Agency Information Collection Activities: Proposed Request and Comment Request, 76378-76382 [2013-29907]

Download as PDF 76378 Federal Register / Vol. 78, No. 242 / Tuesday, December 17, 2013 / Notices By the Commission. Elizabeth M. Murphy, Secretary. [FR Doc. 2013–30068 Filed 12–13–13; 11:15 am] BILLING CODE 8011–01–P SMALL BUSINESS ADMINISTRATION Reporting and Recordkeeping Requirements Under OMB Review Small Business Administration. Notice of 30 day reporting requirements submitted for OMB review. AGENCY: ACTION: Under the provisions of the Paperwork Reduction Act (44 U.S.C. Chapter 35), agencies are required to submit proposed reporting and recordkeeping requirements to OMB for review and approval, and to publish a notice in the Federal Register notifying the public that the agency has made such a submission. DATES: Submit comments on or before January 16, 2014. If you intend to comment but cannot prepare comments promptly, please advise the OMB Reviewer and the Agency Clearance Officer before the deadline. Copies: Request for clearance (OMB 83–1), supporting statement, and other documents submitted to OMB for review may be obtained from the Agency Clearance Officer. ADDRESSES: Address all comments concerning this notice to: Agency Clearance Officer, Curtis Rich, Small Business Administration, 409 3rd Street SW., 5th Floor, Washington, DC 20416; and OMB Reviewer, Office of Information and Regulatory Affairs, Office of Management and Budget, New Executive Office Building, Washington, DC 20503. FOR FURTHER INFORMATION CONTACT: Curtis Rich, Agency Clearance Officer, (202) 205–7030 curtis.rich@sba.gov. SUMMARY: Abstract: The information collected on SBA Form 480, ‘‘Size Status Declaration’’ is a certification of small business size status. This information collection is used to determine whether SBDC financial assistance is provided only to small business concerns as defined in the Small Business Investment Act and SBA size regulations. Without this certification, businesses that exceed SBA’s size standards could benefit from program resources meant for small businesses. SUPPLEMENTARY INFORMATION: Title: Size Status Declaration. Frequency: On Occasion. SBA Form Number: 480. Description of Respondents: Investment Companies. Responses: 2,500. Annual Burden: 417. Curtis Rich, Management Analyst. [FR Doc. 2013–29874 Filed 12–16–13; 8:45 am] BILLING CODE 8025–01–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. 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 Number of respondents Type of respondent 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, OLCA, Attn: Reports Clearance Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410–966–2830, Email address: OR.Reports.Clearance@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 February 18, 2014. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Advanced Notice of Termination of Child’s Benefits & Student’s Statement Regarding School Attendance—20 CFR 404.350–404.352, 404.367–404.368— 0960–0105. SSA collects information on Forms SSA–1372–BK and SSA–1372– BK–FC to determine whether children of an insured worker meet the eligibility requirements for student benefits. The data we collect allows SSA to entitlement to initial and continuning student benefits. The respondents are student claimants for Social Security benefits, their respective schools, and, in some cases, their representative payees. Type of Request: Revision of an OMBapproved information collection. Frequency of response Estimated total annual burden (hours) Average burden per response (minutes) wreier-aviles on DSK5TPTVN1PROD with NOTICES SSA–1372–BK Individuals/Households .................................................................................... State/Local/Tribal Government ........................................................................ 99,850 99,850 1 1 8 3 13,313 4,993 Totals ........................................................................................................ 199,700 ........................ ........................ 18,306 150 150 1 1 8 3 20 8 SSA–1372–BK–FC Individuals/Households .................................................................................... State/Local/TribalGovernment ......................................................................... VerDate Mar<15>2010 14:45 Dec 16, 2013 Jkt 232001 PO 00000 Frm 00110 Fmt 4703 Sfmt 4703 E:\FR\FM\17DEN1.SGM 17DEN1 Federal Register / Vol. 78, No. 242 / Tuesday, December 17, 2013 / Notices Frequency of response Number of respondents Type of respondent Average burden per response (minutes) 76379 Estimated total annual burden (hours) Totals ........................................................................................................ 300 ........................ ........................ 28 Grand Total ....................................................................................... 200,000 ........................ ........................ 18,334 2. State Mental Institution Policy Review Booklet—20 CFR 404.2035, 404.2065, 416.635, & 416.665—0960– 0110. SSA uses Form SSA–9584–BK: (1) To determine if the policies and practices of State mental institutions acting as representative payees for SSA beneficiaries conform to SSA’s regulations in the use of benefits; (2) to confirm that institutions are performing other duties and responsibilities required of a representative payees; and (3) as the basis for conducting onsite reviews of the institutions and preparing subsequent reports of findings. The respondents are State mental institutions serving as representative payees for Social Security beneficiaries and Supplemental Security Income (SSI) recipients. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–9584–BK ................................................................................................. 78 1 60 78 3. Modified Benefit Formula Questionnaire—0960–0395. SSA collects information on Form SSA–150 to determine which formula to use in computing the Social Security benefit for someone who receives a pension from employment not covered by Social Security. The Windfall Elimination Provision (WEP) requires use of a benefit formula replacing a smaller percentage of a worker’s pre-retirement earnings. However, the resulting amount cannot show a difference in the benefit computed using the modified and regular formulas greater than one-half the amount of the pension received in the first month an individual is entitled to both the pension and the Social Security benefit. The SSA–150 collects the information needed to make all the necessary benefit computations. SSA requires the respondents to furnish the information on Form SSA–150 so we can calculate their benefits using the data they supply. SSA calculates the benefits of applicants who do not respond to this questionnaire using the full WEP reduction. SSA employees collect this information once from the applicant at the time they file their claim. The respondents are applicants for old age and disability benefits. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–150 .......................................................................................................... 90,000 1 8 12,000 credit the earnings to the correct individual and SSN. We send the SSA– 4156 to the employer to: (1) identify the employees involved; (2) resolve the discrepancy, and (3) credit the earnings to the correct SSN. The respondents are 4. Employee Identification Statement—20 CFR 404.702—0960– 0473. When two or more individuals report earnings under the same Social Security number (SSN), SSA collects information on Form SSA–4156 to employers involved in erroneous wage reporting for an employee. Type of Request: Revision of an OMBapproved information collection. wreier-aviles on DSK5TPTVN1PROD with NOTICES Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–4156 ........................................................................................................ 4,750 1 10 792 5. Modified Benefit Formula Questionnaire—Employer—20 CFR 401 & 402—0960–0477. Sections 215(a)(7) and 215(d)(3) of the Social Security Act requires SSA to use WEP, a modified VerDate Mar<15>2010 14:45 Dec 16, 2013 Jkt 232001 benefit formula, to compute Social Security retirement or disability benefits for persons first eligible (after 1985) for both a Social Security benefit and a pension or annuity, based on PO 00000 Frm 00111 Fmt 4703 Sfmt 4703 employment not covered by Social Security. SSA determines if the WEP is applicable and when to apply it to a person’s benefit. SSA uses Form SSA– 58 to verify the claimant’s allegations on E:\FR\FM\17DEN1.SGM 17DEN1 76380 Federal Register / Vol. 78, No. 242 / Tuesday, December 17, 2013 / Notices Form SSA–150 (OMB No. 0960–0395, Modified Benefits Formula Questionnaire). SSA sends the SSA–58 to an employer for pension-related information, if the claimant is unable to provide it. The respondents are employers of people who were eligible after 1985 for both Social Security benefits and a pension based on work not covered by SSA. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–58 ............................................................................................................ 30,000 1 20 10,000 6. Employee Work Activity Questionnaire—20 CFR 404.1574, 404.1592—0960–0483. Social Security disability beneficiaries and SSI recipients qualify for payments when a verified physical or mental impairment prevents them from working. If disability claimants attempt to return to work after receiving payments,but are unable to continue working, they submit the SSA–3033, Employee Work Activity Questionnaire, so SSA can evaluate their work attempt. SSA also uses this form to evaluate unsuccessful subsidy work and determine applicants’ continuing eligibility for disability payments. The respondents are employers of Social Security disability beneficiaries and SSI recipients who unsuccessfully attempted to return to work. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–9584–BK ................................................................................................. 78 1 60 78 7. Work History Report—20 CFR 404.1515, 404.1560, 404.1565, 416.960, and 416.3965—0960–0578. Under certain circumstances, SSA asks individuals apply for disability about work they have performed in the past. Applicants use Form SSA–3369, Work Respondents are disability applicants and third parties assisting those applicants. Type of Request: Revision of an OMBapproved information collection. History Report, to provide detailed information about jobs held prior to becoming unable to work. State Disability Determination Services evaluate the information, together with medical evidence, to determine eligibility for disability payments. Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) 1,553,900 38,049 1 1 60 60 1,553,900 38,049 Totals ........................................................................................................ wreier-aviles on DSK5TPTVN1PROD with NOTICES SSA–3369 (Paper form) .................................................................................. Electronic Disability Collect System—3369 ..................................................... 1,591,949 ........................ ........................ 1,591,949 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 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than January 16, 2014. Individuals can obtain copies of the OMB clearance package by writing to OR.Reports.Clearance@ ssa.gov. Consent Based Social Security Number Verification Process—20 CFR 400.100—0960–0760. The Consent Based Social Security Number Verification (CBSV) process is a feebased automated SSN verification service available to private businesses VerDate Mar<15>2010 14:45 Dec 16, 2013 Jkt 232001 and other requesting parties. To use the system, private businesses and requesting parties must register with SSA and obtain valid consent from SSN number holders prior to verification. We collect the information to verify if the submitted name and SSN match the information in SSA records. After completing a registration process and paying the fee, the requesting party can use the CBSV process to submit a file containing the names of number holders who have given valid consent, along with each number holder’s accompanying SSN and date of birth (if available) to obtain real-time results using a web service application or SSA’s Business Services Online (BSO) application. SSA matches the PO 00000 Frm 00112 Fmt 4703 Sfmt 4703 information against the SSA master file of SSNs, using SSN, name, date of birth, and gender code (if available). The requesting party retrieves the results file from SSA, which indicates only a match or no match for each SSN submitted. Under the CBSV process, the requesting party does not submit the consent forms of the number holders to SSA. SSA requires each requesting party to retain a valid consent form for each SSN verification request. The requesting party retains the consent forms in either electronic or paper format. To ensure the integrity of the CBSV process, SSA has added a strong audit component that requires audits (called ‘‘compliance reviews’’) at the discretion of the agency with all audit costs paid E:\FR\FM\17DEN1.SGM 17DEN1 76381 Federal Register / Vol. 78, No. 242 / Tuesday, December 17, 2013 / Notices by the requesting party. Independent certified public accounts (CPAs) conduct these reviews to ensure compliance with all the terms and conditions of the party’s agreement with SSA, including a review of the consent forms. CPAs conduct the reviews at the requesting party’s place of business to ensure the integrity of the process. In addition, SSA reserves the right to perform unannounced onsite inspections of the entire process, including review of the technical systems that maintain the data and transaction records. The respondents to the CBSV collection are the participating companies, members of the public who consent to the SSN verification, and CPAs who provide compliance review services. Note: This is a correction notice: SSA published the incorrect burden information for this collection at 78 FR 59411, on 9/26/ 13. We are correcting this error here. Type of Request: Revision of an OMBapproved information collection. TIME BURDEN—PARTICIPATING COMPANIES Number of respondents Requirement Frequency of response Average burden per response (minutes) Number of responses Total estimated annual burden (hours) Registration process for new participating companies. ....... Creation of file with SSN holder identification data; maintaining required documentation/forms. ............................. Using the system to upload request file, check status, and download results file. ........................................................ Storing Consent Forms ........................................................ Activities related to compliance review ................................ * 14 1 14 120 28 90 ** 251 22,590 60 22,590 90 90 90 251 251 251 22,590 22,590 22,590 5 60 60 1,883 22,590 22,590 Total .............................................................................. ........................ ........................ 90,374 ........................ 69,681 * One-time registration process/approximately 14 new participating companies per year. ** Please note there are 251 Federal business days per year on which a requesting party could submit a file. PARTICIPATING COMPANIES WHO OPT FOR EXTERNAL TESTING ENVIRONMENT (ETE) Number of respondents Requirement ETE Registration Process (includes reviewing and completing ETE User Agreement) .......................................... Web Service Transactions ................................................... Reporting Issues Encountered on Web service testing (e.g., reports on application’s reliability) .......................... Reporting changes in users’ status (e.g., termination or changes in users’ employment status; changes in duties of authorized users) ......................................................... Cancellation of Agreement .................................................. Dispute Resolution ............................................................... Total .............................................................................. Frequency of response Average burden per response (minutes) Number of responses Total estimated annual burden (hours) 20 20 1 1 1 50 180 1 60 17 20 1 50 1 17 20 20 20 1 1 1 1 1 1 60 30 120 20 10 40 20 ........................ ........................ ........................ 144 PEOPLE WHOSE SSNS SSA WILL VERIFY Number of respondents Requirement Frequency of response Number of responses Average burden per response (minutes) Total estimated annual burden (hours) 2,500,000 5,750 1 1 2,500,000 5,750 3 5 125,000 479 Total .............................................................................. wreier-aviles on DSK5TPTVN1PROD with NOTICES Reading and signing authorization for SSA to release SSN verification ........................................................................ Responding to CPA re-contact ............................................ 2,505,750 ........................ 2,165,872 ........................ 125,479 There is one CPA respondent conducting compliance reviews and preparing written reports of findings. The average burden per response is 4,800 minutes for a total burden of 7,200 hours annually. VerDate Mar<15>2010 14:45 Dec 16, 2013 Jkt 232001 Cost Burden The public burden cost is dependent upon the number of companies and transactions. SSA based the cost estimates below upon 90 participating companies submitting a total 2.5 million transactions per year. One-Time per Company Registration Fee—$5,000. PO 00000 Frm 00113 Fmt 4703 Sfmt 4703 Estimated per SSN Transaction Fee— $1.10.i i The annual costs associated with the transaction to each company are dependent upon the number of SSN transactions submitted to SSA by the company on a yearly basis. For example, if a company anticipates submitting 1 million requests to SSA for the year, its total transaction cost for the year would be $1.10 × 1,000,000, or $1,100,000. E:\FR\FM\17DEN1.SGM Continued 17DEN1 76382 Federal Register / Vol. 78, No. 242 / Tuesday, December 17, 2013 / Notices Estimated per Company Cost to Store Consent Forms—$300. Dated: December 12, 2013. Faye Lipsky, Reports Clearance Director, Social Security Administration. [FR Doc. 2013–29907 Filed 12–16–13; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Cancellation of Environmental Impact Statement for the Norfolk International Airport, Norfolk, Virginia Federal Aviation Administration (FAA), DOT. ACTION: Notice of cancellation of preparation of environmental impact statement. AGENCY: The Federal Aviation Administration (FAA) announces that it has discontinued preparation of an Environmental Impact Statement (EIS) for the proposed construction of new Runway 5R/23L and associated development at Norfolk International Airport, Norfolk, Virginia. The FAA’s discontinued preparation of the EIS is based upon the length of time that has elapsed since the issuance of the Notice of Intent (NOI) in 2001 for the project and the need to consider results from additional planning efforts completed by the Norfolk Airport Authority (NAA), the owner and operator of the airport. The additional planning effort by NAA has modified the project purpose and need and refined various project elements, including the need to relocate the Very High Frequency Omnidirectional Range/Tactical Air Navigation (VORTAC) facility. As a result of the additional planning studies, refinements to the project scope, and the time elapsed; the FAA has decided to discontinue the EIS as proposed in the NOI from 2001. FOR FURTHER INFORMATION CONTACT: Andrew Brooks, Environmental Program Manager, Airports Division AEA–610, Federal Aviation Administration, Eastern Region, 1 Aviation Plaza, Jamaica, New York 11434; Telephone (718) 553–2511. SUPPLEMENTARY INFORMATION: On June 28, 2001, the FAA, published in the wreier-aviles on DSK5TPTVN1PROD with NOTICES SUMMARY: Periodically, SSA will calculate our costs to provide CBSV services and adjust the fee charged as needed. SSA notifies companies in writing and via Federal Register Notice of any changes and companies have the opportunity to cancel the agreement or continue service using the new transaction fee. VerDate Mar<15>2010 14:45 Dec 16, 2013 Jkt 232001 Federal Register a Notice of Intent (NOI) to prepare an Environmental Impact Statement (EIS) and hold a Public Scoping Meeting at Norfolk International Airport (Volume 66, Number 125, FR 34508–34509). The EIS and Public Scoping Meeting were to address the proposed construction of new Runway 5R/23L and associated development at the airport, including new taxiway construction, taxiway relocation, runway safety area construction, new airfield lighting, improvements to existing lighting, relocation of the VORTAC facility, installation of a Medium Intensity Approach Lighting System with Runway Alignment Indicator Lights (MALSR) for the new Runway 23L, and a Category II Instrument Landing MALSR for new Runway 5R. In 2001, the FAA based its decision to prepare the EIS on the procedures described in FAA Order 5050.4A, Airport Environmental Handbook, and FAA Order 1050.1D, Policies and Procedures for Considering Environmental Impacts. FAA also based its decision to prepare a federal EIS primarily on NAA’s proposal to construct a new Runway 5R/23L in parallel to the existing Runway 5/23, which would be re-designated as Runway 5L/23R. The new runway was proposed to be 8,000 feet long and 150 feet wide and would have a runway centerline separation from the existing runway of 845 feet. Subsequently, NAA completed supplemental planning efforts that necessitated making changes to the proposed project’s purpose and need. Therefore, the proposed project’s purpose and need has recently been revised and various project components, including the relocation of the VORTAC, are no longer required. The NAA submitted an Airport Layout Plan revision to the FAA that depicted the refined project elements. The Airport Layout Plan was conditionally approved, subject to environmental review by the FAA on October 5, 2011. The FAA will determine the appropriate National Environmental Policy Act (NEPA) documentation necessary to assess the environmental effects of the proposed improvements pursuant to FAA Order 5050.4B, National Environmental Policy Act (NEPA) Implementing Instructions for Airport Actions, and FAA Order 1050.1E, Environmental Impacts: Policies and Procedures. PO 00000 Frm 00114 Fmt 4703 Sfmt 4703 Issued in Jamaica, New York, on December 5, 2013. Debbie Roth, Manager, Airports Division, Eastern Region, AEA–600. [FR Doc. 2013–29981 Filed 12–16–13; 8:45 am] BILLING CODE 4910–13–P DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals Federal Aviation Administration (FAA), DOT. ACTION: Monthly Notice of PFC Approvals and Disapprovals. In May 2013, there were four applications approved. Additionally, 10 approved amendments to previously approved applications are listed. AGENCY: The FAA publishes a monthly notice, as appropriate, of PFC approvals and disapprovals under the provisions of the Aviation Safety and Capacity Expansion Act of 1990 (Title IX of the Omnibus Budget Reconciliation Act of 1990) (Pub. L. 101–508) and Part 158 of the Federal Aviation Regulations (14 CFR part 158). This notice is published pursuant to paragraph d of § 158.29. SUMMARY: PFC Applications Approved PUBLIC AGENCY: County of Sonoma, Santa Rosa, California. APPLICATION NUMBER: 13–05–C– 00–STS. APPLICATION TYPE: Impose and use a PFC. PFC LEVEL: $4.50. TOTAL PFC REVENUE APPROVED IN THIS DECISION: $425,000. EARLIEST CHARGE EFFECTIVE DATE: July 1, 2013. ESTIMATED CHARGE EXPIRATION DATE: June 1, 2014. CLASS OF AIR CARRIERS NOT REQUIRED TO COLLECT PFC’S: None. BRIEF DESCRIPTION OF PROJECTS APPROVED FOR COLLECTION AND USE: Acquire protective equipment for aircraft rescue and firefighting personnel. Acquire Americans with Disabilities Act passenger boarding ramp. Install common use flight information system. DECISION DATE: May 13, 2013. FOR FURTHER INFORMATION CONTACT: Neil Kumar, San Francisco Airports District Office, (650) 827–7627. PUBLIC AGENCY: City of Minot, North Dakota. APPLICATION NUMBER: 13–08–C– 00–MOT. APPLICATION TYPE: Impose and use a PFC. E:\FR\FM\17DEN1.SGM 17DEN1

Agencies

[Federal Register Volume 78, Number 242 (Tuesday, December 17, 2013)]
[Notices]
[Pages 76378-76382]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-29907]


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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 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, OLCA,
Attn: Reports Clearance Director,
3100 West High Rise,
6401 Security Blvd.,
Baltimore, MD 21235,
Fax: 410-966-2830,
Email address: OR.Reports.Clearance@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 
February 18, 2014. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Advanced Notice of Termination of Child's Benefits & Student's 
Statement Regarding School Attendance--20 CFR 404.350-404.352, 404.367-
404.368--0960-0105. SSA collects information on Forms SSA-1372-BK and 
SSA-1372-BK-FC to determine whether children of an insured worker meet 
the eligibility requirements for student benefits. The data we collect 
allows SSA to entitlement to initial and continuning student benefits. 
The respondents are student claimants for Social Security benefits, 
their respective schools, and, in some cases, their representative 
payees.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total  annual
               Type of respondent                   respondents      response      per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
                                                   SSA-1372-BK
----------------------------------------------------------------------------------------------------------------
Individuals/Households..........................          99,850               1               8          13,313
State/Local/Tribal Government...................          99,850               1               3           4,993
                                                 ---------------------------------------------------------------
    Totals......................................         199,700  ..............  ..............          18,306
----------------------------------------------------------------------------------------------------------------
                                                 SSA-1372-BK-FC
----------------------------------------------------------------------------------------------------------------
Individuals/Households..........................             150               1               8              20
State/Local/TribalGovernment....................             150               1               3               8
                                                 ---------------------------------------------------------------

[[Page 76379]]

 
    Totals......................................             300  ..............  ..............              28
                                                 ---------------------------------------------------------------
        Grand Total.............................         200,000  ..............  ..............          18,334
----------------------------------------------------------------------------------------------------------------

    2. State Mental Institution Policy Review Booklet--20 CFR 404.2035, 
404.2065, 416.635, & 416.665--0960-0110. SSA uses Form SSA-9584-BK: (1) 
To determine if the policies and practices of State mental institutions 
acting as representative payees for SSA beneficiaries conform to SSA's 
regulations in the use of benefits; (2) to confirm that institutions 
are performing other duties and responsibilities required of a 
representative payees; and (3) as the basis for conducting onsite 
reviews of the institutions and preparing subsequent reports of 
findings. The respondents are State mental institutions serving as 
representative payees for Social Security beneficiaries and 
Supplemental Security Income (SSI) recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-9584-BK.................................              78                1               60               78
----------------------------------------------------------------------------------------------------------------

    3. Modified Benefit Formula Questionnaire--0960-0395. SSA collects 
information on Form SSA-150 to determine which formula to use in 
computing the Social Security benefit for someone who receives a 
pension from employment not covered by Social Security. The Windfall 
Elimination Provision (WEP) requires use of a benefit formula replacing 
a smaller percentage of a worker's pre-retirement earnings. However, 
the resulting amount cannot show a difference in the benefit computed 
using the modified and regular formulas greater than one-half the 
amount of the pension received in the first month an individual is 
entitled to both the pension and the Social Security benefit. The SSA-
150 collects the information needed to make all the necessary benefit 
computations. SSA requires the respondents to furnish the information 
on Form SSA-150 so we can calculate their benefits using the data they 
supply. SSA calculates the benefits of applicants who do not respond to 
this questionnaire using the full WEP reduction. SSA employees collect 
this information once from the applicant at the time they file their 
claim. The respondents are applicants for old age and disability 
benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden     Estimated
           Modality of completion                Number of       Frequency of     per  response   total  annual
                                                respondents        response        (minutes)     burden  (hours)
----------------------------------------------------------------------------------------------------------------
SSA-150.....................................          90,000                1                8           12,000
----------------------------------------------------------------------------------------------------------------

    4. Employee Identification Statement--20 CFR 404.702--0960-0473. 
When two or more individuals report earnings under the same Social 
Security number (SSN), SSA collects information on Form SSA-4156 to 
credit the earnings to the correct individual and SSN. We send the SSA-
4156 to the employer to: (1) identify the employees involved; (2) 
resolve the discrepancy, and (3) credit the earnings to the correct 
SSN. The respondents are employers involved in erroneous wage reporting 
for an employee.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden     Estimated
           Modality of completion                Number of       Frequency of     per  response   total  annual
                                                respondents        response        (minutes)     burden  (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4156....................................           4,750                1               10              792
----------------------------------------------------------------------------------------------------------------

    5. Modified Benefit Formula Questionnaire--Employer--20 CFR 401 & 
402--0960-0477. Sections 215(a)(7) and 215(d)(3) of the Social Security 
Act requires SSA to use WEP, a modified benefit formula, to compute 
Social Security retirement or disability benefits for persons first 
eligible (after 1985) for both a Social Security benefit and a pension 
or annuity, based on employment not covered by Social Security. SSA 
determines if the WEP is applicable and when to apply it to a person's 
benefit. SSA uses Form SSA-58 to verify the claimant's allegations on

[[Page 76380]]

Form SSA-150 (OMB No. 0960-0395, Modified Benefits Formula 
Questionnaire). SSA sends the SSA-58 to an employer for pension-related 
information, if the claimant is unable to provide it. The respondents 
are employers of people who were eligible after 1985 for both Social 
Security benefits and a pension based on work not covered by SSA.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden     Estimated
           Modality of completion                Number of       Frequency of     per  response   total  annual
                                                respondents        response        (minutes)     burden  (hours)
----------------------------------------------------------------------------------------------------------------
SSA-58......................................          30,000                1               20           10,000
----------------------------------------------------------------------------------------------------------------

    6. Employee Work Activity Questionnaire--20 CFR 404.1574, 
404.1592--0960-0483. Social Security disability beneficiaries and SSI 
recipients qualify for payments when a verified physical or mental 
impairment prevents them from working. If disability claimants attempt 
to return to work after receiving payments,but are unable to continue 
working, they submit the SSA-3033, Employee Work Activity 
Questionnaire, so SSA can evaluate their work attempt. SSA also uses 
this form to evaluate unsuccessful subsidy work and determine 
applicants' continuing eligibility for disability payments. The 
respondents are employers of Social Security disability beneficiaries 
and SSI recipients who unsuccessfully attempted to return to work.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden     Estimated
           Modality of completion                Number of       Frequency of     per  response   total  annual
                                                respondents        response        (minutes)     burden  (hours)
----------------------------------------------------------------------------------------------------------------
SSA-9584-BK.................................              78                1               60               78
----------------------------------------------------------------------------------------------------------------

    7. Work History Report--20 CFR 404.1515, 404.1560, 404.1565, 
416.960, and 416.3965--0960-0578. Under certain circumstances, SSA asks 
individuals apply for disability about work they have performed in the 
past. Applicants use Form SSA-3369, Work History Report, to provide 
detailed information about jobs held prior to becoming unable to work. 
State Disability Determination Services evaluate the information, 
together with medical evidence, to determine eligibility for disability 
payments. Respondents are disability applicants and third parties 
assisting those applicants.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden  per    total  annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3369 (Paper form)...........................       1,553,900               1              60       1,553,900
Electronic Disability Collect System--3369......          38,049               1              60          38,049
                                                 ---------------------------------------------------------------
    Totals......................................       1,591,949  ..............  ..............       1,591,949
----------------------------------------------------------------------------------------------------------------

    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 30 days from the date of this 
publication. To be sure we consider your comments, we must receive them 
no later than January 16, 2014. Individuals can obtain copies of the 
OMB clearance package by writing to OR.Reports.Clearance@ssa.gov.
    Consent Based Social Security Number Verification Process--20 CFR 
400.100--0960-0760. The Consent Based Social Security Number 
Verification (CBSV) process is a fee-based automated SSN verification 
service available to private businesses and other requesting parties. 
To use the system, private businesses and requesting parties must 
register with SSA and obtain valid consent from SSN number holders 
prior to verification. We collect the information to verify if the 
submitted name and SSN match the information in SSA records. After 
completing a registration process and paying the fee, the requesting 
party can use the CBSV process to submit a file containing the names of 
number holders who have given valid consent, along with each number 
holder's accompanying SSN and date of birth (if available) to obtain 
real-time results using a web service application or SSA's Business 
Services Online (BSO) application. SSA matches the information against 
the SSA master file of SSNs, using SSN, name, date of birth, and gender 
code (if available). The requesting party retrieves the results file 
from SSA, which indicates only a match or no match for each SSN 
submitted.
    Under the CBSV process, the requesting party does not submit the 
consent forms of the number holders to SSA. SSA requires each 
requesting party to retain a valid consent form for each SSN 
verification request. The requesting party retains the consent forms in 
either electronic or paper format.
    To ensure the integrity of the CBSV process, SSA has added a strong 
audit component that requires audits (called ``compliance reviews'') at 
the discretion of the agency with all audit costs paid

[[Page 76381]]

by the requesting party. Independent certified public accounts (CPAs) 
conduct these reviews to ensure compliance with all the terms and 
conditions of the party's agreement with SSA, including a review of the 
consent forms. CPAs conduct the reviews at the requesting party's place 
of business to ensure the integrity of the process. In addition, SSA 
reserves the right to perform unannounced onsite inspections of the 
entire process, including review of the technical systems that maintain 
the data and transaction records. The respondents to the CBSV 
collection are the participating companies, members of the public who 
consent to the SSN verification, and CPAs who provide compliance review 
services.

    Note:  This is a correction notice: SSA published the incorrect 
burden information for this collection at 78 FR 59411, on 9/26/13. 
We are correcting this error here.

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

                                      Time Burden--Participating Companies
----------------------------------------------------------------------------------------------------------------
                                                                                      Average          Total
                                     Number of     Frequency of      Number of      burden per       estimated
           Requirement              respondents      response        responses       response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Registration process for new                * 14               1              14             120              28
 participating companies........
Creation of file with SSN holder              90          ** 251          22,590              60          22,590
 identification data;
 maintaining required
 documentation/forms............
Using the system to upload                    90             251          22,590               5           1,883
 request file, check status, and
 download results file..........
Storing Consent Forms...........              90             251          22,590              60          22,590
Activities related to compliance              90             251          22,590              60          22,590
 review.........................
                                 -------------------------------------------------------------------------------
    Total.......................  ..............  ..............          90,374  ..............          69,681
----------------------------------------------------------------------------------------------------------------
* One-time registration process/approximately 14 new participating companies per year.
** Please note there are 251 Federal business days per year on which a requesting party could submit a file.


                     Participating Companies Who Opt for External Testing Environment (ETE)
----------------------------------------------------------------------------------------------------------------
                                                                                      Average          Total
                                     Number of     Frequency of      Number of      burden per       estimated
           Requirement              respondents      response        responses       response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
ETE Registration Process                      20               1               1             180              60
 (includes reviewing and
 completing ETE User Agreement).
Web Service Transactions........              20               1              50               1              17
Reporting Issues Encountered on               20               1              50               1              17
 Web service testing (e.g.,
 reports on application's
 reliability)...................
Reporting changes in users'                   20               1               1              60              20
 status (e.g., termination or
 changes in users' employment
 status; changes in duties of
 authorized users)..............
Cancellation of Agreement.......              20               1               1              30              10
Dispute Resolution..............              20               1               1             120              40
                                 -------------------------------------------------------------------------------
    Total.......................              20  ..............  ..............  ..............             144
----------------------------------------------------------------------------------------------------------------


                                        People Whose SSNs SSA Will Verify
----------------------------------------------------------------------------------------------------------------
                                                                                      Average          Total
                                     Number of     Frequency of      Number of      burden per       estimated
           Requirement              respondents      response        responses       response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Reading and signing                    2,500,000               1       2,500,000               3         125,000
 authorization for SSA to
 release SSN verification.......
Responding to CPA re-contact....           5,750               1           5,750               5             479
                                 -------------------------------------------------------------------------------
    Total.......................       2,505,750  ..............       2,165,872  ..............         125,479
----------------------------------------------------------------------------------------------------------------

    There is one CPA respondent conducting compliance reviews and 
preparing written reports of findings. The average burden per response 
is 4,800 minutes for a total burden of 7,200 hours annually.

Cost Burden

    The public burden cost is dependent upon the number of companies 
and transactions. SSA based the cost estimates below upon 90 
participating companies submitting a total 2.5 million transactions per 
year.
    One-Time per Company Registration Fee--$5,000.
    Estimated per SSN Transaction Fee--$1.10.\i\
---------------------------------------------------------------------------

    \i\ The annual costs associated with the transaction to each 
company are dependent upon the number of SSN transactions submitted 
to SSA by the company on a yearly basis. For example, if a company 
anticipates submitting 1 million requests to SSA for the year, its 
total transaction cost for the year would be $1.10 x 1,000,000, or 
$1,100,000. Periodically, SSA will calculate our costs to provide 
CBSV services and adjust the fee charged as needed. SSA notifies 
companies in writing and via Federal Register Notice of any changes 
and companies have the opportunity to cancel the agreement or 
continue service using the new transaction fee.

---------------------------------------------------------------------------

[[Page 76382]]

---------------------------------------------------------------------------
    Estimated per Company Cost to Store Consent Forms--$300.

    Dated: December 12, 2013.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2013-29907 Filed 12-16-13; 8:45 am]
BILLING CODE 4191-02-P