Agency Information Collection Activities: Proposed Request and Comment Request, 36031-36035 [2015-15380]

Download as PDF 36031 Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Notices N–5 is $30,000 per filing. We continue to believe this estimate for Form N–5’s cost burden is appropriate. Therefore, we estimate that the aggregate cost burden, when calculated using the Commission’s estimate of 0.333 filings per year, is about $10,000 in external costs per year. Estimates of average burden hours and costs are made solely for the purposes of the Paperwork Reduction Act, and are not derived from a comprehensive or even representative survey or study of the costs of Commission rules and forms. Compliance with the collection of information requirements of Form N–5 is mandatory. Responses to the collection of information will not be kept confidential. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public may view the background documentation for this information collection at the following Web site, www.reginfo.gov. Comments should be directed to: (i) Desk Officer for the Securities and Exchange Commission, Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10102, New Executive Office Building, Washington, DC 20503, or by sending an email to: Shagufta_ Ahmed@omb.eop.gov; and (ii) Pamela Dyson, Chief Information Officer, Securities and Exchange Commission, c/ o Remi Pavlik-Simon, 100 F Street NE., Washington, DC 20549 or send an email to: PRA_Mailbox@sec.gov. Comments must be submitted to OMB within 30 days of this notice. Avenue, Suite 206, Wayne, PA 19087, Federal Licensees under the Small Business Investment Act of 1958, as amended (‘‘the Act’’), in connection with the financing of a small concern, has sought an exemption under section 312 of the Act and section 107.730, Financings which Constitute Conflicts of Interest of the Small Business Administration (‘‘SBA’’) Rules and Regulations (13 CFR 107.730). Boathouse Capital II, L.P. provided financing to AvidXchange, Inc., 4421 Stuart Andrew Boulevard, Suite 200, Charlotte, NC 28217. The financing was contemplated for the acquisition of Strongroom Solutions, Inc. and working capital purposes. The financing is brought within the purview of § 107.730(a)(1) of the Regulations because Boathouse Capital, L.P., an Associate of Boathouse Capital II, L.P., has the potential to own more than ten percent of AvidXchange. Therefore, this transaction is considered a financing of an Associate requiring an exemption. Notice is hereby given that any interested person may submit written comments on the transaction within fifteen days of the date of this publication to the Acting Associate Administrator for Investment, U.S. Small Business Administration, 409 Third Street SW., Washington, DC 20416. Javier Saade, Associate Administrator, Office of Investment & Innovation. [FR Doc. 2015–15349 Filed 6–22–15; 8:45 am] BILLING CODE P Dated: June 18, 2015. Brent Fields, Secretary. SOCIAL SECURITY ADMINISTRATION [FR Doc. 2015–15379 Filed 6–22–15; 8:45 am] Agency Information Collection Activities: Proposed Request and Comment Request [Docket No: SSA–2015–0035] BILLING CODE 8011–01–P SMALL BUSINESS ADMINISTRATION [License No. 03/03–0264] mstockstill on DSK4VPTVN1PROD with NOTICES Boathouse Capital II, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Boathouse Capital II, L.P., 200 West Lancaster The Social Security Administration (SSA) publishes a list of information collection packages requiring clearance by the Office of Management and Budget (OMB) in compliance with Public Law 104–13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes revisions and extensions of OMB-approved information collections. Number of respondents Modality of completion SSA–787 .......................................................................................................... VerDate Sep<11>2014 18:39 Jun 22, 2015 Jkt 235001 PO 00000 Frm 00100 Fmt 4703 Sfmt 4703 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. Or you may submit your comments online through www.regulations.gov, referencing Docket ID Number [SSA– 2015–0035]. 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 August 24, 2015. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Physician’s/Medical Officer’s Statement of Patient’s Capability to Manage Benefits—20 CFR 404.2015 and 416.615—0960–0024. SSA appoints a representative payee in cases where we determine beneficiaries are not capable of managing their own benefits. In those instances, we require medical evidence to determine the beneficiaries’ capability of managing or directing their benefit payments. SSA collects medical evidence on Form SSA–787 to (1) determine beneficiaries’ capability or inability to handle their own benefits, and (2) assist in determining the beneficiaries’ need for a representative payee. The respondents are beneficiaries’ physicians, or medical officers of the institution in which the beneficiary resides. Type of Request: Revision of an OMBapproved information collection. Frequency of response 120,000 E:\FR\FM\23JNN1.SGM 1 23JNN1 Average burden per response (minutes) 10 Estimated total annual burden (hours) 20,000 36032 Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Notices 2. State Supplementation Provisions: Agreement; Payments—20 CFR 416.2095–416.2098, 20 CFR 416.2099— 0960–0240. Section 1618 of the Social Security Act (Act) requires those states administering their own supplementary income payment program(s) to demonstrate compliance with the Act by passing Federal cost-of-living increases on to individuals who are eligible for state supplementary payments, and informing SSA of their compliance. In general, states report their supplementary payment information annually by the maintenance-ofpayment levels method. However, SSA may ask them to report up to four times in a year by the total-expenditures method. Regardless of the method, the states confirm their compliance with the requirements, and provide any changes to their optional supplementary payment rates. SSA uses the information to determine each state’s compliance or noncompliance with the pass-along requirements of the Act to determine eligibility for Medicaid reimbursement. If a state fails to keep payments at the required level, it becomes ineligible for Medicaid reimbursement under Title XIX of the Act. Respondents are state agencies administering supplemental programs. Type of Request: Extension of an OMB-approved information collection. Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Total Expenditures ........................................................................................... Maintenance of Payment Levels ..................................................................... 7 26 4 1 60 60 28 26 Total .......................................................................................................... 33 ........................ ........................ 54 3. Surveys in Accordance with E.O. 12862 for the Social Security. Administration—0960–0526. Under the auspices of E. O. 12862, Setting Customer Service Standards, SSA conducts multiple customer satisfaction surveys each year. These voluntary customer satisfaction assessments include paper, Internet, and telephone surveys; mailed questionnaires; and customer comment cards. The purpose of these questionnaires is to assess customer satisfaction with the timeliness, appropriateness, access, and overall quality of existing SSA services and proposed modifications or new Number of respondents (burden for all activities within that year) versions of services. The respondents are recipients of SSA services (including most members of the public), professionals, and individuals who work on behalf of SSA beneficiaries. Type of Request: Extension of an OMB-approved information collection. Frequency of response Burden (burden for all activities within that year; reported in hours) Range of response times (minutes) Year 1 .............................................................................................................. Year 2 .............................................................................................................. Year 3 .............................................................................................................. 7,094,640 7,100,140 7,105,640 1 1 1 3–30 3–30 3–30 1,173,904 1,174,904 1,176,004 Totals ........................................................................................................ 21,300,420 ¥ ¥ 5,722,003 1. Application for Circuit Court Law— 20 CFR 404.985 & 416.1458—0960– 0581. Persons claiming an acquiescence ruling (AR) would change SSA’s prior determination or decision must submit a written readjudication request with specific information. SSA reviews the information in the request to determine if the issues stated in the AR pertain to the claimant’s case, and if the claimant is entitled to readjudication. If readjudication is appropriate, SSA considers the issues the AR covers. Any new determination or decision is subject to administrative or judicial review as specified in the regulations. This information collection request (ICR) is for the information claimants must Number of respondents Modality of completion mstockstill on DSK4VPTVN1PROD with NOTICES AR-based Readjudication ................................................................................ Requests .......................................................................................................... 2. The Ticket to Work and SelfSufficiency Program—20 CFR 411— 0960–0644. SSA’s Ticket to Work (TTW) Program transitions Social Security Disability Insurance and SSI recipients VerDate Sep<11>2014 18:39 Jun 22, 2015 Jkt 235001 Frm 00101 Fmt 4703 Sfmt 4703 Frequency of response 10,000 toward independence by allowing them to receive Social Security payments while maintaining employment under the auspices of the program. SSA uses service providers, called employment PO 00000 provide to request readjudication. Respondents are claimants for Social Security benefits and Supplemental Security Income (SSI) payments who request readjudication. Type of Request: Extension of an OMB-approved information collection. 1 Average burden per response (minutes) 17 Estimated total annual burden (hours) 2,833 networks (ENs), to supervise participant progress through the stages of TTW Program participation, such as job searches and interviews, progress reviews, and changes in ticket status. E:\FR\FM\23JNN1.SGM 23JNN1 36033 Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Notices ENs can be private for-profit and nonprofit organizations, as well as state vocational rehabilitation agencies (VRs). SSA and the ENs utilize the TTW program manager to operate the TTW Program and exchange information about participants. For example, the ENs use the program manager to provide updates on tasks such as selecting a payment system or requesting payments for helping the beneficiary achieve certain work goals. Since the ENs are not PRA-exempt, the multiple information collections within the TTW program manager require OMB approval, and we clear them under this ICR. Most of the categories of information in this ICR are necessary for SSA to: (1) comply with the Ticket to Work legislation; and (2) provide proper Number of respondents Modality of completion oversight of the program. SSA collects this information through several modalities, including forms, electronic exchanges, and written documentation. The respondents are the ENs or state VRs, as well as SSDI beneficiaries and blind or disabled SSI recipients working under the auspices of the TTW Program. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) a) 20 CFR 411.140(d)(2)—Interactive Voice Recognition Telephone ............ a) 20 CFR 411.140(d)(2)—Portal .................................................................... a) 20 CFR 411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1365 ................. a) 20 CFR 411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1365 Portal ...... a) 20 CFR 411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1370 ................. a) 20 CFR 411.140(d)(3); 411.325(a); 411.150(b)(3)—SSA–1370 Portal ...... a) 20 CFR 411.166; 411.170(b)—Electronic File Submission ........................ b) 20 CFR 411.145; 411.325 ........................................................................... b) 20 CFR 411.145; 411.325—Portal .............................................................. b) 20 CFR 411.535(a)(1)(iii)—Data Sharing/Portal ......................................... c) 20 CFR 411.192(b)&(c) ............................................................................... c) 20 CFR 411.200(b)—SSA–1375 ................................................................. c) 20 CFR 411.200(b)—Portal ......................................................................... c) 20 CFR 411.210(b) ...................................................................................... c)20 CFR 411.200(b) Wise Webinar Registration Page ................................. c) 20 CFR 411.200(b) Virtual Job Fair Registration ........................................ d) 20 CFR 411.365; 411.505; 411.515 ........................................................... e) 20 CFR 411.325(d); 411.415 ...................................................................... f) 20 CFR 411.575—SSA–1389; SSA–1391; SSA–1393; SSA–1396; SSA– 1398; SSA–1399 .......................................................................................... f) 20 CFR 411.575—Portal .............................................................................. f) 20 CFR 411.575—Automatic Payments ...................................................... f) 20 CFR 411.560—SSA–1401 ...................................................................... g) 20 CFR 411.325(f) ...................................................................................... h) 20 CFR 411.435; 411.615; 411.625 ........................................................... i) 20 CFR 411.320—SSA–1394 ...................................................................... i) 20 CFR 411.320—SSA–1394 Portal ............................................................ 6,428 25,713 948 3,792 1,956 5,868 40,324 2,494 7,481 8,505 6 112,362 64,824 41 24,000 9,500 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2.5 1.25 15 11 60 10 5 15 11 5 30 15 5 30 3 10 10 480 268 536 237 695 1,956 978 3,360 624 1,372 709 3 28,091 5,402 21 1,200 1,583 1 8 2,805 42,075 11,220 100 1,371 2 52 158 1 1 1 1 1 1 1 1 40 22 0 20 45 120 10 5 1,870 15,428 0 33 1,028 4 9 13 Totals ........................................................................................................ 372,032 ........................ ........................ 65,429 mstockstill on DSK4VPTVN1PROD with NOTICES 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 July 23, 2015. Individuals can obtain copies of the OMB clearance packages by writing to OR.Reports.Clearance@ ssa.gov. 1. Statement of Claimant or Other Person—20 CFR 404.702 & 416.570— 0960–0045. SSA uses Form SSA–795 in special situations where there is no authorized form or questionnaire, yet we require a signed statement from the applicant, claimant, or other persons who have knowledge of facts, in connection with claims for Social Security benefits or SSI. The information we request on the SSA–795 is of sufficient importance that we need both a signed statement and a penalty clause. SSA uses this information to process, in addition to claims for benefits, issues about continuing Number of respondents Modality of completion SSA–795 .......................................................................................................... 2. Disability Report—Adult—20 CFR 404.1512 and 416.912—0960–0579. VerDate Sep<11>2014 18:39 Jun 22, 2015 Jkt 235001 Frm 00102 Fmt 4703 Sfmt 4703 Frequency of response 305,500 State Disability Determination Services (DDS) use the SSA–3368 and its PO 00000 eligibility; ongoing benefit amounts; use of funds by a representative payee; fraud investigation; and a myriad of other program-related matters. The most typical respondents are applicants for Social Security, SSI, or recipients of these programs. However, respondents also include friends and relatives of the involved parties, coworkers, neighbors, or anyone else in a position to provide information pertinent to the issue(s). Type of Request: Revision of an OMBapproved information collection. 1 Average burden per response (minutes) 15 Estimated total annual burden (hours) 76,375 electronic versions to determine if adult disability applicants’ impairments are E:\FR\FM\23JNN1.SGM 23JNN1 36034 Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Notices severe and, if so, how the impairments affect the applicants’ ability to work. This determination dictates whether the DDSs and SSA will find the applicant to be disabled and entitled to SSI payments. The respondents are applicants for Title II disability benefits or Title XVI SSI payments. Number of respondents Modality of completion Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–3368 ........................................................................................................ (Paper form) ..................................................................................................... Electronic Disability Collection System (EDCS) .............................................. i3368 (Internet) ................................................................................................ 7,571 2,484,231 1,060,360 1 1 1 90 90 90 11,357 3,726,346 1,590,540 Totals ........................................................................................................ 3,552,162 ........................ ........................ 5,328,243 3. Request for Internet Services— Authentication; Automated Telephone Speech Technology—Knowledge-Based Authentication (RISA–KBA)—20 CFR 401.45—0960–0596. The Request for Internet Services and 800# Automated Telephone Services (RISA) KnowledgeBased Authentication (KBA) is one of the authentication methods SSA uses to allow individuals access to their personal information through our Internet and Automated Telephone Services. SSA asks individuals and third parties who seek personal information from SSA records, or who register to participate in SSA’s online business services, to provide certain identifying information. As an extra measure of protection, SSA asks requestors who use the Internet and telephone services to provide additional identifying information unique to those individuals so SSA can authenticate their identities before releasing personal information. The respondents are current beneficiaries who are requesting Number of respondents Modality of completion personal information from SSA, and individuals and third parties who are registering for SSA’s online business services. This is a correction notice. SSA published this information collection as a revision on April 9, 2015 at 80 FR 19102. Since we are not revising the Privacy Act Statement, this is now an extension of an OMB-approved information collection. Type of Request: Extension of an OMB-approved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Internet Requestors ......................................................................................... Telephone Requestors .................................................................................... * Change of Address (on hold) ........................................................................ 10,373,917 1,703,367 1 1 1 ........................ 2.5 4 ........................ 432,247 113,558 1 Totals ........................................................................................................ 12,077,286 ........................ ........................ 545,806 * Reducing the burden to a one-hour placeholder burden; Screen Splash and Change of Address applications are on hold. 4. Application for Special Benefits for World War II Veterans—20 CFR 408, Subparts B, C, and D—0960–0615. Title VIII of the Act (Special Benefits for Certain World War II Veterans) allows qualified World War II veterans residing outside the United States to receive monthly payments. These regulations establish the requirements individuals need to qualify for and become entitled to Special Veterans Benefits (SVB). SSA uses Form SSA–2000–F6 to elicit the information we need to determine entitlement to SVB. This ICR comprises Number of respondents Regulations section and modality of completion the relevant regulations and Form SSA– 2006–F6. The respondents are individuals applying for SVB under Title VIII of the Act. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Total estimated annual burden (hours) 50 35 33 35 1 1 1 1 20 15 30 15 17 9 17 9 Totals ........................................................................................................ mstockstill on DSK4VPTVN1PROD with NOTICES SSA–7 .............................................................................................................. § 408.420 (a), (b) ............................................................................................. §§ 408.430 & .432 ............................................................................................ § 408.435 (a), (b), (c) ....................................................................................... 153 ........................ ........................ 52 5. Representative Payment Policies Regulation—20 CFR 404.2011(a)(1), 404.2025, 416.611(a)(1), 416.625—0960– 0679. Per 20 CFR 404.2011 and 20 CFR 416.611 of the Code of Federal VerDate Sep<11>2014 18:39 Jun 22, 2015 Jkt 235001 Regulations, if SSA determines it may cause substantial harm for Title II or Title XVI recipients to receive their payments directly, recipients may dispute that decision. To do so, PO 00000 Frm 00103 Fmt 4703 Sfmt 4703 recipients provide SSA with information the agency uses to reevaluate its determination. In addition, our regulations state that after SSA selects a representative payee to E:\FR\FM\23JNN1.SGM 23JNN1 36035 Federal Register / Vol. 80, No. 120 / Tuesday, June 23, 2015 / Notices receive benefits on a recipient’s behalf, the payees provide SSA with information on their continuing relationship and responsibility for the recipients, and explain how they use the recipients’ payments. Sections 20 CFR 404.2025 and 20 CFR 416.625 of the Code of Federal Regulations provide a process to follow up with the representative payee to verify payee Number of respondents CFR citation performance. The respondents are Title II and Title XVI recipients, and their representative payees. Type of Request: Extension of an OMB-approved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) 404.2011(a)(1); ................................................................................................ 416.611(a)(1) ................................................................................................... 404.2025; ......................................................................................................... 416.625 ............................................................................................................ 250 1 15 63 3,000 1 6 300 Totals ........................................................................................................ 3,250 ........................ ........................ 363 Faye I. Lipsky, Reports Clearance Officer, Social Security Administration. integration of all of these energy resources into plans for meeting future demands for electricity in the TVA region. It has been determined that the Council continues to be needed to provide an additional mechanism for public input regarding energy-related issues. [FR Doc. 2015–15380 Filed 6–22–15; 8:45 am] BILLING CODE 4191–02–P TENNESSEE VALLEY AUTHORITY Renewal of the Regional Energy Resource Council Charter Dated: June 15, 2015. Joseph J. Hoagland, Vice President, Stakeholder Relations, Tennessee Valley Authority. Tennessee Valley Authority (TVA). ACTION: Notice of Charter Renewal. AGENCY: [FR Doc. 2015–15422 Filed 6–22–15; 8:45 am] BILLING CODE 8120–08–P Pursuant to the Federal Advisory Committee Act (FACA) (5 U.S.C. Appendix), the TVA Board of Directors has renewed the Regional Energy Resource Council (Council) charter for an additional two-year period beginning on August 1, 2015. FOR FURTHER INFORMATION CONTACT: Beth A. Keel, 400 West Summit Hill Drive, WT 9D–K, Knoxville, Tennessee 37902– 1499, (865) 632–6113. SUPPLEMENTARY INFORMATION: Pursuant to FACA and its implementing regulations, and following consultation with the Committee Management Secretariat, General Services Administration (GSA), notice is hereby given that the Council has been renewed for a two-year period beginning August 1, 2015. The Council will provide advice to TVA on its energy related resource activities and the priorities among competing objectives and values. The Council was originally established in 2013 to advise TVA on its energy related resource activities which include the construction and operation of various supply-side resources, including fossil-fueled power plants, nuclear plants, hydroelectric dams, and renewable resources; the development and management of demand-side resources, including energy efficiency; the design, construction and operation of power delivery systems; and the Authority mstockstill on DSK4VPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 19:36 Jun 22, 2015 Jkt 235001 DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Policy for Discontinuance of World Aeronautical Chart Series Federal Aviation Administration (FAA), DOT. ACTION: Notice of policy to discontinue the World Aeronautical Chart. AGENCY: This notice announces the FAA’s decision to discontinue providing the World Aeronautical Chart series. Technological advances in aviation navigation capabilities and charting products have made the World Aeronautical Chart series largely obsolete. Charting customers have shifted towards digital chart products. The World Aeronautical Charts are a derivative product from our more detailed Sectional Aeronautical Chart series. With aviators using the more detailed large scale Sectional Aeronautical Charts and often the digital versions in the moving map technology found in modern electronic flight bag system, the World Aeronautical Charts are no longer needed. The discontinuance of this lowdemand product allows the FAA to apply those resources to continue to SUMMARY: PO 00000 Frm 00104 Fmt 4703 modernize charting for safe and efficient navigation. DATES: June 23, 2015. FOR FURTHER INFORMATION CONTACT: For questions or comments concerning this action, contact Mr. Eric Freed, Aeronautical Information Services, Enroute and Visual Charting Group, Manager, Air Traffic Organization, AJV– 5200, Federal Aviation Administration, 1305 East-West HWY, Silver Spring, MD 20910; telephone (301) 427–5080, email eric.freed@faa.gov. SUPPLEMENTARY INFORMATION: Sfmt 4703 Title 49 of the United States Code, section 44721, authorizes the FAA to arrange for the publication of aeronautical maps and charts necessary for the safe and efficient movement of aircraft in air navigation. Specifically, paragraphs (d)(2)and (3) of this section provide that that the Administrator may ‘‘ . . . (2) compile, print, and disseminate aeronautical charts and related products and services of the United States and its territories and possessions; (3) compile, print, and disseminate aeronautical charts and related products and services covering international airspace as required primarily by United Stated civil aviation . . . ’’ (See 49 U.S.C. 44721(d)(2) and (3).) Background The FAA is continuing to expand the availability and capability of modern aeronautical navigation products. At the same time, we must rigorously analyze our suite of products and determine the feasibility and practicability of providing products that are no longer in demand from the public or have become obsolete due to technological advances. Since 2007, unit sales of the World Aeronautical Charts are down 73 percent. (Sales are down 10% year over year 2013/2014.) The cost to develop E:\FR\FM\23JNN1.SGM 23JNN1

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[Federal Register Volume 80, Number 120 (Tuesday, June 23, 2015)]
[Notices]
[Pages 36031-36035]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-15380]


=======================================================================
-----------------------------------------------------------------------

SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2015-0035]


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions and extensions 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.
    Or you may submit your comments online through www.regulations.gov, 
referencing Docket ID Number [SSA-2015-0035].
    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 
August 24, 2015. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Physician's/Medical Officer's Statement of Patient's Capability 
to Manage Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA 
appoints a representative payee in cases where we determine 
beneficiaries are not capable of managing their own benefits. In those 
instances, we require medical evidence to determine the beneficiaries' 
capability of managing or directing their benefit payments. SSA 
collects medical evidence on Form SSA-787 to (1) determine 
beneficiaries' capability or inability to handle their own benefits, 
and (2) assist in determining the beneficiaries' need for a 
representative payee. The respondents are beneficiaries' physicians, or 
medical officers of the institution in which the beneficiary resides.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-787.........................................         120,000               1              10          20,000
----------------------------------------------------------------------------------------------------------------


[[Page 36032]]

    2. State Supplementation Provisions: Agreement; Payments--20 CFR 
416.2095-416.2098, 20 CFR 416.2099--0960-0240. Section 1618 of the 
Social Security Act (Act) requires those states administering their own 
supplementary income payment program(s) to demonstrate compliance with 
the Act by passing Federal cost-of-living increases on to individuals 
who are eligible for state supplementary payments, and informing SSA of 
their compliance. In general, states report their supplementary payment 
information annually by the maintenance-of-payment levels method. 
However, SSA may ask them to report up to four times in a year by the 
total-expenditures method. Regardless of the method, the states confirm 
their compliance with the requirements, and provide any changes to 
their optional supplementary payment rates. SSA uses the information to 
determine each state's compliance or noncompliance with the pass-along 
requirements of the Act to determine eligibility for Medicaid 
reimbursement. If a state fails to keep payments at the required level, 
it becomes ineligible for Medicaid reimbursement under Title XIX of the 
Act. Respondents are state agencies administering supplemental 
programs.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Total Expenditures..............................               7               4              60              28
Maintenance of Payment Levels...................              26               1              60              26
                                                 ---------------------------------------------------------------
    Total.......................................              33  ..............  ..............              54
----------------------------------------------------------------------------------------------------------------

    3. Surveys in Accordance with E.O. 12862 for the Social Security. 
Administration--0960-0526. Under the auspices of E. O. 12862, Setting 
Customer Service Standards, SSA conducts multiple customer satisfaction 
surveys each year. These voluntary customer satisfaction assessments 
include paper, Internet, and telephone surveys; mailed questionnaires; 
and customer comment cards. The purpose of these questionnaires is to 
assess customer satisfaction with the timeliness, appropriateness, 
access, and overall quality of existing SSA services and proposed 
modifications or new versions of services. The respondents are 
recipients of SSA services (including most members of the public), 
professionals, and individuals who work on behalf of SSA beneficiaries.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                      Burden
                                                     Number of                                      (burden for
                                                    respondents                                         all
                                                    (burden for    Frequency of      Range of       activities
                                                        all          response     response times   within  that
                                                    activities                       (minutes)         year;
                                                   within  that                                     reported in
                                                       year)                                          hours)
----------------------------------------------------------------------------------------------------------------
Year 1..........................................       7,094,640               1            3-30       1,173,904
Year 2..........................................       7,100,140               1            3-30       1,174,904
Year 3..........................................       7,105,640               1            3-30       1,176,004
                                                 ---------------------------------------------------------------
    Totals......................................      21,300,420               -               -       5,722,003
----------------------------------------------------------------------------------------------------------------

    1. Application for Circuit Court Law--20 CFR 404.985 & 416.1458--
0960-0581. Persons claiming an acquiescence ruling (AR) would change 
SSA's prior determination or decision must submit a written 
readjudication request with specific information. SSA reviews the 
information in the request to determine if the issues stated in the AR 
pertain to the claimant's case, and if the claimant is entitled to 
readjudication. If readjudication is appropriate, SSA considers the 
issues the AR covers. Any new determination or decision is subject to 
administrative or judicial review as specified in the regulations. This 
information collection request (ICR) is for the information claimants 
must provide to request readjudication. Respondents are claimants for 
Social Security benefits and Supplemental Security Income (SSI) 
payments who request readjudication.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
AR-based Readjudication.........................          10,000               1              17           2,833
Requests........................................
----------------------------------------------------------------------------------------------------------------

    2. The Ticket to Work and Self-Sufficiency Program--20 CFR 411--
0960-0644. SSA's Ticket to Work (TTW) Program transitions Social 
Security Disability Insurance and SSI recipients toward independence by 
allowing them to receive Social Security payments while maintaining 
employment under the auspices of the program. SSA uses service 
providers, called employment networks (ENs), to supervise participant 
progress through the stages of TTW Program participation, such as job 
searches and interviews, progress reviews, and changes in ticket 
status.

[[Page 36033]]

ENs can be private for-profit and nonprofit organizations, as well as 
state vocational rehabilitation agencies (VRs). SSA and the ENs utilize 
the TTW program manager to operate the TTW Program and exchange 
information about participants. For example, the ENs use the program 
manager to provide updates on tasks such as selecting a payment system 
or requesting payments for helping the beneficiary achieve certain work 
goals. Since the ENs are not PRA-exempt, the multiple information 
collections within the TTW program manager require OMB approval, and we 
clear them under this ICR. Most of the categories of information in 
this ICR are necessary for SSA to: (1) comply with the Ticket to Work 
legislation; and (2) provide proper oversight of the program. SSA 
collects this information through several modalities, including forms, 
electronic exchanges, and written documentation. The respondents are 
the ENs or state VRs, as well as SSDI beneficiaries and blind or 
disabled SSI recipients working under the auspices of the TTW Program.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
a) 20 CFR 411.140(d)(2)--Interactive Voice                 6,428               1             2.5             268
 Recognition Telephone..........................
a) 20 CFR 411.140(d)(2)--Portal.................          25,713               1            1.25             536
a) 20 CFR 411.140(d)(3); 411.325(a);                         948               1              15             237
 411.150(b)(3)--SSA-1365........................
a) 20 CFR 411.140(d)(3); 411.325(a);                       3,792               1              11             695
 411.150(b)(3)--SSA-1365 Portal.................
a) 20 CFR 411.140(d)(3); 411.325(a);                       1,956               1              60           1,956
 411.150(b)(3)--SSA-1370........................
a) 20 CFR 411.140(d)(3); 411.325(a);                       5,868               1              10             978
 411.150(b)(3)--SSA-1370 Portal.................
a) 20 CFR 411.166; 411.170(b)--Electronic File            40,324               1               5           3,360
 Submission.....................................
b) 20 CFR 411.145; 411.325......................           2,494               1              15             624
b) 20 CFR 411.145; 411.325--Portal..............           7,481               1              11           1,372
b) 20 CFR 411.535(a)(1)(iii)--Data Sharing/                8,505               1               5             709
 Portal.........................................
c) 20 CFR 411.192(b)&(c)........................               6               1              30               3
c) 20 CFR 411.200(b)--SSA-1375..................         112,362               1              15          28,091
c) 20 CFR 411.200(b)--Portal....................          64,824               1               5           5,402
c) 20 CFR 411.210(b)............................              41               1              30              21
c)20 CFR 411.200(b) Wise Webinar Registration             24,000               1               3           1,200
 Page...........................................
c) 20 CFR 411.200(b) Virtual Job Fair                      9,500               1              10           1,583
 Registration...................................
d) 20 CFR 411.365; 411.505; 411.515.............               6               1              10               1
e) 20 CFR 411.325(d); 411.415...................               1               1             480               8
f) 20 CFR 411.575--SSA-1389; SSA-1391; SSA-1393;           2,805               1              40           1,870
 SSA-1396; SSA-1398; SSA-1399...................
f) 20 CFR 411.575--Portal.......................          42,075               1              22          15,428
f) 20 CFR 411.575--Automatic Payments...........          11,220               1               0               0
f) 20 CFR 411.560--SSA-1401.....................             100               1              20              33
g) 20 CFR 411.325(f)............................           1,371               1              45           1,028
h) 20 CFR 411.435; 411.615; 411.625.............               2               1             120               4
i) 20 CFR 411.320--SSA-1394.....................              52               1              10               9
i) 20 CFR 411.320--SSA-1394 Portal..............             158               1               5              13
                                                 ---------------------------------------------------------------
    Totals......................................         372,032  ..............  ..............          65,429
----------------------------------------------------------------------------------------------------------------

    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 July 23, 2015. Individuals can obtain copies of the OMB 
clearance packages by writing to OR.Reports.Clearance@ssa.gov.
    1. Statement of Claimant or Other Person--20 CFR 404.702 & 
416.570--0960-0045. SSA uses Form SSA-795 in special situations where 
there is no authorized form or questionnaire, yet we require a signed 
statement from the applicant, claimant, or other persons who have 
knowledge of facts, in connection with claims for Social Security 
benefits or SSI. The information we request on the SSA-795 is of 
sufficient importance that we need both a signed statement and a 
penalty clause. SSA uses this information to process, in addition to 
claims for benefits, issues about continuing eligibility; ongoing 
benefit amounts; use of funds by a representative payee; fraud 
investigation; and a myriad of other program-related matters. The most 
typical respondents are applicants for Social Security, SSI, or 
recipients of these programs. However, respondents also include friends 
and relatives of the involved parties, coworkers, neighbors, or anyone 
else in a position to provide information pertinent to the issue(s).
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-795.........................................         305,500               1              15          76,375
----------------------------------------------------------------------------------------------------------------

    2. Disability Report--Adult--20 CFR 404.1512 and 416.912--0960-
0579. State Disability Determination Services (DDS) use the SSA-3368 
and its electronic versions to determine if adult disability 
applicants' impairments are

[[Page 36034]]

severe and, if so, how the impairments affect the applicants' ability 
to work. This determination dictates whether the DDSs and SSA will find 
the applicant to be disabled and entitled to SSI payments. The 
respondents are applicants for Title II disability benefits or Title 
XVI SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3368........................................           7,571               1              90          11,357
(Paper form)....................................
Electronic Disability Collection System (EDCS)..       2,484,231               1              90       3,726,346
i3368 (Internet)................................       1,060,360               1              90       1,590,540
                                                 ---------------------------------------------------------------
    Totals......................................       3,552,162  ..............  ..............       5,328,243
----------------------------------------------------------------------------------------------------------------

    3. Request for Internet Services--Authentication; Automated 
Telephone Speech Technology--Knowledge-Based Authentication (RISA-
KBA)--20 CFR 401.45--0960-0596. The Request for Internet Services and 
800# Automated Telephone Services (RISA) Knowledge-Based Authentication 
(KBA) is one of the authentication methods SSA uses to allow 
individuals access to their personal information through our Internet 
and Automated Telephone Services. SSA asks individuals and third 
parties who seek personal information from SSA records, or who register 
to participate in SSA's online business services, to provide certain 
identifying information. As an extra measure of protection, SSA asks 
requestors who use the Internet and telephone services to provide 
additional identifying information unique to those individuals so SSA 
can authenticate their identities before releasing personal 
information. The respondents are current beneficiaries who are 
requesting personal information from SSA, and individuals and third 
parties who are registering for SSA's online business services.
    This is a correction notice. SSA published this information 
collection as a revision on April 9, 2015 at 80 FR 19102. Since we are 
not revising the Privacy Act Statement, this is now an extension of an 
OMB-approved information collection.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Internet Requestors.............................      10,373,917               1             2.5         432,247
Telephone Requestors............................       1,703,367               1               4         113,558
* Change of Address (on hold)...................               1  ..............  ..............               1
                                                 ---------------------------------------------------------------
    Totals......................................      12,077,286  ..............  ..............         545,806
----------------------------------------------------------------------------------------------------------------
* Reducing the burden to a one-hour placeholder burden; Screen Splash and Change of Address applications are on
  hold.

    4. Application for Special Benefits for World War II Veterans--20 
CFR 408, Subparts B, C, and D--0960-0615. Title VIII of the Act 
(Special Benefits for Certain World War II Veterans) allows qualified 
World War II veterans residing outside the United States to receive 
monthly payments. These regulations establish the requirements 
individuals need to qualify for and become entitled to Special Veterans 
Benefits (SVB). SSA uses Form SSA-2000-F6 to elicit the information we 
need to determine entitlement to SVB. This ICR comprises the relevant 
regulations and Form SSA-2006-F6. The respondents are individuals 
applying for SVB under Title VIII of the Act.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                       Total
                                                     Number of     Frequency of   Average burden     estimated
 Regulations section and modality of completion     respondents      response      per  response   annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7...........................................              50               1              20              17
Sec.   408.420 (a), (b).........................              35               1              15               9
Sec.  Sec.   408.430 & .432.....................              33               1              30              17
Sec.   408.435 (a), (b), (c)....................              35               1              15               9
                                                 ---------------------------------------------------------------
    Totals......................................             153  ..............  ..............              52
----------------------------------------------------------------------------------------------------------------

    5. Representative Payment Policies Regulation--20 CFR 
404.2011(a)(1), 404.2025, 416.611(a)(1), 416.625--0960-0679. Per 20 CFR 
404.2011 and 20 CFR 416.611 of the Code of Federal Regulations, if SSA 
determines it may cause substantial harm for Title II or Title XVI 
recipients to receive their payments directly, recipients may dispute 
that decision. To do so, recipients provide SSA with information the 
agency uses to reevaluate its determination. In addition, our 
regulations state that after SSA selects a representative payee to

[[Page 36035]]

receive benefits on a recipient's behalf, the payees provide SSA with 
information on their continuing relationship and responsibility for the 
recipients, and explain how they use the recipients' payments. Sections 
20 CFR 404.2025 and 20 CFR 416.625 of the Code of Federal Regulations 
provide a process to follow up with the representative payee to verify 
payee performance. The respondents are Title II and Title XVI 
recipients, and their representative payees.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
                  CFR citation                       Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
404.2011(a)(1);.................................             250               1              15              63
416.611(a)(1)...................................
404.2025;.......................................           3,000               1               6             300
416.625.........................................
                                                 ---------------------------------------------------------------
    Totals......................................           3,250  ..............  ..............             363
----------------------------------------------------------------------------------------------------------------


Faye I. Lipsky,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-15380 Filed 6-22-15; 8:45 am]
 BILLING CODE 4191-02-P