098. Claimants for Social Security disability payments who are also receiving Worker’s Compensation/ Public Disability Benefits (WC/PDB) 11 17 Jkt 226001 PO 00000 Frm 00095 Fmt 4703 Sfmt 4703 E:\FR\FM\10APN1.SGM CFR 200.30–3(a)(12). 10APN1 21617 Federal Register / Vol. 77, No. 69 / Tuesday, April 10, 2012 / Notices must notify SSA about their WC/PDB, so the agency can compute the correct reduction of Social Security disability payments. SSA considers the claimants the primary sources of verification; therefore, if claimants provide necessary evidence, such as a copy of their award notice, benefit check, etc., that is sufficient. In cases where claimants cannot provide such evidence, SSA uses form SSA–1709. The entity paying the WC/ PDB benefits, its agent, (such as an insurance carrier), or an administering public agency complete this form. The respondents are Federal, State, and local agencies, insurance carriers, and public or private self-insured companies administering WC/PDB benefits to disability claimants. Type of Request: Revision of an OMBapproved information collection. Collection instrument Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–1709 ........................................................................................................ 120,000 1 15 30,000 2. Claimant’s Medication—20 CFR 404.1512, 416.912—0960–0289. In cases where claimants request a hearing after denial of their claim for Social Security benefits, SSA uses Form HA–4632 to obtain information from the claimant about medications they are using. This information helps the administrative law judge overseeing the case to fully investigate (1) the claimant’s medical treatment and (2) the effects of the medications on the claimant’s medical impairment and functional capacity. The respondents are applicants (or their Number of respondents Collection method representatives) for Social Security benefits or payments requesting a hearing to contest an agency denial of their claim. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) HA–4632 (paper) ............................................................................................. Electronic Records Express ............................................................................ 20,000 180,000 1 1 15 15 5,000 45,000 Total .......................................................................................................... 200,000 ........................ ........................ 50,000 3. Representative Payee Report— Special Veterans Benefits—20 CFR 408.665—0960–0621. Title VIII of the Social Security Act allows for payment of monthly Social Security benefits to qualified World War II veterans residing outside the United States. An SSA- appointed representative payee may receive and manage the monthly payment for the beneficiary’s use and benefit. SSA uses the information from Form SSA–2001–F6 to determine if the payee is using the benefits properly on behalf of the beneficiary. Respondents are persons or organizations who act on behalf of beneficiaries who receive Special Veterans Benefits and live outside the United States. Type of Request: Revision of an OMBapproved information collection. Collection instrument Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–2001–F6 .................................................................................................. 100 1 10 17 srobinson on DSK4SPTVN1PROD with NOTICES 4. Representative Payment Policies Regulation—20 CFR 404.2011, 404.2025, 416.611, 416.625—0960– 0679. If SSA determines it may cause substantial harm for beneficiaries to receive their payments directly, beneficiaries may dispute that decision. To do so, beneficiaries must provide SSA with information the agency will use to re-evaluate its determination. In addition, after SSA selects a representative payee to receive benefits on a beneficiary’s behalf, the payees provide SSA with information on their continuing relationship and responsibility for the beneficiaries, and Number of respondents CFR Section explain how they use the beneficiaries’ payments. This Information Collection Request includes the CFR citations that mandate the above provisions. Type of Request: Extension of an OMB-approved information collection. Average burden per response (minutes) Frequency of response Estimated annual burden (hours) 404.2011(a)(1), 416.611(a)(1) ......................................................................... 404.2025, 416.625 ........................................................................................... 250 3,000 1 1 15 6 63 300 Totals ........................................................................................................ 3,250 ........................ ........................ 363 VerDate Mar<15>2010 16:26 Apr 09, 2012 Jkt 226001 PO 00000 Frm 00096 Fmt 4703 Sfmt 4703 E:\FR\FM\10APN1.SGM 10APN1 21618 Federal Register / Vol. 77, No. 69 / Tuesday, April 10, 2012 / Notices 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 May 10, 2012. Individuals can obtain copies of the OMB clearance packages by calling the SSA Reports Clearance Director at 410–965–8783 or by writing to the above email address. Third Party Liability Information Statement—42 CFR 433.136–433.139— 0960–0323. States may enter into agreements with the Commissioner of Social Security to make Medicaid eligibility determinations for aged, blind, and disabled beneficiaries in those states. Applications for and redeterminations of SSI eligibility in jurisdictions with such agreements are applications and redeterminations of Medicaid eligibility. To reduce Medicaid costs, Medicaid state agencies must identify third party insurers liable for medical care or services for Medicaid beneficiaries. Regulations at 42 CFR 433.136–433.139 require Medicaid state agencies to obtain this information on Medicaid applications and redeterminations as a condition of Medicaid eligibility. The Medicaid state agencies use the information to bill third parties liable Number of responses Collection instrument for medical care, support, or services for a beneficiary to guarantee that Medicaid remains the payer of last resort. Under the Medicaid agreements, SSA obtains third party liability information using Form SSA–8019, and provides that information to the Medicaid state agencies. The respondents are SSI claimants and recipients. Note: This is a correction notice: SSA published this information collection as an extension on January 31, 2012 at 77 FR 4854. Since we are revising the Privacy Act Statement, this is now a revision of an OMBapproved information collection. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) SSA–8012 Paper form ..................................................................................... Modernized SSI Claims System (MSSICS) ..................................................... 130 66,904 1 1 5 5 11 5,575 Totals ........................................................................................................ 67,034 ........................ ........................ 5,586 Dated: April 5, 2012. Faye Lipsky, Reports Clearance Director, Office of Regulations and Reports Clearance, Social Security Administration. [FR Doc. 2012–8546 Filed 4–9–12; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice 7843] 60-Day Notice of Proposed Information Collection: Civilian Response Corps Database In-Processing Electronic Form, OMB Control Number 1405– 0168, Form DS–4096 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: Civilian Response Corps Database InProcessing Electronic Form. • OMB Control Number: 1405–0168. • Type of Request: Extension of a Currently Approved Collection. • Originating Office: Bureau of Conflict and Stabilization Operations (CSO). srobinson on DSK4SPTVN1PROD with NOTICES SUMMARY: VerDate Mar<15>2010 16:26 Apr 09, 2012 Jkt 226001 • Form Numbers: DS–4096. • Respondents: Individuals who are members of or apply for one or more of the three components of the Civilian Response Corps (Active, Standby and Expert Corps). • Estimated Number of Respondents: 2000 per year. • Estimated Number of Responses: 2000 per year. • Average Hours per Response: 1 hour. • Total Estimated Burden: 2000 Hours. • Frequency: On occasion. • Obligation to Respond: Required to receive benefits. DATE(S): The Department will accept comments from the public up to 60 days from April 10, 2012. ADDRESSES FOR COMMENTS AND FURTHER INFORMATION: You may submit comments and request for further information by either of the following methods: • Email: CRCcomments@state.gov. • Mail (paper, disk, or CD–ROM submissions): CRC Comments, Suite 1150, 1900 North Kent Street, Rosslyn, VA 22202. You must include the DS form number (if applicable), information collection title, and OMB control number in any correspondence. SUPPLEMENTARY INFORMATION: We are soliciting public comments to permit the Department to: • Evaluate whether the proposed information collection is necessary for PO 00000 Frm 00097 Fmt 4703 Sfmt 9990 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 is an important part of the Department’s responsibility to coordinate U.S. Government planning; institutionalize U.S. conflict prevention and stabilization capacity; and help stabilize societies in transition from conflict or civil strife so they can reach a sustainable path toward peace, democracy, and a market economy. The information gathered will be used to identify Civilian Response Corps members who are available to participate in CRC missions. Methodology: Respondents will complete an electronic DS–4096 application via the Web site (www.crs.state.gov). Dated: March 30, 2012. John C. Roberts, Director of Civilian Response Operations, Office of the Coordinator for Reconstruction & Stabilization, Department of State. [FR Doc. 2012–8635 Filed 4–9–12; 8:45 am] BILLING CODE 4710–02–P E:\FR\FM\10APN1.SGM 10APN1

Agencies

Social Security Administration

[Federal Register Volume 77, Number 69 (Tuesday, April 10, 2012)]
[Notices]
[Pages 21616-21618]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-8546]

=======================================================================
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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 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions and one extension 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, Email address: OIRA_Submission@omb.eop.gov.
(SSA), Social Security Administration, DCRDP, Attn: Reports Clearance
Director, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD
21235, Fax: 410-966-2830, Email 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
11, 2012. 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. Request for Workers' Compensation/Public Disability Benefit
Information--20 CFR 404.408(e)--0960-0098. Claimants for Social
Security disability payments who are also receiving Worker's
Compensation/Public Disability Benefits (WC/PDB)

[[Page 21617]]

must notify SSA about their WC/PDB, so the agency can compute the
correct reduction of Social Security disability payments. SSA considers
the claimants the primary sources of verification; therefore, if
claimants provide necessary evidence, such as a copy of their award
notice, benefit check, etc., that is sufficient.
In cases where claimants cannot provide such evidence, SSA uses
form SSA-1709. The entity paying the WC/PDB benefits, its agent, (such
as an insurance carrier), or an administering public agency complete
this form. The respondents are Federal, State, and local agencies,
insurance carriers, and public or private self-insured companies
administering WC/PDB benefits to disability claimants.
Type of Request: Revision of an OMB-approved information
collection.

----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Collection instrument Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1709.................................... 120,000 1 15 30,000
----------------------------------------------------------------------------------------------------------------

2. Claimant's Medication--20 CFR 404.1512, 416.912--0960-0289. In
cases where claimants request a hearing after denial of their claim for
Social Security benefits, SSA uses Form HA-4632 to obtain information
from the claimant about medications they are using. This information
helps the administrative law judge overseeing the case to fully
investigate (1) the claimant's medical treatment and (2) the effects of
the medications on the claimant's medical impairment and functional
capacity. The respondents are applicants (or their representatives) for
Social Security benefits or payments requesting a hearing to contest an
agency denial of their claim.
Type of Request: Revision of an OMB-approved information
collection.

----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Collection method respondents response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
HA-4632 (paper)................................. 20,000 1 15 5,000
Electronic Records Express...................... 180,000 1 15 45,000
---------------------------------------------------------------
Total....................................... 200,000 .............. .............. 50,000
----------------------------------------------------------------------------------------------------------------

3. Representative Payee Report--Special Veterans Benefits--20 CFR
408.665--0960-0621. Title VIII of the Social Security Act allows for
payment of monthly Social Security benefits to qualified World War II
veterans residing outside the United States. An SSA-appointed
representative payee may receive and manage the monthly payment for the
beneficiary's use and benefit. SSA uses the information from Form SSA-
2001-F6 to determine if the payee is using the benefits properly on
behalf of the beneficiary. Respondents are persons or organizations who
act on behalf of beneficiaries who receive Special Veterans Benefits
and live outside the United States.
Type of Request: Revision of an OMB-approved information
collection.

----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Collection instrument Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2001-F6................................. 100 1 10 17
----------------------------------------------------------------------------------------------------------------

4. Representative Payment Policies Regulation--20 CFR 404.2011,
404.2025, 416.611, 416.625--0960-0679. If SSA determines it may cause
substantial harm for beneficiaries to receive their payments directly,
beneficiaries may dispute that decision. To do so, beneficiaries must
provide SSA with information the agency will use to re-evaluate its
determination. In addition, after SSA selects a representative payee to
receive benefits on a beneficiary's behalf, the payees provide SSA with
information on their continuing relationship and responsibility for the
beneficiaries, and explain how they use the beneficiaries' payments.
This Information Collection Request includes the CFR citations that
mandate the above provisions.
Type of Request: Extension of an OMB-approved information
collection.

----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
CFR Section respondents response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
404.2011(a)(1), 416.611(a)(1)................... 250 1 15 63
404.2025, 416.625............................... 3,000 1 6 300
---------------------------------------------------------------
Totals...................................... 3,250 .............. .............. 363
----------------------------------------------------------------------------------------------------------------

[[Page 21618]]

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 May 10, 2012. Individuals can obtain copies of the
OMB clearance packages by calling the SSA Reports Clearance Director at
410-965-8783 or by writing to the above email address.
Third Party Liability Information Statement--42 CFR 433.136-
433.139--0960-0323. States may enter into agreements with the
Commissioner of Social Security to make Medicaid eligibility
determinations for aged, blind, and disabled beneficiaries in those
states. Applications for and redeterminations of SSI eligibility in
jurisdictions with such agreements are applications and
redeterminations of Medicaid eligibility.
To reduce Medicaid costs, Medicaid state agencies must identify
third party insurers liable for medical care or services for Medicaid
beneficiaries. Regulations at 42 CFR 433.136-433.139 require Medicaid
state agencies to obtain this information on Medicaid applications and
redeterminations as a condition of Medicaid eligibility. The Medicaid
state agencies use the information to bill third parties liable for
medical care, support, or services for a beneficiary to guarantee that
Medicaid remains the payer of last resort. Under the Medicaid
agreements, SSA obtains third party liability information using Form
SSA-8019, and provides that information to the Medicaid state agencies.
The respondents are SSI claimants and recipients.

Note: This is a correction notice: SSA published this
information collection as an extension on January 31, 2012 at 77 FR
4854. Since we are revising the Privacy Act Statement, this is now a
revision of an OMB-approved information collection.

Type of Request: Revision of an OMB-approved information
collection.

----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Collection instrument responses response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8012 Paper form............................. 130 1 5 11
Modernized SSI Claims System (MSSICS)........... 66,904 1 5 5,575
---------------------------------------------------------------
Totals...................................... 67,034 .............. .............. 5,586
----------------------------------------------------------------------------------------------------------------

Dated: April 5, 2012.
Faye Lipsky,
Reports Clearance Director, Office of Regulations and Reports
Clearance, Social Security Administration.
[FR Doc. 2012-8546 Filed 4-9-12; 8:45 am]
BILLING CODE 4191-02-P

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