Agency Information Collection Activities: Proposed Request and Comment Request, 7736-7738 [2014-02776]
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7736
Federal Register / Vol. 79, No. 27 / Monday, February 10, 2014 / Notices
The AFMAC provides advice and
recommendations to SBA on
government accounting and
performance issues impacting the
Agency. The AFMAC’s scope of
activities includes providing advice as
to industry best practices and methods
of improving results relating to SBA’s
financial reporting and auditing
processes, financial systems, internal
controls, performance measures and
recommendations on how to better
comply with laws and regulations
governing federal financial
management.
The Committee has a total of three (3)
members, including one Chairperson
selected by the SBA Administrator.
Members serve as representatives of the
financial management community and
may consist of financial managers,
auditors, chief financial officers or
financial management and accounting
trade organizations.
Dated: January 31, 2014.
Diana Doukas,
SBA Committee Management Officer.
[FR Doc. 2014–02709 Filed 2–7–14; 8:45 am]
BILLING CODE 8025–01–P
SOCIAL SECURITY ADMINISTRATION
mstockstill on DSK4VPTVN1PROD with NOTICES
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 one new
information collection, and 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
VerDate Mar<15>2010
19:25 Feb 07, 2014
Jkt 232001
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 April 11,
2014. Individuals can obtain copies of
the collection instruments by writing to
the above email address.
1. Promoting Readiness of Minors in
SSI (PROMISE) Evaluation—0960–
NEW.
Background
The Promoting Readiness of Minors in
SSI (PROMISE) demonstration pursues
positive outcomes for children with
disabilities who receive Supplemental
Security Income (SSI) and their families
by reducing dependency on SSI. The
Department of Education (ED) awarded
six cooperative agreements to states to
improve the provision and coordination
of services and support for children
with disabilities who receive SSI and
their families to achieve improved
education and employment outcomes.
ED awarded PROMISE funds to five
single-state projects, and to one six-state
consortium.1 With support from the
Department of Labor (DOL) and the
Department of Health and Human
Services (HHS), SSA will evaluate the
six PROMISE projects. SSA contracted
with Mathematica Policy Research to
conduct the evaluation.
Under PROMISE, targeted outcomes
for youth include an enhanced sense of
self-determination; achievement of
secondary and post-secondary
educational credentials; an attainment
of early work experiences culminating
with competitive employment in an
integrated setting; and long-term
reduction in reliance on SSI. Outcomes
of interest for families include
heightened expectations for and support
of the long-term self-sufficiency of their
youth; parent or guardian attainment of
education and training credentials; and
increases in earnings and total income.
To achieve these outcomes, we expect
the PROMISE projects to make better
use of existing resources by improving
service coordination among multiple
state and local agencies and programs.
ED, SSA, DOL, and HHS intend the
PROMISE projects to address key
limitations in the existing service
system for youth with disabilities. By
intervening early in the lives of these
1 The six-state consortium project goes by the
name Achieving Success by Promoting Readiness
for Education and Employment (ASPIRE) rather
than by PROMISE.
PO 00000
Frm 00107
Fmt 4703
Sfmt 4703
young people, at ages 14–16, the
projects will engage the youth and their
families well before critical decisions
regarding the age 18 redetermination are
upon them. We expect the required
partnerships among the various state
and Federal agencies that serve youth
with disabilities to result in improved
integration of services and fewer
dropped handoffs as youth move from
one agency to another. By requiring the
programs to engage and serve families
and provide youth with paid work
experiences, the initiative is mandating
the adoption of critical best practices in
promoting the independence of youth
with disabilities.
Project Description
SSA is requesting clearance for the
collection of data needed to implement
and evaluate PROMISE. The evaluation
will provide empirical evidence on the
impact of the intervention for youth and
their families in several critical areas,
including: (1) Improved educational
attainment; (2) increased employment
skills, experience, and earnings; and (3)
long-term reduction in use of public
benefits. We will base the PROMISE
evaluation on a rigorous design that will
entail the random assignment of
approximately 2,000 youth in each of
the six projects to treatment or control
groups (12,000 total). Youth in the
treatment groups will be eligible for
enhanced services from the
demonstration programs, whereas youth
in the control groups will be eligible
only for those services already available
in their communities independent of the
interventions.
The evaluation will assess the effect
of PROMISE services on educational
attainment, employment, earnings, and
reduced receipt of disability payments.
The three components of this evaluation
include:
• The process analysis, which will
document program models, assess the
relationships among the partner
organizations, document whether the
programs are implemented as planned,
identify features of the programs that
may account for their impacts on youth
and families, and identify lessons for
future programs with similar objectives.
• The impact analysis, which will
determine whether youth and families
in the treatment groups receive more
services than their counterparts in the
control groups. It will also determine
whether treatment group members have
better results than control group
members with respect to the targeted
outcomes noted above.
• The cost-benefit analysis, which
will assess whether the benefits of
PROMISE, including increases in
E:\FR\FM\10FEN1.SGM
10FEN1
7737
Federal Register / Vol. 79, No. 27 / Monday, February 10, 2014 / Notices
employment and reductions in benefit
receipt, are large enough to justify its
costs. We will conduct this assessment
from a range of perspectives, including
those of the participants, state and
Federal governments, SSA, and society
as a whole.
SSA planned several data collection
efforts for the evaluation. These include:
(1) follow-up interviews with youth and
their parent or guardian 18 months and
5 years after enrollment; (2) phone and
in-person interviews with local program
administrators, program supervisors,
and service delivery staff at two points
in time over the course of the
demonstration; (3) two rounds of focus
groups with participating youth in the
treatment group; (4) two rounds of focus
groups with parents or guardians of
participating youth; and (5) collection of
administrative data.
At this time, SSA requests clearance
only for the interviews we will conduct
with program staff and the focus group
discussions we will conduct with youth
and parents or guardians. We will
conduct these interviews and group
discussions twice: once in 2014, and
once in 2016. SSA will request
clearance for the 18-month and 5-year
survey interviews in a future
submission. The respondents are
PROMISE program staff, the youth
participants in the PROMISE program,
and the parents or guardians of the
youth participants.
Type of Request: This is a new
information collection.
2014 INTERVIEWS AND FOCUS GROUP DISCUSSIONS
Number of
responses
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
Staff Interviews with Administrators or Directors .............................................
Staff Interviews with PROMISE Project Staff ..................................................
Youth Focus Groups—Non-participants ..........................................................
Youth Focus Groups—Participants .................................................................
Parents or Guardian Focus Groups—Non-participants ...................................
Parents or Guardian Focus Groups—Participants ..........................................
75
145
320
80
320
80
1
1
1
1
1
1
66
66
5
100
5
100
83
160
27
133
27
133
Totals .................................................................................................
1,020
........................
........................
563
2016 INTERVIEWS AND FOCUS GROUP DISCUSSIONS
Number of
responses
Modality of completion
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden (hours)
Staff Interviews with Administrators or Directors .............................................
Staff Interviews with PROMISE Project Staff ..................................................
Youth Focus Groups—Non-participants ..........................................................
Youth Focus Groups—Participants .................................................................
Parents or Guardian Focus Groups—Non-participants ...................................
Parents or Guardian Focus Groups—Participants ..........................................
75
145
320
80
320
80
1
1
1
1
1
1
66
66
5
100
5
100
83
160
27
133
27
133
Totals ...............................................................................................................
1,020
........................
........................
563
Grand Total .......................................................................................
2,040
........................
........................
1,126
2. Request for Social Security
Earnings Information—20 CFR 404.810
and 401.100—0960–0525. The Social
Security Act permits wage earners, or
their authorized representative, to
request Social Security earnings
information from SSA using Form SSA–
7050–F4. SSA uses the information to
verify the requestor’s right to access the
information and to produce the earnings
statement. The respondents are wage
earners and their authorized
representatives.
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–7050–F4 ..................................................................................................
mstockstill on DSK4VPTVN1PROD with NOTICES
Modality of completion
66,800
1
11
12,247
3. Request for Medical Treatment in
an SSA Employee Health Facility:
Patient Self-Administered or Staff
Administered Care—0960–0772. SSA
operates onsite Employee Health Clinics
(EHC) in eight different states. These
clinics provide health care for all SSA
employees including treatments of
VerDate Mar<15>2010
19:25 Feb 07, 2014
Jkt 232001
personal medical conditions when
authorized through a physician. Form
SSA–5072 is the employee’s personal
physician’s order form. The information
we collect on Form SSA–5072 gives the
EHC nurses the guidance they need by
law to perform certain medical
procedures and to administer
PO 00000
Frm 00108
Fmt 4703
Sfmt 4703
prescription medications such as allergy
immunotherapy. In addition, the
information allows the SSA Medical
Officer to determine whether the
treatment can be administered safely
and appropriately in the SSA EHCs.
Respondents are physicians of SSA
E:\FR\FM\10FEN1.SGM
10FEN1
7738
Federal Register / Vol. 79, No. 27 / Monday, February 10, 2014 / Notices
employees who need to have medical
treatment in an SSA EHC.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Modality of completion
Frequency
of response
Number of
responses
Estimated
total
annual
burden
(hours)
Average
burden per
response
(minutes)
SSA–5072 ............................................................................
Annually ...............................................................................
SSA–5072 ............................................................................
Bi-Annually ...........................................................................
25
1
25
5
2
75
2
150
5
13
Totals ............................................................................
100
........................
175
........................
15
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
March 12, 2014. Individuals can obtain
copies of the OMB clearance packages
by writing to OR.Reports.Clearance@
ssa.gov.
Petition to Obtain Approval of a Fee
for Representing a Claimant Before the
Social Security Administration—20 CFR
404.1720 and 404.1725; 20 CFR
416.1520 and 416.1525—0960–0104.
SSA attorney and non-attorney claimant
representatives use Form SSA–1560–U4
to petition SSA for authorization to
charge and collect a fee. Claimants may
also use the form to agree with or
contest the requested fee amount or
other information the representative
provides on the form. SSA officials use
the form to determine a reasonable fee
amount representatives may charge for
their services. The respondents are
attorneys and non-attorneys who
represent Social Security claimants and
their claimants.
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–1560–U4 .................................................................................................
48,110
1
30
24,055
Dated: February 5, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security
Administration.
[FR Doc. 2014–02776 Filed 2–7–14; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF TRANSPORTATION
National Highway Traffic Safety
Administration
[U.S. DOT Docket No. NHTSA–2014–0008]
Reports, Forms, and Record Keeping
Requirements
National Highway Traffic
Safety Administration (NHTSA), DOT.
ACTION: Request for public comment on
proposed collection of information.
AGENCY:
Before a Federal agency can
collect certain information from the
public, it must receive approval from
the Office of Management and Budget
(OMB). Under procedures established
by the Paperwork Reduction Act of
1995, before seeking OMB approval,
Federal agencies must solicit public
comment on proposed collections of
information, including extensions and
mstockstill on DSK4VPTVN1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
19:25 Feb 07, 2014
Jkt 232001
reinstatements of previously approved
collections.
This document describes the
collection of information for which
NHTSA intends to seek OMB approval.
DATES: Comments must be received on
or before April 11, 2014.
ADDRESSES: You may submit comments
identified by DOT Docket ID Number
NHTSA–2014–0008 using any of the
following methods:
Electronic submissions: Go to https://
www.regulations.gov. Follow the online instructions for submitting
comments.
Mail: Docket Management Facility,
M–30, U.S. Department of
Transportation, 1200 New Jersey
Avenue SE., West Building Ground
Floor, Room W12–140, Washington, DC
20590.
Hand Delivery: West Building Ground
Floor, Room W12–140, 1200 New Jersey
Avenue SE., Washington, DC, between 9
a.m. and 5 p.m., Monday through
Friday, except Federal holidays.
Fax: 1-(202) 493–2251.
Instructions: Each submission must
include the Agency name and the
Docket number for this Notice. Note that
all comments received will be posted
without change to https://
PO 00000
Frm 00109
Fmt 4703
Sfmt 4703
www.regulations.gov including any
personal information provided. Please
see the Privacy Act heading below.
Privacy Act: Anyone is able to search
the electronic form for all comments
received into any of our dockets by the
name of the individual submitting the
comments (or signing the comment, if
submitted on behalf of an association,
business, labor union, etc.). You may
review DOT’s complete Privacy Act
Statement in the Federal Register
published on April 11, 2000 (65 FR
19477–78) or you may visit https://
DocketsInfo.dot.gov.
Dr.
Russell Pierce, Contracting Officer’s
Technical Representative, Office of
Behavioral Safety Research (NTI–132),
National Highway Traffic Safety
Administration, 1200 New Jersey
Avenue SE., W46–472, Washington, DC
20590. Dr. Pierce’s phone number is
(202) 366–5599 and his email address is
russell.pierce@dot.gov.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995,
before an agency submits a proposed
collection of information to OMB for
approval, it must publish a document in
the Federal Register providing a 60-day
comment period and otherwise consult
FOR FURTHER INFORMATION CONTACT:
E:\FR\FM\10FEN1.SGM
10FEN1
]]>Agencies
[Federal Register Volume 79, Number 27 (Monday, February 10, 2014)]
[Notices]
[Pages 7736-7738]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-02776]
=======================================================================
-----------------------------------------------------------------------
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 one new information collection, and 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
April 11, 2014. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Promoting Readiness of Minors in SSI (PROMISE) Evaluation--0960-
NEW.
Background
The Promoting Readiness of Minors in SSI (PROMISE) demonstration
pursues positive outcomes for children with disabilities who receive
Supplemental Security Income (SSI) and their families by reducing
dependency on SSI. The Department of Education (ED) awarded six
cooperative agreements to states to improve the provision and
coordination of services and support for children with disabilities who
receive SSI and their families to achieve improved education and
employment outcomes. ED awarded PROMISE funds to five single-state
projects, and to one six-state consortium.\1\ With support from the
Department of Labor (DOL) and the Department of Health and Human
Services (HHS), SSA will evaluate the six PROMISE projects. SSA
contracted with Mathematica Policy Research to conduct the evaluation.
---------------------------------------------------------------------------
\1\ The six-state consortium project goes by the name Achieving
Success by Promoting Readiness for Education and Employment (ASPIRE)
rather than by PROMISE.
---------------------------------------------------------------------------
Under PROMISE, targeted outcomes for youth include an enhanced
sense of self-determination; achievement of secondary and post-
secondary educational credentials; an attainment of early work
experiences culminating with competitive employment in an integrated
setting; and long-term reduction in reliance on SSI. Outcomes of
interest for families include heightened expectations for and support
of the long-term self-sufficiency of their youth; parent or guardian
attainment of education and training credentials; and increases in
earnings and total income. To achieve these outcomes, we expect the
PROMISE projects to make better use of existing resources by improving
service coordination among multiple state and local agencies and
programs.
ED, SSA, DOL, and HHS intend the PROMISE projects to address key
limitations in the existing service system for youth with disabilities.
By intervening early in the lives of these young people, at ages 14-16,
the projects will engage the youth and their families well before
critical decisions regarding the age 18 redetermination are upon them.
We expect the required partnerships among the various state and Federal
agencies that serve youth with disabilities to result in improved
integration of services and fewer dropped handoffs as youth move from
one agency to another. By requiring the programs to engage and serve
families and provide youth with paid work experiences, the initiative
is mandating the adoption of critical best practices in promoting the
independence of youth with disabilities.
Project Description
SSA is requesting clearance for the collection of data needed to
implement and evaluate PROMISE. The evaluation will provide empirical
evidence on the impact of the intervention for youth and their families
in several critical areas, including: (1) Improved educational
attainment; (2) increased employment skills, experience, and earnings;
and (3) long-term reduction in use of public benefits. We will base the
PROMISE evaluation on a rigorous design that will entail the random
assignment of approximately 2,000 youth in each of the six projects to
treatment or control groups (12,000 total). Youth in the treatment
groups will be eligible for enhanced services from the demonstration
programs, whereas youth in the control groups will be eligible only for
those services already available in their communities independent of
the interventions.
The evaluation will assess the effect of PROMISE services on
educational attainment, employment, earnings, and reduced receipt of
disability payments. The three components of this evaluation include:
The process analysis, which will document program models,
assess the relationships among the partner organizations, document
whether the programs are implemented as planned, identify features of
the programs that may account for their impacts on youth and families,
and identify lessons for future programs with similar objectives.
The impact analysis, which will determine whether youth
and families in the treatment groups receive more services than their
counterparts in the control groups. It will also determine whether
treatment group members have better results than control group members
with respect to the targeted outcomes noted above.
The cost-benefit analysis, which will assess whether the
benefits of PROMISE, including increases in
[[Page 7737]]
employment and reductions in benefit receipt, are large enough to
justify its costs. We will conduct this assessment from a range of
perspectives, including those of the participants, state and Federal
governments, SSA, and society as a whole.
SSA planned several data collection efforts for the evaluation.
These include: (1) follow-up interviews with youth and their parent or
guardian 18 months and 5 years after enrollment; (2) phone and in-
person interviews with local program administrators, program
supervisors, and service delivery staff at two points in time over the
course of the demonstration; (3) two rounds of focus groups with
participating youth in the treatment group; (4) two rounds of focus
groups with parents or guardians of participating youth; and (5)
collection of administrative data.
At this time, SSA requests clearance only for the interviews we
will conduct with program staff and the focus group discussions we will
conduct with youth and parents or guardians. We will conduct these
interviews and group discussions twice: once in 2014, and once in 2016.
SSA will request clearance for the 18-month and 5-year survey
interviews in a future submission. The respondents are PROMISE program
staff, the youth participants in the PROMISE program, and the parents
or guardians of the youth participants.
Type of Request: This is a new information collection.
2014 Interviews and Focus Group Discussions
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Modality of completion responses response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Staff Interviews with Administrators or 75 1 66 83
Directors......................................
Staff Interviews with PROMISE Project Staff..... 145 1 66 160
Youth Focus Groups--Non-participants............ 320 1 5 27
Youth Focus Groups--Participants................ 80 1 100 133
Parents or Guardian Focus Groups--Non- 320 1 5 27
participants...................................
Parents or Guardian Focus Groups--Participants.. 80 1 100 133
---------------------------------------------------------------
Totals.................................. 1,020 .............. .............. 563
----------------------------------------------------------------------------------------------------------------
2016 Interviews and Focus Group Discussions
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Modality of completion responses response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Staff Interviews with Administrators or 75 1 66 83
Directors......................................
Staff Interviews with PROMISE Project Staff..... 145 1 66 160
Youth Focus Groups--Non-participants............ 320 1 5 27
Youth Focus Groups--Participants................ 80 1 100 133
Parents or Guardian Focus Groups--Non- 320 1 5 27
participants...................................
Parents or Guardian Focus Groups--Participants.. 80 1 100 133
---------------------------------------------------------------
Totals.......................................... 1,020 .............. .............. 563
===============================================================
Grand Total............................. 2,040 .............. .............. 1,126
----------------------------------------------------------------------------------------------------------------
2. Request for Social Security Earnings Information--20 CFR 404.810
and 401.100--0960-0525. The Social Security Act permits wage earners,
or their authorized representative, to request Social Security earnings
information from SSA using Form SSA-7050-F4. SSA uses the information
to verify the requestor's right to access the information and to
produce the earnings statement. The respondents are wage earners and
their authorized representatives.
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-7050-F4................................. 66,800 1 11 12,247
----------------------------------------------------------------------------------------------------------------
3. Request for Medical Treatment in an SSA Employee Health
Facility: Patient Self-Administered or Staff Administered Care--0960-
0772. SSA operates onsite Employee Health Clinics (EHC) in eight
different states. These clinics provide health care for all SSA
employees including treatments of personal medical conditions when
authorized through a physician. Form SSA-5072 is the employee's
personal physician's order form. The information we collect on Form
SSA-5072 gives the EHC nurses the guidance they need by law to perform
certain medical procedures and to administer prescription medications
such as allergy immunotherapy. In addition, the information allows the
SSA Medical Officer to determine whether the treatment can be
administered safely and appropriately in the SSA EHCs. Respondents are
physicians of SSA
[[Page 7738]]
employees who need to have medical treatment in an SSA EHC.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of Number of burden per total annual
Modality of completion respondents response responses response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-5072........................ 25 1 25 5 2
Annually........................
SSA-5072........................ 75 2 150 5 13
Bi-Annually.....................
-------------------------------------------------------------------------------
Totals...................... 100 .............. 175 .............. 15
----------------------------------------------------------------------------------------------------------------
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 March 12, 2014. Individuals can obtain copies of the OMB
clearance packages by writing to OR.Reports.Clearance@ssa.gov.
Petition to Obtain Approval of a Fee for Representing a Claimant
Before the Social Security Administration--20 CFR 404.1720 and
404.1725; 20 CFR 416.1520 and 416.1525--0960-0104. SSA attorney and
non-attorney claimant representatives use Form SSA-1560-U4 to petition
SSA for authorization to charge and collect a fee. Claimants may also
use the form to agree with or contest the requested fee amount or other
information the representative provides on the form. SSA officials use
the form to determine a reasonable fee amount representatives may
charge for their services. The respondents are attorneys and non-
attorneys who represent Social Security claimants and their claimants.
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-1560-U4................................. 48,110 1 30 24,055
----------------------------------------------------------------------------------------------------------------
Dated: February 5, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-02776 Filed 2-7-14; 8:45 am]
BILLING CODE 4191-02-P
