Agency Information Collection Activities: Proposed Request, 57650-57653 [2014-22809]
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Federal Register / Vol. 79, No. 186 / Thursday, September 25, 2014 / Notices
Comments may be submitted by any of
the following methods:
Electronic Comments
• Use the Commission’s Internet
comment form (https://www.sec.gov/
rules/sro.shtml); or
• Send an email to rule-comments@
sec.gov. Please include File Number SR–
SCCP–2014–01 on the subject line.
Paper Comments
• Send paper comments in triplicate
to Secretary, Securities and Exchange
Commission, 100 F Street NE.,
Washington, DC 20549–1090.
mstockstill on DSK4VPTVN1PROD with NOTICES
All submissions should refer to File
Number SR–SCCP–2014–01. This file
number should be included on the
subject line if email is used. To help the
Commission process and review your
comments more efficiently, please use
only one method. The Commission will
post all comments on the Commission’s
Internet Web site (https://www.sec.gov/
rules/sro.shtml). Copies of the
submission, all subsequent
amendments, all written statements
with respect to the proposed rule
change that are filed with the
Commission, and all written
communications relating to the
proposed rule change between the
Commission and any person, other than
those that may be withheld from the
public in accordance with the
provisions of 5 U.S.C. 552, will be
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 the
filing also will be available for
inspection and copying at the principal
office of SCCP. All comments 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 Number SR–SCCP–
2014–01 and should be submitted on or
before October 16, 2014.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.6
Kevin M. O’Neill,
Deputy Secretary.
[FR Doc. 2014–22783 Filed 9–24–14; 8:45 am]
BILLING CODE 8011–01–P
6 17
CFR 200.30–3(a)(12).
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SMALL BUSINESS ADMINISTRATION
Reporting and Recordkeeping
Requirements Under OMB Review
Small Business Administration.
30-Day Notice.
AGENCY:
ACTION:
The Small Business
Administration (SBA) is publishing this
notice to comply with requirements of
the Paperwork Reduction Act (PRA) (44
U.S.C. Chapter 35), which requires
agencies to submit proposed reporting
and recordkeeping requirements to
OMB for review and approval, and to
publish a notice in the Federal Register
notifying the public that the agency has
made such a submission. This notice
also allows an additional 30 days for
public comments.
DATES: Submit comments on or before
October 27, 2014.
ADDRESSES: Comments should refer to
the information collection by name and/
or OMB Control Number and should be
sent to: Agency Clearance Officer, Curtis
Rich, Small Business Administration,
409 3rd Street SW., 5th Floor,
Washington, DC 20416; and SBA Desk
Officer, Office of Information and
Regulatory Affairs, Office of
Management and Budget, New
Executive Office Building, Washington,
DC 20503.
FOR FURTHER INFORMATION CONTACT:
Curtis Rich, Agency Clearance Officer,
(202) 205–7030 curtis.rich@sba.gov.
Copies: A copy of the Form OMB 83–
1, supporting statement, and other
documents submitted to OMB for
review may be obtained from the
Agency Clearance Officer.
SUPPLEMENTARY INFORMATION: SBA Form
641 and 888 are used to collect
information from the Agency’s resource
partners, including: Small Business
Development Centers, SCORE, and
Women’s Business Centers that provide
training and counseling to existing or
potential small business owners through
SBA funded grants, or cooperative
agreements. SBA uses the information to
facilitate its management and oversight
of these SBA funded grants, assist in
evaluating their impact on the small
business community, and facilitate
performance reporting to Congress and
the President. The information is
uploaded to SBA through the
Entrepreneurial Development
Management Information System
(EDMIS).
SUMMARY:
Solicitation of Public Comments
Comments may be submitted on (a)
whether the collection of information is
necessary for the agency to properly
perform its functions; (b) whether the
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burden estimates are accurate; (c)
whether there are ways to minimize the
burden, including through the use of
automated techniques or other forms of
information technology; and (d) whether
there are ways to enhance the quality,
utility, and clarity of the information.
Summary of Information Collections
(1) Title: Entrepreneurial
Development Management Information
System (EDMIS) Customer Intake Form
& Management Training Report Form.
Description of Respondents: SBA
resource partners, including Small
Business Development Centers (SBDCs),
Women’s Business Centers (WBCs), and
SCORE, Form Numbers: Form 641
(Counseling Information Form) and
Form 888 (Management Training
Report).
Form Numbers: SBA Form 641, 888.
Estimated Annual Respondents:
1,265,000.
Estimated Annual Responses:
1,265,000.
Estimated Annual Hour Burden:
379,500.
Curtis B. Rich,
Management Analyst .
[FR Doc. 2014–22826 Filed 9–24–14; 8:45 am]
BILLING CODE 8025–01–P
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection
Activities: Proposed 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 (PRA) of 1995, effective
October 1, 1995. This notice includes
revisions of OMB-approved information
collections.
SSA is soliciting comments on the
accuracy of the agency’s burden
estimate; the need for the information;
its practical utility; ways to enhance its
quality, utility, and clarity; and ways to
minimize burden on respondents,
including the use of automated
collection techniques or other forms of
information technology. Mail, email, or
fax your comments and
recommendations on the information
collection(s) to the OMB Desk Officer
and SSA Reports Clearance Officer at
the following addresses or fax numbers.
(OMB), Office of Management and
Budget, Attn: Desk Officer for SSA, Fax:
202–395–6974, Email address: OIRA_
Submission@omb.eop.gov.
(SSA), Social Security
Administration, OLCA, Attn: Reports
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Federal Register / Vol. 79, No. 186 / Thursday, September 25, 2014 / Notices
Clearance Director, 3100 West High
Rise, 6401 Security Blvd., Baltimore,
MD 21235, Fax: 410–966–2830, Email
address: OR.Reports.Clearance@ssa.gov.
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 November 24, 2014.
Individuals can obtain copies of the
collection instruments by writing to the
above email address.
1. Letter to Employer Requesting
Information About Wages Earned By
Beneficiary—20 CFR 416.703, 404.801 &
404.820—0960–0034. Social Security
disability recipients receive payments
based on their inability to engage in
substantial gainful activity (SGA)
because of a physical or mental
condition. If the recipients work, SSA
must evaluate and determine if they
continue to meet the disability
requirements of the law. Therefore, we
use Form SSA–L725 to request monthly
57651
earnings information from the
recipient’s employer. We then use the
earnings data to determine whether the
recipient is engaging in SGA, since work
after a recipient becomes entitled to
benefits can cause a cessation of
disability. The respondents are
businesses that employ Social Security
disability recipients.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency of
response
Average burden
per response
(minutes)
Estimated total
annual burden
(hours)
SSA–L725 ................................................................................
150,000
1
40
100,000
2. Letter to Employer Requesting
Wage Information—0960–0138. SSA
must establish and verify wage
information for Supplemental Security
Income (SSI) applicants and recipients
when determining SSI eligibility and
payment amounts. SSA uses Form SSA–
L4201 to collect wage data from
employers. SSA uses the information to
determine eligibility and proper
payment amounts for SSI applicants and
recipients. The respondents are
employers of SSI applicants and
recipients.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency of
response
Average burden
per response
(minutes)
Estimated total
annual burden
(hours)
SSA–L4201 ..............................................................................
133,000
1
30
66,500
3. Statement of Living Arrangements,
In-Kind Support, and Maintenance—20
CFR 416.1130–416.1148—0960–0174.
SSA determines SSI payment amounts
based on applicants’ and recipients’
needs. We measure individuals’ needs,
in part, by the amount of income they
receive, including in-kind support and
maintenance in the form of food and
shelter provided by other persons. SSA
uses Form SSA–8006–F4 to determine if
in-kind support and maintenance exists
for SSI applicants and recipients. This
information also assists SSA in
determining the income value of in-kind
support and maintenance SSI applicants
and recipients receive. The respondents
are individuals who apply for SSI
payments, or who complete an SSI
eligibility redetermination.
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–8006–F4 ..........................................................................
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Modality of completion
173,380
1
7
20,228
4. Claimant’s Recent Medical
Treatment—20 CFR 404.1512 and
416.912—0960–0292. When Disability
Determinations Services (DDS) deny a
claim at the reconsideration level, the
claimant has a right to request a hearing
before an administrative law judge
(ALJ). For the hearing, SSA asks the
claimant to complete and return the
HA–4631 if the claimant’s file does not
reflect a current, complete medical
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17:25 Sep 24, 2014
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history as the claimant proceeds
through the appeals process. ALJs must
obtain the information to update and
complete the record and to verify the
accuracy of the information. Through
this process, ALJs can ascertain whether
the claimant’s situation changed. The
ALJs and hearing office staff use the
response to make arrangements for
consultative examination(s) and the
attendance of an expert witness(es), if
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appropriate. During the hearing, the ALJ
offers any completed questionnaires as
exhibits and may use them to (1) refresh
the claimant’s memory; and (2) shape
their questions. The respondents are
claimant’s requesting hearings on
entitlement to Old Age, Survivors, and
Disability Insurance (OASDI) benefits or
SSI payments.
Type of Request: Revision of an OMBapproved information collection.
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Federal Register / Vol. 79, No. 186 / Thursday, September 25, 2014 / Notices
Modality of completion
Number of
respondents
Frequency of
response
Average burden
per response
(minutes)
Estimated total
annual burden
(hours)
HA–4631 ..................................................................................
200,000
1
10
33,333
5. Supplemental Security Income
(SSI) Claim Information Notice—20 CFR
416.210—0960–0324. Section 1611(e)(2)
of the Social Security Act requires
individuals to file for and obtain all
payments (annuities, pensions,
disability benefits, veteran’s
compensation, etc.) for which they are
eligible before qualifying for SSI
payments. Individuals do not qualify for
SSI if they do not first apply for all other
benefits. SSA uses the information on
Form SSA–L8050–U3 to verify and
establish a claimant or recipient’s
eligibility under the SSI program.
Respondents are SSI applicants or
recipients who may be eligible for other
payments from public or private
programs.
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)
SSA–L–8050–U3 .....................................................................
17,044
1
10
2,841
6. You Can Make Your Payment by
Credit Card—0960–0462. Using
information from Form SSA–4588 and
its electronic application, Form SSA–
4589, SSA updates individuals’ Social
Security records to reflect payments
made on their overpayments. In
addition, SSA uses this information to
process payments through the
appropriate credit card company. SSA
provides the SSA–4588 when we inform
an individual that we detected an
overpayment. Individuals may choose to
make a one-time payment or recurring
monthly payments by completing and
submitting the SSA–4588. SSA uses the
SSA–4589 electronic intranet
application only when individuals
choose to telephone the Program Service
Centers to make a one-time payment in
Number of
respondents
Modality of completion
lieu of completing Form SSA–4588. An
SSA debtor contact representative
completes the SSA–4589 electronic
intranet application. Respondents are
OASDI beneficiaries and SSI recipients
who have outstanding overpayments.
Type of Request: Revision of an OMBapproved information collection.
Average burden
per response
(minutes)
Frequency of
response
Estimated total
annual burden
(hours)
SSA–4588 paper form .............................................................
SSA–4589 electronic intranet application ................................
13,200
221,316
1
1
10
5
2,200
18,443
Totals ................................................................................
234,516
..............................
..............................
20,643
7. Application for Extra Help with
Medicare Prescription Drug Plan
Costs—20 CFR 418.3101—0960–0696.
The Medicare Modernization Act of
2003 mandated the creation of the
Medicare Part D prescription drug
coverage program and the provision of
subsidies for eligible Medicare
beneficiaries. SSA uses Form SSA–1020
or the Internet i1020, the Application
for Extra Help with Medicare
Prescription Drug Plan Costs, to obtain
income and resource information from
Medicare beneficiaries and to make a
Number of
respondents
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Modality of completion
subsidy decision. The respondents are
Medicare beneficiaries applying for the
Part D low-income subsidy.
Type of Request: Revision of an OMBapproved information collection.
Average burden
per response
(minutes)
Frequency of
response
Estimated total
annual burden
(hours)
SSA–1020 (paper application form) ........................................
i1020 (online application) .........................................................
Field Office Interview ...............................................................
617,070
282,228
155,687
1
1
1
30
25
30
308,535
117,595
77,844
Totals ................................................................................
1,054,985
..............................
..............................
503,974
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57653
Federal Register / Vol. 79, No. 186 / Thursday, September 25, 2014 / Notices
8. Certification of Low Birth Weight
for SSI Eligibility of Funds You
Provided to Another and Statement of
Funds You Received—20 CFR 416.931,
416.926a(m), and 416.924—0960–0720.
Hospitals and claimants use Form SSA–
3380 to provide medical information to
local field offices (FO) and DDSs on
behalf of infants with low birth weight.
FOs use the form as a protective filing
statement and the medical information
to make presumptive disability findings,
which allow expedited payment to
eligible claimants. DDSs use the medical
information to determine disability and
continuing disability. The respondents
are hospitals and claimants who have
information identifying low birth weight
babies and their medical conditions.
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–3380 ................................................................................
28,125
1
15
7,031
Dated: September 22, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security
Administration.
mailing address is U.S. Department of
State, SA–5, L/PD, Fifth Floor (Suite
5H03), Washington, DC 20522–0505.
Dated: September 19, 2014.
Kelly Keiderling,
Principal Deputy Assistant Secretary, Bureau
of Educational and Cultural Affairs,
Department of State.
[FR Doc. 2014–22809 Filed 9–24–14; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
BILLING CODE 4710–05–P
Culturally Significant Objects Imported
for Exhibition Determinations:
‘‘Picasso/Dali, Dali/Picasso’’
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 ‘‘Picasso/
Dali, Dali/Picasso,’’ imported from
abroad for temporary exhibition within
the United States, are of cultural
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 Salvador
Dali Museum, St. Petersburg, Florida,
from on or about November 8, 2014,
until on or about February 16, 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 CONTACT: 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
SUMMARY:
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Barbara J. Hairston,
Supervisory Dockets Officer, Docket
Operations, Federal Register Liaison.
[FR Doc. 2014–22146 Filed 9–24–14; 8:45 am]
BILLING CODE 4910–9X–P
[FR Doc. 2014–22845 Filed 9–24–14; 8:45 am]
[Public Notice 8884]
transportation of persons, property, and
mail.
VerDate Sep<11>2014
17:25 Sep 24, 2014
Jkt 232001
DEPARTMENT OF TRANSPORTATION
Office of the Secretary
DEPARTMENT OF TRANSPORTATION
Office of the Secretary
Notice of Applications for Certificates
of Public Convenience and Necessity
and Foreign Air Carrier Permits Filed
Under Subpart B (Formerly Subpart Q)
During the Week Ending September 6,
2014
The following Applications for
Certificates of Public Convenience and
Necessity and Foreign Air Carrier
Permits were filed under Subpart B
(formerly Subpart Q) of the Department
of Transportation’s Procedural
Regulations (See 14 CFR 302.201 et.
seq.). The due date for Answers,
Conforming Applications, or Motions to
Modify Scope are set forth below for
each application. Following the Answer
period DOT may process the application
by expedited procedures. Such
procedures may consist of the adoption
of a show-cause order, a tentative order,
or in appropriate cases a final order
without further proceedings.
Docket Number: DOT–OST–2014–
0152.
Date Filed: September 2, 2014.
Due Date for Answers, Conforming
Applications, or Motion to Modify
Scope: September 23, 2014.
Description: Application of Caribbean
Sun Airlines, Inc. d/b/a World Atlantic
Airlines (‘‘World Atlantic’’) requesting a
certificate of public convenience and
necessity authorizing World Atlantic to
engage in interstate charter air
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Fmt 4703
Sfmt 4703
Notice of Applications for Certificates
of Public Convenience and Necessity
and Foreign Air Carrier Permits Filed
Under Subpart B (Formerly Subpart Q)
During the Week Ending August 9,
2014
The following Applications for
Certificates of Public Convenience and
Necessity and Foreign Air Carrier
Permits were filed under Subpart B
(formerly Subpart Q) of the Department
of Transportation’s Procedural
Regulations (See 14 CFR 302.201 et.
seq.). The due date for Answers,
Conforming Applications, or Motions to
Modify Scope are set forth below for
each application. Following the Answer
period DOT may process the application
by expedited procedures. Such
procedures may consist of the adoption
of a show-cause order, a tentative order,
or in appropriate cases a final order
without further proceedings.
Docket Number: DOT–OST–2014–
0134.
Date Filed: August 5, 2014.
Due Date for Answers, Conforming
Applications, or Motion to Modify
Scope: August 26, 2014.
Description: Application of
Aeroenlaces Nacionales, S.A. de C.V.(d/
b/a vivaAerobus) requesting an
exemption authorizing it to engage in
scheduled foreign airtransport of
persons, property and mail between
Houston, Texas and Cancun, Mexico. In
addition, vivaAerobus requests that the
Department amend the carrier’s foreign
air carrier permit to integrate the
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]]>Agencies
[Federal Register Volume 79, Number 186 (Thursday, September 25, 2014)]
[Notices]
[Pages 57650-57653]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-22809]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed 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 (PRA) of 1995, effective October 1, 1995. This
notice includes revisions of OMB-approved information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and ways to minimize burden
on respondents, including the use of automated collection techniques or
other forms of information technology. Mail, email, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer at the following
addresses or fax numbers.
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974, Email address: OIRASubmission@omb.eop.gov.
(SSA), Social Security Administration, OLCA, Attn: Reports
[[Page 57651]]
Clearance Director, 3100 West High Rise, 6401 Security Blvd.,
Baltimore, MD 21235, Fax: 410-966-2830, Email address:
OR.Reports.Clearance@ssa.gov.
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
November 24, 2014. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Letter to Employer Requesting Information About Wages Earned By
Beneficiary--20 CFR 416.703, 404.801 & 404.820--0960-0034. Social
Security disability recipients receive payments based on their
inability to engage in substantial gainful activity (SGA) because of a
physical or mental condition. If the recipients work, SSA must evaluate
and determine if they continue to meet the disability requirements of
the law. Therefore, we use Form SSA-L725 to request monthly earnings
information from the recipient's employer. We then use the earnings
data to determine whether the recipient is engaging in SGA, since work
after a recipient becomes entitled to benefits can cause a cessation of
disability. The respondents are businesses that employ Social Security
disability recipients.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated total
Modality of completion Number of Frequency of Average burden per annual burden
respondents response response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L725........................ 150,000 1 40 100,000
----------------------------------------------------------------------------------------------------------------
2. Letter to Employer Requesting Wage Information--0960-0138. SSA
must establish and verify wage information for Supplemental Security
Income (SSI) applicants and recipients when determining SSI eligibility
and payment amounts. SSA uses Form SSA-L4201 to collect wage data from
employers. SSA uses the information to determine eligibility and proper
payment amounts for SSI applicants and recipients. The respondents are
employers of SSI applicants and recipients.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated total
Modality of completion Number of Frequency of Average burden per annual burden
respondents response response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L4201....................... 133,000 1 30 66,500
----------------------------------------------------------------------------------------------------------------
3. Statement of Living Arrangements, In-Kind Support, and
Maintenance--20 CFR 416.1130-416.1148--0960-0174. SSA determines SSI
payment amounts based on applicants' and recipients' needs. We measure
individuals' needs, in part, by the amount of income they receive,
including in-kind support and maintenance in the form of food and
shelter provided by other persons. SSA uses Form SSA-8006-F4 to
determine if in-kind support and maintenance exists for SSI applicants
and recipients. This information also assists SSA in determining the
income value of in-kind support and maintenance SSI applicants and
recipients receive. The respondents are individuals who apply for SSI
payments, or who complete an SSI eligibility redetermination.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated total
Modality of completion Number of Frequency of Average burden per annual burden
respondents response response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8006-F4..................... 173,380 1 7 20,228
----------------------------------------------------------------------------------------------------------------
4. Claimant's Recent Medical Treatment--20 CFR 404.1512 and
416.912--0960-0292. When Disability Determinations Services (DDS) deny
a claim at the reconsideration level, the claimant has a right to
request a hearing before an administrative law judge (ALJ). For the
hearing, SSA asks the claimant to complete and return the HA-4631 if
the claimant's file does not reflect a current, complete medical
history as the claimant proceeds through the appeals process. ALJs must
obtain the information to update and complete the record and to verify
the accuracy of the information. Through this process, ALJs can
ascertain whether the claimant's situation changed. The ALJs and
hearing office staff use the response to make arrangements for
consultative examination(s) and the attendance of an expert
witness(es), if appropriate. During the hearing, the ALJ offers any
completed questionnaires as exhibits and may use them to (1) refresh
the claimant's memory; and (2) shape their questions. The respondents
are claimant's requesting hearings on entitlement to Old Age,
Survivors, and Disability Insurance (OASDI) benefits or SSI payments.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 57652]]
----------------------------------------------------------------------------------------------------------------
Estimated total
Modality of completion Number of Frequency of Average burden per annual burden
respondents response response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
HA-4631......................... 200,000 1 10 33,333
----------------------------------------------------------------------------------------------------------------
5. Supplemental Security Income (SSI) Claim Information Notice--20
CFR 416.210--0960-0324. Section 1611(e)(2) of the Social Security Act
requires individuals to file for and obtain all payments (annuities,
pensions, disability benefits, veteran's compensation, etc.) for which
they are eligible before qualifying for SSI payments. Individuals do
not qualify for SSI if they do not first apply for all other benefits.
SSA uses the information on Form SSA-L8050-U3 to verify and establish a
claimant or recipient's eligibility under the SSI program. Respondents
are SSI applicants or recipients who may be eligible for other payments
from public or private programs.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated total
Modality of completion Number of Frequency of Average burden per annual burden
responses response response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L-8050-U3................... 17,044 1 10 2,841
----------------------------------------------------------------------------------------------------------------
6. You Can Make Your Payment by Credit Card--0960-0462. Using
information from Form SSA-4588 and its electronic application, Form
SSA-4589, SSA updates individuals' Social Security records to reflect
payments made on their overpayments. In addition, SSA uses this
information to process payments through the appropriate credit card
company. SSA provides the SSA-4588 when we inform an individual that we
detected an overpayment. Individuals may choose to make a one-time
payment or recurring monthly payments by completing and submitting the
SSA-4588. SSA uses the SSA-4589 electronic intranet application only
when individuals choose to telephone the Program Service Centers to
make a one-time payment in lieu of completing Form SSA-4588. An SSA
debtor contact representative completes the SSA-4589 electronic
intranet application. Respondents are OASDI beneficiaries and SSI
recipients who have outstanding overpayments.
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-4588 paper form................. 13,200 1 10 2,200
SSA-4589 electronic intranet 221,316 1 5 18,443
application........................
---------------------------------------------------------------------------
Totals.......................... 234,516 ................. ................. 20,643
----------------------------------------------------------------------------------------------------------------
7. Application for Extra Help with Medicare Prescription Drug Plan
Costs--20 CFR 418.3101--0960-0696. The Medicare Modernization Act of
2003 mandated the creation of the Medicare Part D prescription drug
coverage program and the provision of subsidies for eligible Medicare
beneficiaries. SSA uses Form SSA-1020 or the Internet i1020, the
Application for Extra Help with Medicare Prescription Drug Plan Costs,
to obtain income and resource information from Medicare beneficiaries
and to make a subsidy decision. The respondents are Medicare
beneficiaries applying for the Part D low-income subsidy.
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-1020 (paper application form)... 617,070 1 30 308,535
i1020 (online application).......... 282,228 1 25 117,595
Field Office Interview.............. 155,687 1 30 77,844
---------------------------------------------------------------------------
Totals.......................... 1,054,985 ................. ................. 503,974
----------------------------------------------------------------------------------------------------------------
[[Page 57653]]
8. Certification of Low Birth Weight for SSI Eligibility of Funds
You Provided to Another and Statement of Funds You Received--20 CFR
416.931, 416.926a(m), and 416.924--0960-0720. Hospitals and claimants
use Form SSA-3380 to provide medical information to local field offices
(FO) and DDSs on behalf of infants with low birth weight. FOs use the
form as a protective filing statement and the medical information to
make presumptive disability findings, which allow expedited payment to
eligible claimants. DDSs use the medical information to determine
disability and continuing disability. The respondents are hospitals and
claimants who have information identifying low birth weight babies and
their medical conditions.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Estimated total
Modality of completion Number of Frequency of Average burden per annual burden
respondents response response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3380........................ 28,125 1 15 7,031
----------------------------------------------------------------------------------------------------------------
Dated: September 22, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-22809 Filed 9-24-14; 8:45 am]
BILLING CODE 4191-02-P
