Agency Information Collection Activities: Proposed Request and Comment Request, 42863-42867 [2014-17275]
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42863
Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices
available for Web site viewing and
printing in the Commission’s Public
Reference Room, 100 F Street NE.,
Washington, DC 20549, on official
business days between the hours of
10:00 a.m. and 3:00 p.m. Copies of such
filing will also be available for
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received will be posted without change;
the Commission does not edit personal
identifying information from
submissions. You should submit only
information that you wish to make
available publicly. All submissions
should refer to File No. SR–BATS–
2014–026 and should be submitted on
or before August 13, 2014.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.44
Kevin M. O’Neill,
Deputy Secretary.
[FR Doc. 2014–17265 Filed 7–22–14; 8:45 am]
BILLING CODE 8011–01–P
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
by the Office of Management and
Budget (OMB) in compliance with
Public Law 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes extensions
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 September
22, 2014. Individuals can obtain copies
of the collection instruments by writing
to the above email address.
1. Application for Search of Census
Records for Proof of Age—20 CFR
404.716—0960–0097. When preferred
evidence of age is not available, or the
available evidence is not convincing,
SSA may ask the U.S. Department of
Commerce, Bureau of the Census, to
search its records to establish a
claimant’s date of birth. SSA collects
information from claimants using Form
SSA–1535–U3 to provide the Census
Bureau with sufficient identification
information to allow an accurate search
of census records. Additionally, the
Census Bureau uses a completed, signed
SSA–1535–U3 to bill SSA for the
search. The respondents are applicants
for Social Security benefits who need to
establish their date of birth as a factor
of entitlement.
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–1535–U3 .........................................................................................................
18,030
1
12
3,606
broadcasting systems so they can inform
the public about various programs and
activities SSA conducts. SSA frequently
sends follow-up business reply cards for
these public information materials to
obtain suggestions for improving them.
2. Public Information Campaign—
0960–0544. Periodically, SSA sends
various public information materials,
including public service
announcements, news releases, and
educational tapes, to public
The respondents are broadcast
television sources.
Type of Request: Extension of an
OMB-approved information collection.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated total
burden
(hours)
Television .................................................................................................................
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Modality of completion
1,000
2
1
33
3. Medicare Subsidy Quality Review
Forms—20 CFR 418(b)(5)—0960–0707.
The Medicare Modernization Act
(MMA) of 2003 mandated the creation
of the Medicare Part D prescription drug
coverage program and provides certain
subsidies for eligible Medicare
beneficiaries to help pay for the cost of
44 17
prescription drugs. As part of its
stewardship duties of the Medicare Part
D subsidy program, SSA must conduct
periodic quality review checks of the
information Medicare beneficiaries
report on their subsidy applications
(Form SSA–1020). SSA uses the
Medicare Quality Review program to
conduct these checks. The respondents
are applicants for the Medicare Part D
subsidy whom SSA chose to undergo a
quality review.
Type of Request: Revision of an OMBapproved information collection.
CFR 200.30–3(a)(12).
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Frequency
of response
Average
burden per
response
(minutes
Estimated total
annual burden
(hours)
3,500
1
30
1,750
3,500
1
15
875
350
7,000
3,500
450
50
1
1
1
1
1
15
15
5
15
15
88
1,750
292
113
13
2,500
1
15
625
Number of
respondents
Modality of completion
SSA–9301 (Medicare Subsidy Quality Review Case Analysis Questionnaire) ......
SSA–9302 (Notice of Quality Review Acknowledgement Form for those with
Phones) ................................................................................................................
SSA–9303 (Notice of Quality Review Acknowledgement Form for those without
Phones) ................................................................................................................
SSA–9308 (Request for Information) ......................................................................
SSA–9310 (Request for Documents) ......................................................................
SSA–9311 (Notice of Appointment—Denial—Reviewer Will Call) ..........................
SSA–9312 (Notice of Appointment—Denial—Please Call Reviewer) .....................
SSA–9313 (Notice of Quality Review Acknowledgement Form for those with
Phones) ................................................................................................................
SSA–9314 (Notice of Quality Review Acknowledgement Form for those without
Phones) ................................................................................................................
SSA–8510 (Authorization to the Social Security Administration to Obtain Personal Information) ................................................................................................
500
1
15
125
3,500
1
5
292
Totals ................................................................................................................
24,850
¥
¥
5,923
4. Application to Collect a Fee for
Payee Service—20 CFR 416.640.640(a),
416.1103(f)—0960–0719. Sections
205(j)(4)(A) and (B) and 1631(a)(2) of the
Social Security Act (Act) allow SSA to
authorize certain organizational
representative payees to collect a fee for
sector businesses or State and local
government offices applying to become
fee-for-service organizational
representative payees.
Type of Request: Revision of an OMBapproved information collection.
providing payee services. Before
organizations may collect this fee, they
complete and submit Form SSA–445.
SSA uses the information to determine
whether to authorize or deny
permission to collect fees for payee
services. The respondents are private
Number of
responses
Modality of completion
Frequency
of response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
Private sector business ...........................................................................................
State/local government offices ................................................................................
90
10
1
1
10
10
15
2
Totals ................................................................................................................
100
....................
....................
17
5. Redetermination of Eligibility for
Help with Medicare Prescription Drug
Plan Costs—0960–0723. As per the
requirements of the MMA of 2003, SSA
conducts low-income subsidy eligibility
redeterminations for Medicare
beneficiaries who currently receive the
Medicare Part D subsidy and who meet
certain criteria. Respondents complete
Form SSA–1026–REDE under the
following circumstances: (1) When
individuals became entitled to the
Medicare Part D subsidy during the past
12 months; (2) if they were eligible for
the Part D subsidy for more than 12
months; or (3) if they reported a change
in income, resources, or household size.
Part D beneficiaries complete the SSA–
1026–SCE when they need to report a
potentially subsidy-changing event,
including the following: (1) Marriage,
(2) spousal separation, (3) divorce, (4)
Number of
respondents
Modality of completion
annulment of a marriage, (5) spousal
death, or (6) moving back in with one’s
spouse following a separation. The
respondents are current recipients of the
Medicare Part D low-income subsidy
who will undergo an eligibility
redetermination for one of the reasons
mentioned above.
Type of Request: Revision of an OMBapproved information collection.
Frequency
of response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
9,176
161,766
1
1
18
18
2,753
48,530
Total ..................................................................................................................
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SSA–1026–OCR–MS–SCE .....................................................................................
SSA–1026–OCR–SM–REDE ..................................................................................
170,942
....................
....................
51,283
6. Electronic Records Express (Third
Parties)—20 CFR 404.1700–404.1715—
0960–0767. Electronic Records Express
(ERE) is an online system which enables
medical providers and various third
party representatives to download and
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submit disability claimant information
electronically to SSA as part of the
disability application process. To ensure
only authorized people access ERE, SSA
requires third parties to complete a
unique registration process if they wish
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to use this system. This information
collection request (ICR) includes the
third-party registration process; the
burden for submitting evidence to SSA
is part of other, various ICRs. The
respondents are third party
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Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices
representatives of disability applicants
or recipients who want to use ERE to
electronically access clients’ disability
files online and submit information to
SSA.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Number of
responses
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
ERE ..............................................................................................
12,000
281
(3,372,000)
1
56,200
7. Screen Pop—20 CFR 401.45—
0960–0790. Section 205(a) of the Act
requires SSA to verify the identity of
individuals who request a record or
information pertaining to themselves,
and to establish procedures for
disclosing personal information. SSA
established Screen Pop, an automated
telephone process, to increase speed of
verification for such individuals.
Accessing Screen Pop, callers enter their
Social Security number (SSN) using
their telephone keypad or speech
technology prior to speaking with a
National 800 Number Network (N8NN)
agent. The automated Screen Pop
application collects the SSN and routes
it to the ‘‘Start New Call’’ Customer
Help and Information (CHIP) screen.
Functionality for the Screen Pop
application ends once the SSN connects
to the CHIP screen and the SSN routes
to the agent’s screen. When the call
connects to the N8NN agent, the agent
can use the SSN to access the caller’s
record as needed. The respondents for
this collection are individuals who
contact SSA’s N8NN to speak with an
agent.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
responses
Frequency
of response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
Screen Pop ..............................................................................................................
55,600,000
1
1
926,667
II. SSA submitted the information
collections below to OMB for clearance.
Your comments regarding the
information collections would be most
useful if OMB and SSA receive them 30
days from the date of this publication.
To be sure we consider your comments,
we must receive them no later than
August 22, 2014. Individuals can obtain
copies of the OMB clearance packages
by writing to OR.Reports.Clearance@
ssa.gov.
1. Statement Regarding Date of Birth
and Citizenship—20 CFR 404.716—
0960–0016. Section 205(a) of the Act
gives the Commissioner of SSA the
authority to make rules and regulations,
and to establish procedures for
collecting evidence from individuals
applying for Social Security benefits.
When individuals apply for Social
Security benefits and cannot provide
preferred methods of proving age or
citizenship, SSA uses Form SSA–702 to
establish these facts. Specifically, SSA
uses the SSA–702 to establish age as a
factor of entitlement to Social Security
benefits or U.S. citizenship as a
payment factor. Respondents are
individuals with knowledge about the
date of birth or citizenship of applicants
filing for one or more Social Security
benefits who need to establish age or
citizenship.
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–7157 ................................................................................................................
1,200
1
10
200
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2. Application for Benefits under a
U.S. International Social Security
Agreement—20 CFR 404.1925—0960–
0448. Section 233(a) of the Act
authorizes the President of the United
States to broker international Social
Security agreements (Totalization
Agreements) between the United States
and foreign countries. SSA collects
information using Form SSA–2490–BK
to determine entitlement to Social
Security benefits from the United States,
or from a country that enters into a
totalization agreement with the United
Number of
respondents
Modality of completion
States. The respondents are individuals
applying for Old Age, Survivors, and
Disability Insurance benefits from the
United States or from a Totalization
Agreement country.
Type of Request: Revision of an OMBapproved information collection.
Frequency
of response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
SSA–2490–BK (Modernized Claims System) .........................................................
SSA–2490–BK (paper) ............................................................................................
14,175
2,025
1
1
30
30
7,088
1,013
Totals ................................................................................................................
16,200
....................
....................
8,101
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3. Teacher Questionnaire and Request
for Administrative Information—20 CFR
416.1103(f)—0960–0646. When
determining the effects of a child’s
impairment for children applying for
Title II childhood disability benefits,
SSA obtains information about the
child’s functioning from teachers,
parents, and others who observe the
child on a daily basis. SSA obtains
results of formal testing, teacher reports,
therapy progress notes, individualized
education programs, and other records
of a child’s educational aptitude and
Number of
respondents
Modality of completion
achievement using Forms SSA–5665–
BK and SSA–5666. The respondents are
parents, teachers, and other education
personnel.
Type of Request: Revision of an OMBapproved information collection.
Frequency
of response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
SSA–5665–BK (electronic) ......................................................................................
SSA–5665 (paper form) ...........................................................................................
SSA–5666 (electronic) .............................................................................................
SSA–5666 (paper form) ...........................................................................................
368,098
2,562
137,590
1,843
1
1
1
1
40
40
30
30
245,399
1,708
68,795
922
Totals ................................................................................................................
510,093
....................
....................
316,824
4. Medicare Part D Subsidies
Regulations—20 CFR 418.3625,
418.3645, 418.3665(a), and 418.3670—
0960–0702. The MMA of 2003
established the Medicare Part D program
for voluntary prescription drug coverage
of premium, deductible, and copayment costs for certain low-income
individuals. The MMA also mandated
the provision of subsidies for those
individuals who qualify for the program
and who meet eligibility criteria for help
with premium, deductible, or copayment costs. This law requires SSA to
make eligibility determinations and to
provide a process for appealing SSA’s
determinations. Regulation sections
418.3625(c), 418.3645, 418.3665(a), and
Number of
respondents
Modality of completion
418.3670 contain public reporting
requirements pertaining to
administrative review hearings.
Respondents are applicants for the
Medicare Part D subsidies who request
an administrative review hearing.
Type of Request: Extension of an
existing OMB-approved information
collection.
Frequency
of response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
418.3625(c) ..............................................................................................................
418.3645 ..................................................................................................................
418.3665(a) ..............................................................................................................
418.3670 ..................................................................................................................
150
10
300
0
1
1
1
1
5
20
5
10
13
3
25
0
Total ..................................................................................................................
460
....................
....................
41
5. Help America Vote Act—0960–
0706. House Rule 3295, the Help
America Vote Act of 2002, mandates
that States verify the identities of newly
registered voters. When newly
registered voters do not have driver’s
licenses or State-issued ID cards, they
must supply the last four digits of their
Social Security number to their local
State election agencies for verification.
The election agencies forward this
information to their State Motor Vehicle
Administration (MVA), who inputs the
data into the American Association of
MVAs, a central consolidation system
that routes the voter data to SSA’s Help
America Vote Verification (HAVV)
system. Once SSA’s HAVV system has
confirmed the identity of the voter, the
information will return along the same
route in reverse until it reaches the State
election agency. The official
respondents for this collection are the
State MVAs.
Note: This is a correction notice: SSA
published the incorrect burden
information for this collection at 79 FR
37828 on 07/02/14. We are correcting
this error here.
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)
HAVV .......................................................................................................................
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Modality of completion
4,878,239
1
2
162,608
Dated: July 18, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security
Administration.
[FR Doc. 2014–17275 Filed 7–22–14; 8:45 am]
BILLING CODE 4191–02–P
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Federal Register / Vol. 79, No. 141 / Wednesday, July 23, 2014 / Notices
SOCIAL SECURITY ADMINISTRATION
[Docket No. SSA–2014–0038]
Finding Regarding Foreign Social
Insurance or Pension System—
Slovenia
Social Security Administration.
Notice of Finding Regarding
Foreign Social Insurance or Pension
System—Slovenia.
AGENCY:
mstockstill on DSK4VPTVN1PROD with NOTICES
ACTION:
Finding: Section 202(t)(1) of the
Social Security Act (42 U.S.C. 402(t)(1))
prohibits payment of monthly benefits
to any individual who is not a United
States citizen or national for any month
after he or she has been outside the
United States for 6 consecutive months.
This prohibition does not apply to such
an individual where one of the
exceptions described in section 202(t)(2)
through 202(t)(5) of the Social Security
Act (42 U.S.C. 402(t)(2) through
402(t)(5)) affects his or her case.
Section 202(t)(2) of the Social
Security Act provides that, subject to
certain residency requirements of
Section 202(t)(11), the prohibition
against payment shall not apply to any
individual who is a citizen of a country
which the Commissioner of Social
Security finds has in effect a social
insurance or pension system which is of
general application in such country and
which:
(a) Pays periodic benefits, or the
actuarial equivalent thereof, on account
of old age, retirement, or death; and
(b) permits individuals who are
United States citizens but not citizens of
that country and who qualify for such
benefits to receive those benefits, or the
actuarial equivalent thereof, while
outside the foreign country regardless of
the duration of the absence.
The Commissioner of Social Security
has delegated the authority to make
such a finding to the Associate
Commissioner of the Office of
International Programs. Under that
authority, the Associate Commissioner
of the Office of International Programs
approved a finding that Slovenia,
beginning April 1, 1992, has a social
insurance system of general application
which:
(a) Pays periodic benefits, or the
actuarial equivalent thereof, on account
of old age, retirement, or death; and
(b) permits United States citizens who
are not citizens of Slovenia to receive
such benefits, or their actuarial
equivalent, at the full rate without
qualification or restriction while outside
Slovenia.
Accordingly, notice is given that it
has been determined and found that
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18:52 Jul 22, 2014
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Slovenia has in effect, beginning April
1, 1992, a social insurance system
which meets the requirements of section
202(t)(2) of the Social Security Act (42
U.S.C. 402(t)(2)).
This determination is our first finding
under section 202(t) of the Social
Security Act for Slovenia. On April 1,
1992, the United States recognized
Slovenia as an independent nation.
Before that time, it was considered to be
part of former Yugoslavia which, on
March 25, 1959, had been determined to
have a system that met section 202(t)(2)
of the Social Security Act. The system
remained in force in Slovenia until the
Law on Pension and Disability
Insurance went into effect on April 1,
1992. Thus, prior to that date Slovenian
citizens were afforded the social
insurance exception to the alien
nonpayment provision based on the
Yugoslavian system which was then in
effect.
FOR FURTHER INFORMATION CONTACT:
Donna L. Powers, 3700 Robert Ball
Building, 6401 Security Boulevard,
Baltimore, MD 21235–6401, (410) 965–
3558.
42867
significance. The objects are imported
pursuant to loan agreements with the
foreign owners or custodians. I also
determine that the exhibition or display
of the exhibit objects at the Museum of
Modern Art, New York, New York, from
on or about October 12, 2014, until on
or about February 8, 2015, and at
possible additional exhibitions or
venues yet to be determined, is in the
national interest. I have ordered that
Public Notice of these Determinations
be published in the Federal Register.
For
further information, including a list of
the imported objects, contact Paul W.
Manning, Attorney-Adviser, Office of
the Legal Adviser, U.S. Department of
State (telephone: 202–632–6469). The
mailing address is U.S. Department of
State, SA–5, L/PD, Fifth Floor (Suite
5H03), Washington, DC 20522–0505.
FOR FURTHER INFORMATION CONTACT:
Dated: July 16, 2014.
Kelly Keiderling,
Principal Deputy Assistant Secretary, Bureau
of Educational and Cultural Affairs,
Department of State.
(Catalog of Federal Domestic Assistance:
Program Nos. 96.001 Social Security—
Disability Insurance; 96.00S Social
Security—Retirement Insurance; 96–004
Social Security—Survivors Insurance).
[FR Doc. 2014–17333 Filed 7–22–14; 8:45 am]
Dated: July 16, 2014.
Vance Teel,
Associate Commissioner Office of
International Programs.
DEPARTMENT OF TRANSPORTATION
[FR Doc. 2014–17283 Filed 7–22–14; 8:45 am]
BILLING CODE 4710–05–P
Connected Vehicle Reference
Implementation Architecture
Workshop; Notice of Public Meeting
BILLING CODE 4191–02–P
ITS Joint Program Office, Office
of the Assistant Secretary for Research
and Technology, U.S. Department of
Transportation.
AGENCY:
DEPARTMENT OF STATE
[Public Notice: 8806]
ACTION:
Culturally Significant Objects Imported
for Exhibition Determinations: ‘‘Henri
Matisse: The Cut-Outs’’
Notice is hereby given of the
following determinations: Pursuant to
the authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, and Delegation of
Authority No. 236–3 of August 28, 2000
(and, as appropriate, Delegation of
Authority No. 257 of April 15, 2003), I
hereby determine that the objects to be
included in the exhibition ‘‘Henri
Matisse: The Cut-Outs,’’ imported from
abroad for temporary exhibition within
the United States, are of cultural
SUMMARY:
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Notice.
The U.S. Department of
Transportation (USDOT) Intelligent
Transportation System Joint Program
Office (ITS JPO) will host a free
Connected Vehicle Reference
Implementation Architecture (CVRIA)
public workshop meeting to present and
seek input on the emerging results of its
Connected Vehicle interfaces and
standards analysis. The public meeting
will take place August 20, 2014, 8:30
a.m.–5:00 p.m. PDT and August 21,
2014, 8:30 a.m.–4:00 p.m. PDT at the
Holiday Inn Golden Gateway Hotel,
1500 Van Ness Ave, San Francisco,
California 94109.
To register for the CVRIA Workshop,
please visit www.itsa.org/
cvriaregistration.
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Agencies
[Federal Register Volume 79, Number 141 (Wednesday, July 23, 2014)]
[Notices]
[Pages 42863-42867]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-17275]
=======================================================================
-----------------------------------------------------------------------
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 extensions 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
September 22, 2014. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application for Search of Census Records for Proof of Age--20
CFR 404.716--0960-0097. When preferred evidence of age is not
available, or the available evidence is not convincing, SSA may ask the
U.S. Department of Commerce, Bureau of the Census, to search its
records to establish a claimant's date of birth. SSA collects
information from claimants using Form SSA-1535-U3 to provide the Census
Bureau with sufficient identification information to allow an accurate
search of census records. Additionally, the Census Bureau uses a
completed, signed SSA-1535-U3 to bill SSA for the search. The
respondents are applicants for Social Security benefits who need to
establish their date of birth as a factor of entitlement.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency burden per Estimated total
Modality of completion respondents of response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1535-U3....................................... 18,030 1 12 3,606
----------------------------------------------------------------------------------------------------------------
2. Public Information Campaign--0960-0544. Periodically, SSA sends
various public information materials, including public service
announcements, news releases, and educational tapes, to public
broadcasting systems so they can inform the public about various
programs and activities SSA conducts. SSA frequently sends follow-up
business reply cards for these public information materials to obtain
suggestions for improving them. The respondents are broadcast
television sources.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated total
Modality of completion respondents response response burden (hours)
(minutes)
----------------------------------------------------------------------------------------------------------------
Television........................................ 1,000 2 1 33
----------------------------------------------------------------------------------------------------------------
3. Medicare Subsidy Quality Review Forms--20 CFR 418(b)(5)--0960-
0707. The Medicare Modernization Act (MMA) of 2003 mandated the
creation of the Medicare Part D prescription drug coverage program and
provides certain subsidies for eligible Medicare beneficiaries to help
pay for the cost of prescription drugs. As part of its stewardship
duties of the Medicare Part D subsidy program, SSA must conduct
periodic quality review checks of the information Medicare
beneficiaries report on their subsidy applications (Form SSA-1020). SSA
uses the Medicare Quality Review program to conduct these checks. The
respondents are applicants for the Medicare Part D subsidy whom SSA
chose to undergo a quality review.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 42864]]
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes (hours)
----------------------------------------------------------------------------------------------------------------
SSA-9301 (Medicare Subsidy Quality Review Case 3,500 1 30 1,750
Analysis Questionnaire)..............................
SSA-9302 (Notice of Quality Review Acknowledgement 3,500 1 15 875
Form for those with Phones)..........................
SSA-9303 (Notice of Quality Review Acknowledgement 350 1 15 88
Form for those without Phones).......................
SSA-9308 (Request for Information).................... 7,000 1 15 1,750
SSA-9310 (Request for Documents)...................... 3,500 1 5 292
SSA-9311 (Notice of Appointment--Denial--Reviewer Will 450 1 15 113
Call)................................................
SSA-9312 (Notice of Appointment--Denial--Please Call 50 1 15 13
Reviewer)............................................
SSA-9313 (Notice of Quality Review Acknowledgement 2,500 1 15 625
Form for those with Phones)..........................
SSA-9314 (Notice of Quality Review Acknowledgement 500 1 15 125
Form for those without Phones).......................
SSA-8510 (Authorization to the Social Security 3,500 1 5 292
Administration to Obtain Personal Information).......
---------------------------------------------------------
Totals............................................ 24,850 - - 5,923
----------------------------------------------------------------------------------------------------------------
4. Application to Collect a Fee for Payee Service--20 CFR
416.640.640(a), 416.1103(f)--0960-0719. Sections 205(j)(4)(A) and (B)
and 1631(a)(2) of the Social Security Act (Act) allow SSA to authorize
certain organizational representative payees to collect a fee for
providing payee services. Before organizations may collect this fee,
they complete and submit Form SSA-445. SSA uses the information to
determine whether to authorize or deny permission to collect fees for
payee services. The respondents are private sector businesses or State
and local government offices applying to become fee-for-service
organizational representative payees.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency burden per total annual
Modality of completion responses of response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Private sector business............................... 90 1 10 15
State/local government offices........................ 10 1 10 2
---------------------------------------------------------
Totals............................................ 100 ........... ........... 17
----------------------------------------------------------------------------------------------------------------
5. Redetermination of Eligibility for Help with Medicare
Prescription Drug Plan Costs--0960-0723. As per the requirements of the
MMA of 2003, SSA conducts low-income subsidy eligibility
redeterminations for Medicare beneficiaries who currently receive the
Medicare Part D subsidy and who meet certain criteria. Respondents
complete Form SSA-1026-REDE under the following circumstances: (1) When
individuals became entitled to the Medicare Part D subsidy during the
past 12 months; (2) if they were eligible for the Part D subsidy for
more than 12 months; or (3) if they reported a change in income,
resources, or household size. Part D beneficiaries complete the SSA-
1026-SCE when they need to report a potentially subsidy-changing event,
including the following: (1) Marriage, (2) spousal separation, (3)
divorce, (4) annulment of a marriage, (5) spousal death, or (6) moving
back in with one's spouse following a separation. The respondents are
current recipients of the Medicare Part D low-income subsidy who will
undergo an eligibility redetermination for one of the reasons mentioned
above.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1026-OCR-MS-SCE................................... 9,176 1 18 2,753
SSA-1026-OCR-SM-REDE.................................. 161,766 1 18 48,530
---------------------------------------------------------
Total............................................. 170,942 ........... ........... 51,283
----------------------------------------------------------------------------------------------------------------
6. Electronic Records Express (Third Parties)--20 CFR 404.1700-
404.1715--0960-0767. Electronic Records Express (ERE) is an online
system which enables medical providers and various third party
representatives to download and submit disability claimant information
electronically to SSA as part of the disability application process. To
ensure only authorized people access ERE, SSA requires third parties to
complete a unique registration process if they wish to use this system.
This information collection request (ICR) includes the third-party
registration process; the burden for submitting evidence to SSA is part
of other, various ICRs. The respondents are third party
[[Page 42865]]
representatives of disability applicants or recipients who want to use
ERE to electronically access clients' disability files online and
submit information to SSA.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of Number of per response annual burden
respondents response responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
ERE.............................. 12,000 281 (3,372,000) 1 56,200
----------------------------------------------------------------------------------------------------------------
7. Screen Pop--20 CFR 401.45--0960-0790. Section 205(a) of the Act
requires SSA to verify the identity of individuals who request a record
or information pertaining to themselves, and to establish procedures
for disclosing personal information. SSA established Screen Pop, an
automated telephone process, to increase speed of verification for such
individuals. Accessing Screen Pop, callers enter their Social Security
number (SSN) using their telephone keypad or speech technology prior to
speaking with a National 800 Number Network (N8NN) agent. The automated
Screen Pop application collects the SSN and routes it to the ``Start
New Call'' Customer Help and Information (CHIP) screen. Functionality
for the Screen Pop application ends once the SSN connects to the CHIP
screen and the SSN routes to the agent's screen. When the call connects
to the N8NN agent, the agent can use the SSN to access the caller's
record as needed. The respondents for this collection are individuals
who contact SSA's N8NN to speak with an agent.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated total
Modality of completion responses response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Screen Pop........................................ 55,600,000 1 1 926,667
----------------------------------------------------------------------------------------------------------------
II. SSA submitted the information collections below to OMB for
clearance. Your comments regarding the information collections would be
most useful if OMB and SSA receive them 30 days from the date of this
publication. To be sure we consider your comments, we must receive them
no later than August 22, 2014. Individuals can obtain copies of the OMB
clearance packages by writing to OR.Reports.Clearance@ssa.gov.
1. Statement Regarding Date of Birth and Citizenship--20 CFR
404.716--0960-0016. Section 205(a) of the Act gives the Commissioner of
SSA the authority to make rules and regulations, and to establish
procedures for collecting evidence from individuals applying for Social
Security benefits. When individuals apply for Social Security benefits
and cannot provide preferred methods of proving age or citizenship, SSA
uses Form SSA-702 to establish these facts. Specifically, SSA uses the
SSA-702 to establish age as a factor of entitlement to Social Security
benefits or U.S. citizenship as a payment factor. Respondents are
individuals with knowledge about the date of birth or citizenship of
applicants filing for one or more Social Security benefits who need to
establish age or citizenship.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated total
Modality of completion respondents response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7157.......................................... 1,200 1 10 200
----------------------------------------------------------------------------------------------------------------
2. Application for Benefits under a U.S. International Social
Security Agreement--20 CFR 404.1925--0960-0448. Section 233(a) of the
Act authorizes the President of the United States to broker
international Social Security agreements (Totalization Agreements)
between the United States and foreign countries. SSA collects
information using Form SSA-2490-BK to determine entitlement to Social
Security benefits from the United States, or from a country that enters
into a totalization agreement with the United States. The respondents
are individuals applying for Old Age, Survivors, and Disability
Insurance benefits from the United States or from a Totalization
Agreement country.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2490-BK (Modernized Claims System)................ 14,175 1 30 7,088
SSA-2490-BK (paper)................................... 2,025 1 30 1,013
---------------------------------------------------------
Totals............................................ 16,200 ........... ........... 8,101
----------------------------------------------------------------------------------------------------------------
[[Page 42866]]
3. Teacher Questionnaire and Request for Administrative
Information--20 CFR 416.1103(f)--0960-0646. When determining the
effects of a child's impairment for children applying for Title II
childhood disability benefits, SSA obtains information about the
child's functioning from teachers, parents, and others who observe the
child on a daily basis. SSA obtains results of formal testing, teacher
reports, therapy progress notes, individualized education programs, and
other records of a child's educational aptitude and achievement using
Forms SSA-5665-BK and SSA-5666. The respondents are parents, teachers,
and other education personnel.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-5665-BK (electronic).............................. 368,098 1 40 245,399
SSA-5665 (paper form)................................. 2,562 1 40 1,708
SSA-5666 (electronic)................................. 137,590 1 30 68,795
SSA-5666 (paper form)................................. 1,843 1 30 922
---------------------------------------------------------
Totals............................................ 510,093 ........... ........... 316,824
----------------------------------------------------------------------------------------------------------------
4. Medicare Part D Subsidies Regulations--20 CFR 418.3625,
418.3645, 418.3665(a), and 418.3670--0960-0702. The MMA of 2003
established the Medicare Part D program for voluntary prescription drug
coverage of premium, deductible, and co-payment costs for certain low-
income individuals. The MMA also mandated the provision of subsidies
for those individuals who qualify for the program and who meet
eligibility criteria for help with premium, deductible, or co-payment
costs. This law requires SSA to make eligibility determinations and to
provide a process for appealing SSA's determinations. Regulation
sections 418.3625(c), 418.3645, 418.3665(a), and 418.3670 contain
public reporting requirements pertaining to administrative review
hearings. Respondents are applicants for the Medicare Part D subsidies
who request an administrative review hearing.
Type of Request: Extension of an existing OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
418.3625(c)........................................... 150 1 5 13
418.3645.............................................. 10 1 20 3
418.3665(a)........................................... 300 1 5 25
418.3670.............................................. 0 1 10 0
---------------------------------------------------------
Total............................................. 460 ........... ........... 41
----------------------------------------------------------------------------------------------------------------
5. Help America Vote Act--0960-0706. House Rule 3295, the Help
America Vote Act of 2002, mandates that States verify the identities of
newly registered voters. When newly registered voters do not have
driver's licenses or State-issued ID cards, they must supply the last
four digits of their Social Security number to their local State
election agencies for verification. The election agencies forward this
information to their State Motor Vehicle Administration (MVA), who
inputs the data into the American Association of MVAs, a central
consolidation system that routes the voter data to SSA's Help America
Vote Verification (HAVV) system. Once SSA's HAVV system has confirmed
the identity of the voter, the information will return along the same
route in reverse until it reaches the State election agency. The
official respondents for this collection are the State MVAs.
Note: This is a correction notice: SSA published the incorrect
burden information for this collection at 79 FR 37828 on 07/02/14. We
are correcting this error here.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated total
Modality of completion respondents response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
HAVV.............................................. 4,878,239 1 2 162,608
----------------------------------------------------------------------------------------------------------------
Dated: July 18, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-17275 Filed 7-22-14; 8:45 am]
BILLING CODE 4191-02-P