Agency Information Collection Activities: Proposed Request and Comment Request, 47688-47690 [2012-19493]
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Federal Register / Vol. 77, No. 154 / Thursday, August 9, 2012 / Notices
No. SR–BOX–2012–003 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 No.
SR–BOX–2012–003. 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 such filing
also will be available for inspection and
copying at the principal office of the
Exchange. All comments received will
be posted without change; the
Commission does not edit personal
identifying information from
submissions. You should submit only
information that you wish to make
available publicly. All submissions
should refer to File No. SR–BOX–2012–
003 and should be submitted on or
before August 30, 2012.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.43
Kevin M. O’Neill,
Deputy Secretary.
[FR Doc. 2012–19489 Filed 8–8–12; 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 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes revisions
of OMB-approved information
collections, and one new information
collection.
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 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 9, 2012. Individuals
can obtain copies of the collection
instrument by writing to the above
email address.
Statement of Care and Responsibility
for Beneficiary—20 CFR 404.2020,
404.2025, 408.620, 408.625, 416.620,
416.625—0960–0109. SSA uses the
information from Form SSA–788 to
verify payee applicants’ statements of
concern and to identify other potential
payees. SSA is concerned with selecting
the most qualified representative payee
who will use Social Security benefits in
the beneficiary’s best interest. SSA
considers factors such as the payee
applicant’s capacity to perform payee
duties, awareness of the beneficiary’s
situation and needs, demonstration of
past and current concern for the
beneficiary’s well-being, etc. If the
payee applicant does not have custody
of the beneficiary, SSA will obtain
information from the custodian for
evaluation against information provided
by the applicant. Respondents are
individuals who have custody of the
beneficiary in cases where someone else
has filed to be the beneficiary’s
representative payee.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–788 ..........................................................................................................
tkelley on DSK3SPTVN1PROD with NOTICES
Collection instrument
130,000
1
10
212,667
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 30
days from the date of this publication.
To be sure we consider your comments,
we must receive them no later than
September 10, 2012. Individuals can
obtain copies of the OMB clearance
packages by writing to
OPLM.RCO@ssa.gov.
43 17
1. Automated Scheduling Application
(ASA)—20 CFR 404.929, 404.936,
404.950, 416.1429, 416.1436, and
416.1450–416.1451—0960–NEW. SSA is
creating an online-based scheduling
tool, the Automated Scheduling
Application (ASA), to document the
availability and special needs of
participants for hearings before
administrative law judges (ALJ). The
respondents are disability applicants or
recipients, ALJ staff, SSA Hearing Office
employees, appointed representatives,
medical experts, vocational experts, and
verbatim hearing recorders who need to
schedule or request special needs
related to an ALJ hearing. All
respondents will use the ASA system
(via SSA’s Intranet for SSA employees,
and a public-facing Internet site for
members of the public) to document
their hearings availability and needs,
and to view scheduled hearings in an
electronic calendar. SSA staff will
CFR 200.30–3(a)(12).
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16:38 Aug 08, 2012
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PO 00000
Frm 00100
Fmt 4703
Sfmt 4703
E:\FR\FM\09AUN1.SGM
09AUN1
47689
Federal Register / Vol. 77, No. 154 / Thursday, August 9, 2012 / Notices
provide technical support to external
users via our 800 number.
Type of Request: This is a new
information collection request.
Number of
respondents
Respondent type
Medical Experts, Vocational Experts, Hearing Reporters—
Availability Reporting Using External ASA .......................
Appointed Representatives—Availability Reporting Using
External ASA ....................................................................
Medical Experts, Vocational Experts, Hearing Reporters—
Requests to HO To Change Availability Using Internal
ASA ..................................................................................
Appointed Representatives—Requests to HO To Change
Availability Using Internal ASA .........................................
Totals ............................................................................
2. Statement of Claimant or Other
Person—20 CFR 404.702 & 416.570
—0960–0045. In cases where claimants
or others want to share information
relating to Supplemental Security
Income (SSI) or Social Security benefits,
and SSA has no standard form to
document this information, the agency
Frequency of
response
Average
burden per
response
(minutes)
Number of
responses
Estimated total
annual burden
(hours)
3,300
52
(171,600)
8
22,880
16,600
52
(863,200)
8
115,093
3,300
6
(19,800)
8
2,640
16,600
6
(99,600)
8
13,280
39,800
........................
(1,154,200)
........................
153,893
uses Form SSA–795. The agency
documents whatever information the
claimant or other member of the public
provides, and considers it when
processing benefits claims or when
making decisions on ongoing issues
relating to the above programs. The
respondents are applicants or recipients
of SSI or Social Security benefits, or
others who are in a position to provide
relevant information on an existing
claim or case.
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–795 ..........................................................................................................
305,500
1
15
76,375
3. Disability Report—Adult—20 CFR
404.1512 and 416.912—0960–0579.
State Disability Determination Services
(DDS) use the SSA–3368 and its
electronic versions to determine if adult
disability applicants’ impairments are
severe and, if so, how the impairments
affect the applicants’ ability to work.
This determination dictates whether the
DDSs and SSA will find the applicant
to be disabled and entitled to SSI
payments. The respondents are
Number of
respondents
Collection method
applicants for title II disability benefits
or title XVI SSI payments.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
responses
(minutes)
Estimated
annual
burden
(hours)
29,072
2,853,426
421,226
1
1
1
60
60
90
29,072
2,853,426
631,839
Totals ........................................................................................................
tkelley on DSK3SPTVN1PROD with NOTICES
SSA–3368 (Paper Form) .................................................................................
Electronic Disability Collect System (EDCS) ...................................................
i3368 (Internet) ................................................................................................
3,303,724
........................
........................
3,514,337
4. Social Security Number
Verification Services—20 CFR 401.45—
0960–0660. Internal Revenue Service
regulations require employers to
provide wage and tax data to SSA using
Form W–2 or its electronic equivalent.
As part of this process, the employer
must furnish the employee’s name and
Social Security number (SSN). In
addition, the employee’s name and SSN
VerDate Mar<15>2010
16:38 Aug 08, 2012
Jkt 226001
must match SSA’s records for SSA to
post earnings to the employee’s earnings
record, which SSA maintains. SSA
offers the Social Security Number
Verification Service (SSNVS), which
allows employers to verify that the
reported names and SSNs of their
employees match those in SSA’s
records. SSNVS is a cost-free method for
employers to verify employee
PO 00000
Frm 00101
Fmt 4703
Sfmt 4703
information either through the Internet
or via telephone. The respondents are
employers who need to verify SSN data
using SSA’s records. This is a correction
notice: SSA published incorrect burden
information for this collection at 77 FR
29441, on 5/17/12. We are correcting
this error here.
Type of Request: Revision of an OMBapproved information collection.
E:\FR\FM\09AUN1.SGM
09AUN1
47690
Federal Register / Vol. 77, No. 154 / Thursday, August 9, 2012 / Notices
Number of
respondents
Verification system
Frequency of
response
Number of
responses
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
SSNVS .................................................................................
SSNVS Telephone ...............................................................
52,157
6,000
57
2
(2,972,949)
(12,000)
5
10
247,746
2,000
Totals ............................................................................
58,157
........................
(2,984,949)
........................
249,746
5. Statement of Reclamation Action—
31 CFR 210—0960–0734. Regulations
governing the Federal Government
Participation in the Automated Clearing
House (1) allow SSA to send Social
Security payments to Canada and (2)
mandate the reclamation of funds paid
erroneously to a Canadian bank or
financial institution after the death of a
Social Security beneficiary. SSA uses
Form SSA–1713, Notice of Reclamation
Action, to determine if, how, and when
the Canadian bank or financial
institution will return erroneous
payments after the death of a Social
Security beneficiary who elected to have
payments sent to Canada. Form SSA–
1712 (or SSA–1712 CN), Notice of
Reclamation—Canada Payment Made in
the United States, is the cover sheet SSA
prepares to request return of the
payment. The respondents are Canadian
banks and financial institutions who
erroneously received Social Security
payments.
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–1713 ........................................................................................................
15
1
5
1
6. Electronic Records Express (Third
Parties)—20 CFR 404.1700–404.1715—
0960–0767. Electronic Records Express
(ERE) is an online system that enables
medical providers and various thirdparty representatives to download and
submit disability claimant information
electronically to SSA as part of the
disability application process. To ensure
only authorized people access ERE, SSA
requires third parties to complete a
unique registration process if they wish
to use this system. This Information
Collection Request (ICR) includes the
third-party registration process; the
burden for submitting evidence to SSA
is part of other, various ICRs. The
respondents are third-party
representatives of disability applicants
or recipients who want to use ERE to
electronically access clients’ disability
files online and submit information to
SSA.
Type of Request: Revision to an OMBapproved information collection.
Collection instrument
Number of
respondents
Frequency of
response
Number of
responses
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
ERE ......................................................................................
9,000
283
(2,547,000)
1
42,450
Dated: August 6, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security
Administration.
[FR Doc. 2012–19493 Filed 8–8–12; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
tkelley on DSK3SPTVN1PROD with NOTICES
[Public Notice 7976]
30-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
comment and submission to OMB of
proposed collection of information.
ACTION:
The Department of State has
submitted the following information
SUMMARY:
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16:38 Aug 08, 2012
Jkt 226001
collection request to the Office of
Management and Budget (OMB) for
approval 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).
• 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:
2,000 per year.
• Estimated Number of Responses:
2,000 per year.
PO 00000
Frm 00102
Fmt 4703
Sfmt 4703
• Average Hours per Response: 1
hour.
• Total Estimated Burden: 2,000
Hours.
• Frequency: On occasion.
• Obligation To Respond: Required to
receive benefits.
DATES: Submit comments to the Office
of Management and Budget (OMB) for
up to 30 days from August 9, 2012.
ADDRESSES: 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, 1800 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.
E:\FR\FM\09AUN1.SGM
09AUN1
]]>Agencies
[Federal Register Volume 77, Number 154 (Thursday, August 9, 2012)]
[Notices]
[Pages 47688-47690]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-19493]
=======================================================================
-----------------------------------------------------------------------
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 of OMB-approved information collections, and one new
information collection.
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 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 9, 2012. Individuals can obtain copies of the collection
instrument by writing to the above email address.
Statement of Care and Responsibility for Beneficiary--20 CFR
404.2020, 404.2025, 408.620, 408.625, 416.620, 416.625--0960-0109. SSA
uses the information from Form SSA-788 to verify payee applicants'
statements of concern and to identify other potential payees. SSA is
concerned with selecting the most qualified representative payee who
will use Social Security benefits in the beneficiary's best interest.
SSA considers factors such as the payee applicant's capacity to perform
payee duties, awareness of the beneficiary's situation and needs,
demonstration of past and current concern for the beneficiary's well-
being, etc. If the payee applicant does not have custody of the
beneficiary, SSA will obtain information from the custodian for
evaluation against information provided by the applicant. Respondents
are individuals who have custody of the beneficiary in cases where
someone else has filed to be the beneficiary's representative payee.
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-788..................................... 130,000 1 10 212,667
----------------------------------------------------------------------------------------------------------------
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 30 days from the date of this
publication. To be sure we consider your comments, we must receive them
no later than September 10, 2012. Individuals can obtain copies of the
OMB clearance packages by writing to OPLM.RCO@ssa.gov.
1. Automated Scheduling Application (ASA)--20 CFR 404.929, 404.936,
404.950, 416.1429, 416.1436, and 416.1450-416.1451--0960-NEW. SSA is
creating an online-based scheduling tool, the Automated Scheduling
Application (ASA), to document the availability and special needs of
participants for hearings before administrative law judges (ALJ). The
respondents are disability applicants or recipients, ALJ staff, SSA
Hearing Office employees, appointed representatives, medical experts,
vocational experts, and verbatim hearing recorders who need to schedule
or request special needs related to an ALJ hearing. All respondents
will use the ASA system (via SSA's Intranet for SSA employees, and a
public-facing Internet site for members of the public) to document
their hearings availability and needs, and to view scheduled hearings
in an electronic calendar. SSA staff will
[[Page 47689]]
provide technical support to external users via our 800 number.
Type of Request: This is a new information collection request.
----------------------------------------------------------------------------------------------------------------
Estimated
Number of Frequency of Number of Average burden total annual
Respondent type respondents response responses per response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Medical Experts, Vocational 3,300 52 (171,600) 8 22,880
Experts, Hearing Reporters--
Availability Reporting Using
External ASA...................
Appointed Representatives-- 16,600 52 (863,200) 8 115,093
Availability Reporting Using
External ASA...................
Medical Experts, Vocational 3,300 6 (19,800) 8 2,640
Experts, Hearing Reporters--
Requests to HO To Change
Availability Using Internal ASA
Appointed Representatives-- 16,600 6 (99,600) 8 13,280
Requests to HO To Change
Availability Using Internal ASA
-------------------------------------------------------------------------------
Totals...................... 39,800 .............. (1,154,200) .............. 153,893
----------------------------------------------------------------------------------------------------------------
2. Statement of Claimant or Other Person--20 CFR 404.702 & 416.570
--0960-0045. In cases where claimants or others want to share
information relating to Supplemental Security Income (SSI) or Social
Security benefits, and SSA has no standard form to document this
information, the agency uses Form SSA-795. The agency documents
whatever information the claimant or other member of the public
provides, and considers it when processing benefits claims or when
making decisions on ongoing issues relating to the above programs. The
respondents are applicants or recipients of SSI or Social Security
benefits, or others who are in a position to provide relevant
information on an existing claim or case.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Collection instrument Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-795..................................... 305,500 1 15 76,375
----------------------------------------------------------------------------------------------------------------
3. Disability Report--Adult--20 CFR 404.1512 and 416.912--0960-
0579. State Disability Determination Services (DDS) use the SSA-3368
and its electronic versions to determine if adult disability
applicants' impairments are severe and, if so, how the impairments
affect the applicants' ability to work. This determination dictates
whether the DDSs and SSA will find the applicant to be disabled and
entitled to SSI payments. The respondents are applicants for title II
disability benefits or title XVI SSI payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Collection method respondents response responses annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3368 (Paper Form)........................... 29,072 1 60 29,072
Electronic Disability Collect System (EDCS)..... 2,853,426 1 60 2,853,426
i3368 (Internet)................................ 421,226 1 90 631,839
---------------------------------------------------------------
Totals...................................... 3,303,724 .............. .............. 3,514,337
----------------------------------------------------------------------------------------------------------------
4. Social Security Number Verification Services--20 CFR 401.45--
0960-0660. Internal Revenue Service regulations require employers to
provide wage and tax data to SSA using Form W-2 or its electronic
equivalent. As part of this process, the employer must furnish the
employee's name and Social Security number (SSN). In addition, the
employee's name and SSN must match SSA's records for SSA to post
earnings to the employee's earnings record, which SSA maintains. SSA
offers the Social Security Number Verification Service (SSNVS), which
allows employers to verify that the reported names and SSNs of their
employees match those in SSA's records. SSNVS is a cost-free method for
employers to verify employee information either through the Internet or
via telephone. The respondents are employers who need to verify SSN
data using SSA's records. This is a correction notice: SSA published
incorrect burden information for this collection at 77 FR 29441, on 5/
17/12. We are correcting this error here.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 47690]]
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of Number of burden per total annual
Verification system respondents response responses response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSNVS........................... 52,157 57 (2,972,949) 5 247,746
SSNVS Telephone................. 6,000 2 (12,000) 10 2,000
-------------------------------------------------------------------------------
Totals...................... 58,157 .............. (2,984,949) .............. 249,746
----------------------------------------------------------------------------------------------------------------
5. Statement of Reclamation Action--31 CFR 210--0960-0734.
Regulations governing the Federal Government Participation in the
Automated Clearing House (1) allow SSA to send Social Security payments
to Canada and (2) mandate the reclamation of funds paid erroneously to
a Canadian bank or financial institution after the death of a Social
Security beneficiary. SSA uses Form SSA-1713, Notice of Reclamation
Action, to determine if, how, and when the Canadian bank or financial
institution will return erroneous payments after the death of a Social
Security beneficiary who elected to have payments sent to Canada. Form
SSA-1712 (or SSA-1712 CN), Notice of Reclamation--Canada Payment Made
in the United States, is the cover sheet SSA prepares to request return
of the payment. The respondents are Canadian banks and financial
institutions who erroneously received Social Security 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
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1713.................................... 15 1 5 1
----------------------------------------------------------------------------------------------------------------
6. Electronic Records Express (Third Parties)--20 CFR 404.1700-
404.1715--0960-0767. Electronic Records Express (ERE) is an online
system that enables medical providers and various third-party
representatives to download and submit disability claimant information
electronically to SSA as part of the disability application process. To
ensure only authorized people access ERE, SSA requires third parties to
complete a unique registration process if they wish to use this system.
This Information Collection Request (ICR) includes the third-party
registration process; the burden for submitting evidence to SSA is part
of other, various ICRs. The respondents are third-party representatives
of disability applicants or recipients who want to use ERE to
electronically access clients' disability files online and submit
information to SSA.
Type of Request: Revision to an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Collection instrument Number of Frequency of Number of per response annual burden
respondents response responses (minutes) (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
ERE................................................................ 9,000 283 (2,547,000) 1 42,450
--------------------------------------------------------------------------------------------------------------------------------------------------------
Dated: August 6, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2012-19493 Filed 8-8-12; 8:45 am]
BILLING CODE 4191-02-P
