Agency Information Collection Activities: Comment Request, 56428-56430 [2014-22341]
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56428
Federal Register / Vol. 79, No. 182 / Friday, September 19, 2014 / Notices
Submit completed loan
applications to: U.S. Small Business
Administration, Processing And
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW., Suite 6050,
Washington, DC 20416.
SUPPLEMENTARY INFORMATION: Notice is
hereby given that as a result of the
President’s major disaster declaration on
09/10/2014, Private Non-Profit
organizations that provide essential
services of governmental nature may file
disaster loan applications at the address
listed above or other locally announced
locations.
The following areas have been
determined to be adversely affected by
the disaster:
Primary Counties:
Guam
The Interest Rates are:
ADDRESSES:
Percent
For Physical Damage:
Non-Profit Organizations With
Credit Available Elsewhere ...
Non-Profit Organizations Without Credit Available Elsewhere .....................................
For Economic Injury:
Non-Profit Organizations Without Credit Available Elsewhere .....................................
2.625
2.625
2.625
The number assigned to this disaster
for physical damage is 141148 and for
economic injury is 141158.
(Catalog of Federal Domestic Assistance
Numbers 59002 and 59008).
Joseph P. Loddo,
Acting Associate Administrator, for Disaster
Assistance.
[FR Doc. 2014–22330 Filed 9–18–14; 8:45 am]
BILLING CODE 8025–01–P
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection
Activities: 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 (PRA), 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
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
October 20, 2014. Individuals can obtain
copies of the OMB clearance packages
by writing to OR.Reports.Clearance@
ssa.gov.
1. Marital Relationship
Questionnaire—20 CFR 416.1826—
0960–0460. SSA uses Form SSA–4178,
Marital Relationship Questionnaire, to
determine if unrelated individuals of
the opposite sex who live together are
misrepresenting themselves as husband
and wife. SSA needs this information to
determine whether we are making
correct payments to couples and
individuals applying for or currently
receiving Supplemental Security
Income (SSI) payments. The
respondents are applicants for and
recipients of SSI payments.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Total
estimated
annual burden
(hours)
SSA–4178 ........................................................................................................
tkelley on DSK3SPTVN1PROD with NOTICES
Modality of completion
5,100
1
5
425
2. SSI Notice of Interim Assistance
Reimbursement (IAR)—0960–0546.
Section 1631(g) of the Social Security
Act authorizes SSA to reimburse an IAR
agency from an individual’s retroactive
SSI payment for assistance the IAR
agency gave the individual for meeting
basic needs while an SSI claim was
pending or SSI payments were
suspended or terminated. The State or
local agency needs an IAR agreement
with SSA to participate in the IAR
program. The individual receiving the
IAR payment signs an authorization
form with an IAR agency to allow SSA
to repay the IAR agency for funds paid
in advance prior to SSA’s determination
on the individual’s claim. The
authorization represents the
VerDate Sep<11>2014
17:15 Sep 18, 2014
Jkt 232001
individual’s intent to file for SSI, if they
did not file an application prior to SSA
receiving the authorization. Agencies
who wish to enter into an IAR
agreement with SSA need to meet the
following requirements:
(a) Reporting Requirements—Each
IAR agency agrees to:
(1) Notify SSA of receipt of an
authorization for initial claims or cases
they are appealing, and submit a copy
of that authorization either through a
manual or electronic process;
(2) inform SSA of the amount of
reimbursement;
(3) submit a written request for
dispute resolution on a determination;
PO 00000
Frm 00094
Fmt 4703
Sfmt 4703
(4) notify SSA of interim assistance
paid (using the SSA–8125 or the SSA–
L8125–F6);
(5) inform SSA of any deceased
claimants who participate in the IAR
program and;
(6) review and sign an agreement with
SSA.
(b) Recordkeeping Requirements—
The IAR agencies agree to retain all
notices, agreement, authorizations, and
accounting forms for the period defined
in the IAR agreement for the purposes
of SSA verifying transactions covered
under the agreement.
(c) Third Party Disclosure
Requirements: Each participating IAR
agency agrees to send written notices
from the IAR agency to the recipient
E:\FR\FM\19SEN1.SGM
19SEN1
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Federal Register / Vol. 79, No. 182 / Friday, September 19, 2014 / Notices
regarding payment amounts and appeal
rights.
(d) Periodic Review of Agency
Accounting Process—The IAR agency
makes the IAR accounting records of
paid cases available for SSA review and
verification. SSA conducts reviews
either onsite or through the mail of the
authorization forms, notices to the
claimant and accounting forms. Upon
completion of the review, SSA provides
Number of
respondents
(States)
Modality of completion
Frequency of response
a written report of findings to the IAR
agency director.
The respondents are State IAR
officers.
Type of Request: Revision of an OMBapproved information collection.
Total
estimated
annual
burden
(hours)
Average
burden per
response
(minutes)
Number of
responses
Reporting Requirements
(a) State notification of receipt of authorization (Electronic Process).
(b) State submission of copy of authorization (Manual Process).
(c) State submission of amount of IA paid to
recipients (using eIAR).
(d) State request for determination—dispute
resolution.
(e) State computation of reimbursement due
from SSA using paper Form SSA–L8125–
F6.
(f) State notification to SSA of deceased
claimant.
11
Once per SSI Claimant ........
97,330
1
1,622
27
Once per SSI Claimant ........
68,405
3
3,420
38
Once per SSI Claimant ........
101,352
8
13,514
(1)
As needed ............................
2
30
1
38
Once per SSI Claimant ........
1,524
30
762
20
40
15
10
(g) State reviewing/signing of IAR Agreement.
38
As needed when SSI claimant dies while claim is
pending.
Once during life of the IAR
agreement.
38
212
456
3165,735
101,352
3
3
8,287
5,068
101,352
7
11,824
12
3
36
12
16
192
6
4
24
639,161
Varies
45,217
Recordkeeping Requirements
(h) Maintenance of authorization forms ........
(i) Maintenance of accounting forms and notices.
38
38
One form per SSI claimant ...
One set per SSI claimant .....
Third Party Disclosure Requirements
(j) Written notice from State to recipient regarding amount of payment.
38
One per SSI claimant ...........
Periodic Review of Agency Accounting Process
(k) Retrieve and consolidate authorization
and accounting forms.
12
(l) Participate in periodic review ...................
12
(m) Correct administrative and accounting
discrepancies.
6
One set of forms per SSI
claimant for review by SSA
once every 2 to 3 years.
For review by SSA once
every 2 to 3 years.
To correct errors discovered
by SSA in periodic review.
Total Administrative Burden
Totals .....................................................
1Average
38
Varies ....................................
of about 2 States per year.
2Hours.
tkelley on DSK3SPTVN1PROD with NOTICES
3Includes
both denied and approved SSI claims.
3. Medical Source Statement of
Ability To Do Work Related Activities
(Physical and Mental)—20 CFR
404.1512–404.1514, 404.912–404.914,
404.1517, 416.917, 404.1519–404.1520,
416.919–416.920, 404.946, 416.946,
404–1546—0960–0662. In some
instances when a claimant appeals a
denied disability claim, SSA may ask
the claimant to have a consultative
examination, at the agency’s expense, if
VerDate Sep<11>2014
17:15 Sep 18, 2014
Jkt 232001
the claimant’s medical sources cannot
or will not give the agency sufficient
evidence to determine whether the
claimant is disabled. The medical
providers who perform these
consultative examinations provide a
statement about the claimant’s state of
disability. Specifically, these medical
source statements determine the workrelated capabilities of these claimants.
SSA collects the medical data on the
PO 00000
Frm 00095
Fmt 4703
Sfmt 4703
HA–1151 and HA–1152 to assess the
work-related physical and mental
capabilities of claimants who appeal
SSA’s previous determination on their
issue of disability. The respondents are
medical sources who provide reports
based either on existing medical
evidence or on consultative
examinations.
Type of Request: Revision of an OMBapproved information collection.
E:\FR\FM\19SEN1.SGM
19SEN1
56430
Federal Register / Vol. 79, No. 182 / Friday, September 19, 2014 / Notices
Number of
respondents
Modality of completion
Frequency
of response
Total
estimated
annual
burden
(hours)
Average
burden per
response
Number of
responses
HA–1151 ..............................................................................
HA–1152 ..............................................................................
5,000
5,000
30
30
150,000
150,000
15
15
37,500
37,500
Totals ............................................................................
10,000
........................
300,000
........................
75,000
4. Electronic Records Express—20
CFR 404.1512 and 416.912—0960–0753.
Electronic Records Express (ERE) is a
Web-based SSA program that allows
medical and educational providers to
electronically submit disability claimant
data to SSA. Both medical providers
and other third parties with connections
to disability applicants or recipients
(e.g., teachers and school administrators
for child disability applicants) use this
system once they complete the
registration process. SSA employees and
State agency employees request the
medical and educational records
collected through the ERE Web site. The
agency uses the information collected
through ERE to make a determination on
an Application for Benefits. We also use
the ERE Web site to order and receive
consultative examinations when we are
unable to collect enough medical
records to determine disability findings.
The respondents are medical providers
who evaluate or treat disability
claimants or recipients, and other third
parties with connections to disability
applicants or recipients (ex: Teachers
and school administrators for child
disability applicants), who voluntarily
choose to use ERE for submitting
information.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Total
estimated
annual burden
(hours)
ERE ..................................................................................................................
4,508,968
1
10
751,495
5. Application for Access to SSA
Systems—20 CFR 401.45—0960–0791.
SSA uses Form SSA–120, Application
for Access to SSA Systems, to allow
limited access to SSA’s information
resources for SSA employees and nonFederal employees (contractors). SSA
requires supervisory approval, and local
or component Security Officer review
prior to granting this access. The
respondents are SSA employees and
non-Federal Employees (contractors)
who require access to SSA systems to
perform their jobs.
Number of
respondents
Modality of completion
Note: Because SSA employees are
Federal workers exempt from the
requirements of the PRA, the burden
below is only for SSA contractors.
Type of Request: Revision of an OMBapproved information collection.
Total
estimated
annual
burden
(hours)
Average
burden per
response
(minutes)
Frequency
of response
SSA–120 (paper version) ................................................................................
SSA–120 (Internet version) .............................................................................
2,148
1,105
1
1
2
3
73
37
Totals ........................................................................................................
3,289
........................
........................
110
Dated: September 16, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security
Administration.
[FR Doc. 2014–22341 Filed 9–18–14; 8:45 am]
tkelley on DSK3SPTVN1PROD with NOTICES
BILLING CODE 4191–02–P
DEPARTMENT OF TRANSPORTATION
Federal Aviation Administration
Office of Commercial Space
Transportation; Notice of Availability
and Request for Comment on the Draft
Environmental Assessment (EA) for
the Kodiak Launch Complex Launch
Pad 3, Kodiak Island, Alaska
Federal Aviation
Administration (FAA), Department of
Transportation (DOT).
AGENCY:
Notice of availability, notice of
public comment period, notice of public
meeting and request for comment.
ACTIONS:
VerDate Sep<11>2014
17:15 Sep 18, 2014
Jkt 232001
PO 00000
Frm 00096
Fmt 4703
Sfmt 4703
In accordance with the
National Environmental Policy Act of
1969, as amended (NEPA; 42 United
States Code 4321 et seq.), Council on
Environmental Quality NEPA
implementing regulations (40 Code of
Federal Regulations parts 1500 to 1508),
and FAA Order 1050.1E, Change 1,
Environmental Impacts: Policies and
Procedures, the FAA is announcing the
availability of and requesting comments
on the Draft Environmental Assessment
for the Kodiak Launch Complex Launch
Pad 3 (Draft EA).
FOR FURTHER INFORMATION CONTACT:
Stacey M. Zee, Federal Aviation
Administration, c/o ICF International,
9300 Lee Highway, Fairfax, VA 22031;
SUMMARY:
E:\FR\FM\19SEN1.SGM
19SEN1
]]>Agencies
[Federal Register Volume 79, Number 182 (Friday, September 19, 2014)]
[Notices]
[Pages 56428-56430]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-22341]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: 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 (PRA), 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: OIRASubmission@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
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 October 20, 2014. Individuals can obtain copies of the
OMB clearance packages by writing to OR.Reports.Clearance@ssa.gov.
1. Marital Relationship Questionnaire--20 CFR 416.1826--0960-0460.
SSA uses Form SSA-4178, Marital Relationship Questionnaire, to
determine if unrelated individuals of the opposite sex who live
together are misrepresenting themselves as husband and wife. SSA needs
this information to determine whether we are making correct payments to
couples and individuals applying for or currently receiving
Supplemental Security Income (SSI) payments. The respondents are
applicants for and recipients of SSI payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Total estimated
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4178.................................... 5,100 1 5 425
----------------------------------------------------------------------------------------------------------------
2. SSI Notice of Interim Assistance Reimbursement (IAR)--0960-0546.
Section 1631(g) of the Social Security Act authorizes SSA to reimburse
an IAR agency from an individual's retroactive SSI payment for
assistance the IAR agency gave the individual for meeting basic needs
while an SSI claim was pending or SSI payments were suspended or
terminated. The State or local agency needs an IAR agreement with SSA
to participate in the IAR program. The individual receiving the IAR
payment signs an authorization form with an IAR agency to allow SSA to
repay the IAR agency for funds paid in advance prior to SSA's
determination on the individual's claim. The authorization represents
the individual's intent to file for SSI, if they did not file an
application prior to SSA receiving the authorization. Agencies who wish
to enter into an IAR agreement with SSA need to meet the following
requirements:
(a) Reporting Requirements--Each IAR agency agrees to:
(1) Notify SSA of receipt of an authorization for initial claims or
cases they are appealing, and submit a copy of that authorization
either through a manual or electronic process;
(2) inform SSA of the amount of reimbursement;
(3) submit a written request for dispute resolution on a
determination;
(4) notify SSA of interim assistance paid (using the SSA-8125 or
the SSA-L8125-F6);
(5) inform SSA of any deceased claimants who participate in the IAR
program and;
(6) review and sign an agreement with SSA.
(b) Recordkeeping Requirements--The IAR agencies agree to retain
all notices, agreement, authorizations, and accounting forms for the
period defined in the IAR agreement for the purposes of SSA verifying
transactions covered under the agreement.
(c) Third Party Disclosure Requirements: Each participating IAR
agency agrees to send written notices from the IAR agency to the
recipient
[[Page 56429]]
regarding payment amounts and appeal rights.
(d) Periodic Review of Agency Accounting Process--The IAR agency
makes the IAR accounting records of paid cases available for SSA review
and verification. SSA conducts reviews either onsite or through the
mail of the authorization forms, notices to the claimant and accounting
forms. Upon completion of the review, SSA provides a written report of
findings to the IAR agency director.
The respondents are State IAR officers.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Total
Number of Frequency of Number of Average burden estimated
Modality of completion respondents response responses per response annual burden
(States) (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Reporting Requirements
----------------------------------------------------------------------------------------------------------------
(a) State notification of 11 Once per SSI 97,330 1 1,622
receipt of authorization Claimant.
(Electronic Process).
(b) State submission of copy 27 Once per SSI 68,405 3 3,420
of authorization (Manual Claimant.
Process).
(c) State submission of amount 38 Once per SSI 101,352 8 13,514
of IA paid to recipients Claimant.
(using eIAR).
(d) State request for (\1\) As needed....... 2 30 1
determination--dispute
resolution.
(e) State computation of 38 Once per SSI 1,524 30 762
reimbursement due from SSA Claimant.
using paper Form SSA-L8125-F6.
(f) State notification to SSA 20 As needed when 40 15 10
of deceased claimant. SSI claimant
dies while
claim is
pending.
(g) State reviewing/signing of 38 Once during life 38 \2\12 456
IAR Agreement. of the IAR
agreement.
----------------------------------------------------------------------------------------------------------------
Recordkeeping Requirements
----------------------------------------------------------------------------------------------------------------
(h) Maintenance of 38 One form per SSI \3\165,735 3 8,287
authorization forms. claimant.
(i) Maintenance of accounting 38 One set per SSI 101,352 3 5,068
forms and notices. claimant.
----------------------------------------------------------------------------------------------------------------
Third Party Disclosure Requirements
----------------------------------------------------------------------------------------------------------------
(j) Written notice from State 38 One per SSI 101,352 7 11,824
to recipient regarding amount claimant.
of payment.
----------------------------------------------------------------------------------------------------------------
Periodic Review of Agency Accounting Process
----------------------------------------------------------------------------------------------------------------
(k) Retrieve and consolidate 12 One set of forms 12 3 36
authorization and accounting per SSI
forms. claimant for
review by SSA
once every 2 to
3 years.
(l) Participate in periodic 12 For review by 12 16 192
review. SSA once every
2 to 3 years.
(m) Correct administrative and 6 To correct 6 4 24
accounting discrepancies. errors
discovered by
SSA in periodic
review.
----------------------------------------------------------------------------------------------------------------
Total Administrative Burden
----------------------------------------------------------------------------------------------------------------
Totals.................... 38 Varies.......... 639,161 Varies 45,217
----------------------------------------------------------------------------------------------------------------
\1\Average of about 2 States per year.
\2\Hours.
\3\Includes both denied and approved SSI claims.
3. Medical Source Statement of Ability To Do Work Related
Activities (Physical and Mental)--20 CFR 404.1512-404.1514, 404.912-
404.914, 404.1517, 416.917, 404.1519-404.1520, 416.919-416.920,
404.946, 416.946, 404-1546--0960-0662. In some instances when a
claimant appeals a denied disability claim, SSA may ask the claimant to
have a consultative examination, at the agency's expense, if the
claimant's medical sources cannot or will not give the agency
sufficient evidence to determine whether the claimant is disabled. The
medical providers who perform these consultative examinations provide a
statement about the claimant's state of disability. Specifically, these
medical source statements determine the work-related capabilities of
these claimants. SSA collects the medical data on the HA-1151 and HA-
1152 to assess the work-related physical and mental capabilities of
claimants who appeal SSA's previous determination on their issue of
disability. The respondents are medical sources who provide reports
based either on existing medical evidence or on consultative
examinations.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 56430]]
----------------------------------------------------------------------------------------------------------------
Total
Number of Frequency of Number of Average burden estimated
Modality of completion respondents response responses per response annual burden
(hours)
----------------------------------------------------------------------------------------------------------------
HA-1151......................... 5,000 30 150,000 15 37,500
HA-1152......................... 5,000 30 150,000 15 37,500
-------------------------------------------------------------------------------
Totals...................... 10,000 .............. 300,000 .............. 75,000
----------------------------------------------------------------------------------------------------------------
4. Electronic Records Express--20 CFR 404.1512 and 416.912--0960-
0753. Electronic Records Express (ERE) is a Web-based SSA program that
allows medical and educational providers to electronically submit
disability claimant data to SSA. Both medical providers and other third
parties with connections to disability applicants or recipients (e.g.,
teachers and school administrators for child disability applicants) use
this system once they complete the registration process. SSA employees
and State agency employees request the medical and educational records
collected through the ERE Web site. The agency uses the information
collected through ERE to make a determination on an Application for
Benefits. We also use the ERE Web site to order and receive
consultative examinations when we are unable to collect enough medical
records to determine disability findings. The respondents are medical
providers who evaluate or treat disability claimants or recipients, and
other third parties with connections to disability applicants or
recipients (ex: Teachers and school administrators for child disability
applicants), who voluntarily choose to use ERE for submitting
information.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Total estimated
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
ERE......................................... 4,508,968 1 10 751,495
----------------------------------------------------------------------------------------------------------------
5. Application for Access to SSA Systems--20 CFR 401.45--0960-0791.
SSA uses Form SSA-120, Application for Access to SSA Systems, to allow
limited access to SSA's information resources for SSA employees and
non-Federal employees (contractors). SSA requires supervisory approval,
and local or component Security Officer review prior to granting this
access. The respondents are SSA employees and non-Federal Employees
(contractors) who require access to SSA systems to perform their jobs.
Note: Because SSA employees are Federal workers exempt from the
requirements of the PRA, the burden below is only for SSA contractors.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Total
Number of Frequency of Average burden estimated
Modality of completion respondents response per response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-120 (paper version)......................... 2,148 1 2 73
SSA-120 (Internet version)...................... 1,105 1 3 37
---------------------------------------------------------------
Totals...................................... 3,289 .............. .............. 110
----------------------------------------------------------------------------------------------------------------
Dated: September 16, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-22341 Filed 9-18-14; 8:45 am]
BILLING CODE 4191-02-P
