Agency Information Collection Activities: Proposed Request and Comment Request, 47908-47910 [2012-19615]
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<![CDATA[
47908
Federal Register / Vol. 77, No. 155 / Friday, August 10, 2012 / Notices
Percent
Non-Profit
Organizations
Without Credit Available
Elsewhere ..........................
For Economic Injury:
Non-Profit
Organizations
Without Credit Available
Elsewhere ..........................
3.000
BILLING CODE 8025–01–P
3.000
3.125
3.000
3.000
The number assigned to this disaster
for physical damage is 131666 and for
economic injury is 131676.
(Catalog of Federal Domestic Assistance
Numbers 59002 and 59008)
This is a Notice of the
Presidential declaration of a major
disaster for Public Assistance Only for
the State of MINNESOTA (FEMA–4069–
DR), dated 07/06/2012.
Incident: Severe Storms and Flooding.
Incident Period: 06/14/2012 through
06/21/2012.
Effective Date: 07/06/2012.
Physical Loan Application Deadline
Date: 09/04/2012.
Economic Injury (EIDL) Loan
Application Deadline Date: 04/08/2013.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW., Suite 6050,
Washington, DC 20416.
SUPPLEMENTARY INFORMATION: Notice is
hereby given that as a result of the
President’s major disaster declaration on
07/06/2012, Private Non-Profit
organizations that provide essential
services of governmental nature may file
disaster loan applications at the address
listed above or other locally announced
locations.
The following areas have been
determined to be adversely affected by
the disaster:
Primary Counties: Aitkin, Carlton, Cass,
Cook, Crow Wing, Dakota,
Goodhue, Itasca, Kandiyohi, Lake,
Meeker, Pine, Rice, Saint Louis,
Sibley; and the Fond Du Lac Band
of Lake Superior Chippewa, Grand
Portage Band of Lake Superior
Chippewa, and the Mille Lacs Band
of Ojibwe.
The Interest Rates are:
SUMMARY:
BILLING CODE 8025–01–P
SMALL BUSINESS ADMINISTRATION
[Disaster Declaration #13154 and #13155]
West Virginia Disaster Number WV–
00028
U.S. Small Business
Administration.
ACTION: Amendment 1.
AGENCY:
mstockstill on DSK4VPTVN1PROD with NOTICES
Non-Profit Organizations
with Credit Available Elsewhere ...............................
Non-Profit Organizations
without Credit Available
Elsewhere ........................
For Economic Injury:
Non-Profit Organizations
without Credit Available
Elsewhere ........................
U.S. Small Business
Administration.
ACTION: Notice.
[FR Doc. 2012–19669 Filed 8–9–12; 8:45 am]
This is an amendment of the
Presidential declaration of a major
disaster for Public Assistance Only for
the State of West Virginia (FEMA–4071–
DR), dated 07/23/2012.
Incident: Severe Storms and Straightline Winds.
Incident Period: 06/29/2012 through
07/08/2012.
DATES: Effective Date: 08/01/2012.
Physical Loan Application Deadline
Date: 09/21/2012.
Economic Injury (EIDL) Loan
Application Deadline Date: 04/23/2013.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW., Suite 6050,
Washington, DC 20416.
SUPPLEMENTARY INFORMATION: The notice
of the President’s major disaster
declaration for Private Non-Profit
organizations in the State of West
Virginia, dated 07/23/2012, is hereby
amended to re-establish the incident
period for this disaster as beginning 06/
29/2012 and continuing through 07/08/
2012.
All other information in the original
declaration remains unchanged.
Jkt 226001
[Disaster Declaration #13166 and #13167]
AGENCY:
James E. Rivera,
Associate Administrator for Disaster
Assistance.
SUMMARY:
SMALL BUSINESS ADMINISTRATION
Percent
MINNESOTA Disaster #MN–00038
(Catalog of Federal Domestic Assistance
Numbers 59002 and 59008)
18:02 Aug 09, 2012
James E. Rivera,
Associate Administrator for Disaster
Assistance.
[FR Doc. 2012–19668 Filed 8–9–12; 8:45 am]
The number assigned to this disaster
for physical damage is 13172B and for
economic injury is 13173B
VerDate Mar<15>2010
(Catalog of Federal Domestic Assistance
Numbers 59002 and 59008)
Percent
For Physical Damage:
PO 00000
Frm 00109
Fmt 4703
Sfmt 4703
James E. Rivera,
Associate Administrator for Disaster
Assistance.
[FR Doc. 2012–19637 Filed 8–10–12; 8:45 am]
BILLING CODE 8025–01–M
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
by the Office of Management and
Budget (OMB) in compliance with
Public Law 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes revisions
to 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 Director 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.
E:\FR\FM\10AUN1.SGM
10AUN1
47909
Federal Register / Vol. 77, No. 155 / Friday, August 10, 2012 / Notices
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 October 9,
2012. Individuals can obtain copies of
the collection instruments by writing to
the above email address.
1. Employment Relationship
Questionnaire—20 CFR 404.1007—
0960–0040. When SSA needs
information to determine a worker’s
employment status for the purpose of
maintaining a worker’s earning records,
the agency uses Form SSA–7160–F4 to
determine the existence of an employeremployee relationship. We use the
Number of
respondents
Respondent type
information to document the
employment relationship; specifically,
to determine whether a beneficiary is
self-employed or an employee. The
respondents are individuals seeking to
establish their status as employees and
their alleged employers.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
Individuals ........................................................................................................
Business ..........................................................................................................
State/Local Government ..................................................................................
8,000
7,200
800
1
1
1
25
25
25
3,333
3,000
333
Totals ........................................................................................................
16,000
........................
........................
6,666
2. Blood Donor Locator Service
(BDLS)—20 CFR 401.200—0960–0501.
The regulations on Privacy and
Disclosure of Official Records and
Information, Subpart C, stipulate that
when blood donor facilities identify
blood donations as human
immunodeficiency virus (HIV)-positive,
the overseeing state agency must
provide the names and Social Security
Numbers of the affected donors to SSA’s
Blood Donor Locator Service. SSA uses
this information to furnish the state
agencies with the blood donors’ address
information to notify the blood donors.
Respondents are state agencies acting on
behalf of blood donor facilities.
Type of Request. Extension of an
OMB-approved information collection.
Regulations section
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
20 CFR 401.200 ..............................................................................................
10
5
15
13
3. The Ticket to Work and SelfSufficiency Program—20 CFR 411—
0960–0644. SSA’s Ticket to Work
(Ticket) Program transitions Social
Security Disability Insurance (SSDI) and
Supplemental Security Income (SSI)
recipients toward independence by
allowing them to receive Social Security
payments while maintaining
employment under the auspices of the
program. SSA uses service providers,
called Employment Networks (ENs), to
supervise participant progress through
the stages of Ticket Program
participation, such as job searches and
interviews, progress reviews, and
changes in ticket status. ENs can be
private for-profit and nonprofit
organizations, as well as state vocational
rehabilitation agencies (VRs).
SSA and the ENs utilize the Ticket to
Work Program Manager to operate the
Ticket Program and exchange
information about participants. For
example, the ENs use the Program
Manager to provide updates on tasks
such as selecting a payment system or
requesting payments for helping the
beneficiary achieve certain work goals.
Since the ENs are not PRA-exempt,
the multiple information collections
within the Ticket Program Manager
require OMB approval, and we clear
Number of
respondents
mstockstill on DSK4VPTVN1PROD with NOTICES
Collection instrument
(a)
(a)
(a)
(a)
(a)
(a)
(a)
(a)
(b)
(b)
(b)
20
20
20
20
20
20
20
20
20
20
20
CFR
CFR
CFR
CFR
CFR
CFR
CFR
CFR
CFR
CFR
CFR
411.140(d)(2)—Regular Telephone ..............................................
411.140(d)(2)—Interactive Voice Recognition Telephone ...........
411.140(d)(2)—Portal ...................................................................
411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1365 ................
411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1365 Portal .....
411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1370 ................
411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1370 Portal .....
411.166; 411.170(b)—Electronic File Submission .......................
411.145; 411.325 .........................................................................
411.145; 411.325—Portal .............................................................
411.535(a)(1)(iii)—Data Sharing/Portal ........................................
VerDate Mar<15>2010
18:02 Aug 09, 2012
Jkt 226001
PO 00000
Frm 00110
Fmt 4703
Sfmt 4703
them under this information collection
request (ICR). Most of the categories of
information in this ICR are necessary for
SSA to: (1) Comply with the Ticket to
Work legislation; and (2) provide proper
oversight of the program. SSA collects
this information through several
modalities, including forms, electronic
exchanges, and written documentation.
The respondents are the ENs or state
VRs, as well as SSDI beneficiaries and
blind or disabled SSI recipients working
under the auspices of the Ticket to Work
Program.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
3,214
12,856
16,071
2,370
2,370
3,913
3,912
35,584
4,988
4,988
8,505
E:\FR\FM\10AUN1.SGM
1
1
1
1
1
1
1
1
1
1
1
10AUN1
Average
burden per
response
(minutes)
5
2.5
1.25
15
11
60
45
5
15
11
5
Estimated total
annual burden
(hours)
268
536
335
593
434
3,913
2,934
2,965
1,247
914
709
47910
Federal Register / Vol. 77, No. 155 / Friday, August 10, 2012 / Notices
Number of
respondents
Collection instrument
Frequency of
response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
(c) 20 CFR 411.192(b) & (c) ............................................................................
(c) 20 CFR 411.200(b)—SSA–1375 ................................................................
(c) 20 CFR 411.200(b)—Portal .......................................................................
(c) 20 CFR 411.210(b) ....................................................................................
(d) 20 CFR 411.365; 411.505; 411.515 ..........................................................
(e) 20 CFR 411.325(d); 411.415 .....................................................................
(f) 20 CFR 411.575—SSA–1389; SSA–1391; SSA–1393; SSA–1396; SSA–
1398; SSA–1399 ..........................................................................................
(f) 20 CFR 411.575—Portal .............................................................................
(f) 20 CFR 411.575—Automatic Payments .....................................................
(f) 20 CFR 411.560—SSA–1401 .....................................................................
(g) 20 CFR 411.325(f) .....................................................................................
(h) 20 CFR 411.435; 411.615; 411.625 ..........................................................
(i) 20 CFR 411.320—SSA–1394 .....................................................................
(i) 20 CFR 411.320—SSA–1394 Portal ...........................................................
6
112,362
64,824
41
5
1
1
1
1
1
1
1
30
15
10
30
10
480
3
28,091
10,804
21
1
8
14,025
14,025
28,050
100
1,371
2
105
105
1
1
1
1
1
1
1
1
40
22
0
20
45
120
7.5
7.5
9,350
5,142
0
33
1,028
4
13
13
Totals ........................................................................................................
333,793
........................
........................
69,360
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 September 10, 2012.
Individuals can obtain copies of the
OMB clearance package by writing to
OPLM.RCO@ssa.gov.
Authorization for the Social Security
Administration to Obtain Account
Records from a Financial Institution
and Request for Records (Medicare)—
0960–0729. Under the aegis of the
Medicare Modernization Act of 2003,
Medicare beneficiaries can apply for a
Medicare Prescription Drug Plan (Part
D) program subsidy. In some cases, SSA
will verify the details of applicants’
accounts at financial institutions to
determine if they are eligible for the
Number of
respondents
Type of respondent
subsidy. Form SSA–4640 provides the
applicant authorization SSA needs to
contact financial institutions about
applicants’ accounts. Financial
institutions use the form to verify the
information SSA requests. The
respondents are applicants for the
Medicare Part D program subsidy, and
financial institutions where these
applicants are account holders.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
Medicare Part D Subsidy Applicants ...............................................................
Financial Institutions ........................................................................................
5,000
5,000
1
1
1
4
83
333
Totals ........................................................................................................
10,000
........................
........................
416
Dated: August 7, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security
Administration.
suspension of ATPA or ATPDEA
benefits by presenting evidence that the
eligibility criteria of the program are not
being met. USTR will publish a list of
petitions filed in response to this
announcement in the Federal Register.
[FR Doc. 2012–19615 Filed 8–9–12; 8:45 am]
BILLING CODE 4191–02–P
The deadline for the submission
of petitions for the 2012 Annual ATPA
Review is 5 p.m. EDT, September 17,
2012.
DATES:
OFFICE OF THE UNITED STATES
TRADE REPRESENTATIVE
mstockstill on DSK4VPTVN1PROD with NOTICES
Andean Trade Preference Act (ATPA):
Notice Regarding the 2012 Annual
Review
Office of the United States
Trade Representative.
ACTION: Notice and request for petitions.
AGENCY:
This notice announces the
2012 Annual Review of the Andean
Trade Preference Act (ATPA). Under
this process, petitions may be filed
calling for the limitation, withdrawal or
SUMMARY:
VerDate Mar<15>2010
18:02 Aug 09, 2012
Jkt 226001
Public comments should be
submitted electronically to
www.regulations.gov, docket number
USTR–2012–0019. If you are unable to
provide submissions through
www.regulations.gov, please contact
Bennett Harman, at (202) 395–9446 to
arrange for an alternative method of
transmission.
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
Bennett Harman, Deputy Assistant
PO 00000
Frm 00111
Fmt 4703
Sfmt 4703
USTR for Latin America, at (202) 395–
9446.
SUPPLEMENTARY INFORMATION: The
ATPA, as amended by the Andean
Trade Promotion and Drug Eradication
Act of 2002 (ATPDEA) in the Trade Act
of 2002, 19 U.S.C. 3201 et seq., provides
trade benefits for eligible Andean
countries. The original Act allowed only
Bolivia, Ecuador, Colombia, and Peru to
be considered as beneficiary countries if
they met eligibility requirements laid
out in 19 U.S.C. 3203(b)(6)(B).
In Proclamation 8323 of November 25,
2008, the President determined that
Bolivia no longer satisfies the eligibility
criteria related to counternarcotics and
suspended Bolivia’s status as a
beneficiary country for purposes of the
ATPA and ATPDEA. In a June 30, 2009
report to Congress the President did not
determine that Bolivia satisfies the
requirements set forth in section 203(c)
E:\FR\FM\10AUN1.SGM
10AUN1
]]>Agencies
[Federal Register Volume 77, Number 155 (Friday, August 10, 2012)]
[Notices]
[Pages 47908-47910]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-19615]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions to 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 Director 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.
[[Page 47909]]
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
October 9, 2012. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. When SSA needs information to determine a worker's employment
status for the purpose of maintaining a worker's earning records, the
agency uses Form SSA-7160-F4 to determine the existence of an employer-
employee relationship. We use the information to document the
employment relationship; specifically, to determine whether a
beneficiary is self-employed or an employee. The respondents are
individuals seeking to establish their status as employees and their
alleged employers.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Respondent type respondents response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Individuals..................................... 8,000 1 25 3,333
Business........................................ 7,200 1 25 3,000
State/Local Government.......................... 800 1 25 333
---------------------------------------------------------------
Totals...................................... 16,000 .............. .............. 6,666
----------------------------------------------------------------------------------------------------------------
2. Blood Donor Locator Service (BDLS)--20 CFR 401.200--0960-0501.
The regulations on Privacy and Disclosure of Official Records and
Information, Subpart C, stipulate that when blood donor facilities
identify blood donations as human immunodeficiency virus (HIV)-
positive, the overseeing state agency must provide the names and Social
Security Numbers of the affected donors to SSA's Blood Donor Locator
Service. SSA uses this information to furnish the state agencies with
the blood donors' address information to notify the blood donors.
Respondents are state agencies acting on behalf of blood donor
facilities.
Type of Request. Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Regulations section Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
20 CFR 401.200.............................. 10 5 15 13
----------------------------------------------------------------------------------------------------------------
3. The Ticket to Work and Self-Sufficiency Program--20 CFR 411--
0960-0644. SSA's Ticket to Work (Ticket) Program transitions Social
Security Disability Insurance (SSDI) and Supplemental Security Income
(SSI) recipients toward independence by allowing them to receive Social
Security payments while maintaining employment under the auspices of
the program. SSA uses service providers, called Employment Networks
(ENs), to supervise participant progress through the stages of Ticket
Program participation, such as job searches and interviews, progress
reviews, and changes in ticket status. ENs can be private for-profit
and nonprofit organizations, as well as state vocational rehabilitation
agencies (VRs).
SSA and the ENs utilize the Ticket to Work Program Manager to
operate the Ticket Program and exchange information about participants.
For example, the ENs use the Program Manager to provide updates on
tasks such as selecting a payment system or requesting payments for
helping the beneficiary achieve certain work goals.
Since the ENs are not PRA-exempt, the multiple information
collections within the Ticket Program Manager require OMB approval, and
we clear them under this information collection request (ICR). Most of
the categories of information in this ICR are necessary for SSA to: (1)
Comply with the Ticket to Work legislation; and (2) provide proper
oversight of the program. SSA collects this information through several
modalities, including forms, electronic exchanges, and written
documentation. The respondents are the ENs or state VRs, as well as
SSDI beneficiaries and blind or disabled SSI recipients working under
the auspices of the Ticket to Work Program.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Collection instrument respondents response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
(a) 20 CFR 411.140(d)(2)--Regular Telephone..... 3,214 1 5 268
(a) 20 CFR 411.140(d)(2)--Interactive Voice 12,856 1 2.5 536
Recognition Telephone..........................
(a) 20 CFR 411.140(d)(2)--Portal................ 16,071 1 1.25 335
(a) 20 CFR 411.140(d)(3); 411.325(a); 2,370 1 15 593
411.150(b)(3)--SSA-1365........................
(a) 20 CFR 411.140(d)(3); 411.325(a); 2,370 1 11 434
411.150(b)(3)--SSA-1365 Portal.................
(a) 20 CFR 411.140(d)(3); 411.325(a); 3,913 1 60 3,913
411.150(b)(3)--SSA-1370........................
(a) 20 CFR 411.140(d)(3); 411.325(a); 3,912 1 45 2,934
411.150(b)(3)--SSA-1370 Portal.................
(a) 20 CFR 411.166; 411.170(b)--Electronic File 35,584 1 5 2,965
Submission.....................................
(b) 20 CFR 411.145; 411.325..................... 4,988 1 15 1,247
(b) 20 CFR 411.145; 411.325--Portal............. 4,988 1 11 914
(b) 20 CFR 411.535(a)(1)(iii)--Data Sharing/ 8,505 1 5 709
Portal.........................................
[[Page 47910]]
(c) 20 CFR 411.192(b) & (c)..................... 6 1 30 3
(c) 20 CFR 411.200(b)--SSA-1375................. 112,362 1 15 28,091
(c) 20 CFR 411.200(b)--Portal................... 64,824 1 10 10,804
(c) 20 CFR 411.210(b)........................... 41 1 30 21
(d) 20 CFR 411.365; 411.505; 411.515............ 5 1 10 1
(e) 20 CFR 411.325(d); 411.415.................. 1 1 480 8
(f) 20 CFR 411.575--SSA-1389; SSA-1391; SSA- 14,025 1 40 9,350
1393; SSA-1396; SSA-1398; SSA-1399.............
(f) 20 CFR 411.575--Portal...................... 14,025 1 22 5,142
(f) 20 CFR 411.575--Automatic Payments.......... 28,050 1 0 0
(f) 20 CFR 411.560--SSA-1401.................... 100 1 20 33
(g) 20 CFR 411.325(f)........................... 1,371 1 45 1,028
(h) 20 CFR 411.435; 411.615; 411.625............ 2 1 120 4
(i) 20 CFR 411.320--SSA-1394.................... 105 1 7.5 13
(i) 20 CFR 411.320--SSA-1394 Portal............. 105 1 7.5 13
---------------------------------------------------------------
Totals...................................... 333,793 .............. .............. 69,360
----------------------------------------------------------------------------------------------------------------
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 September 10, 2012. Individuals can obtain copies of
the OMB clearance package by writing to OPLM.RCO@ssa.gov.
Authorization for the Social Security Administration to Obtain
Account Records from a Financial Institution and Request for Records
(Medicare)--0960-0729. Under the aegis of the Medicare Modernization
Act of 2003, Medicare beneficiaries can apply for a Medicare
Prescription Drug Plan (Part D) program subsidy. In some cases, SSA
will verify the details of applicants' accounts at financial
institutions to determine if they are eligible for the subsidy. Form
SSA-4640 provides the applicant authorization SSA needs to contact
financial institutions about applicants' accounts. Financial
institutions use the form to verify the information SSA requests. The
respondents are applicants for the Medicare Part D program subsidy, and
financial institutions where these applicants are account holders.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Type of respondent respondents response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Medicare Part D Subsidy Applicants.............. 5,000 1 1 83
Financial Institutions.......................... 5,000 1 4 333
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Totals...................................... 10,000 .............. .............. 416
----------------------------------------------------------------------------------------------------------------
Dated: August 7, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2012-19615 Filed 8-9-12; 8:45 am]
BILLING CODE 4191-02-P
