Agency Information Collection Activities: Proposed Request and Comment Request, 43828-43830 [2015-18040]
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43828
Federal Register / Vol. 80, No. 141 / Thursday, July 23, 2015 / Notices
• Send an email to rule-comments@
sec.gov. Please include File Number SR–
ISEGemini-2015–13 on the subject line.
should refer to File Number SR–
ISEGemini-2015–13, and should be
submitted on or before August 13, 2015.
Paper Comments
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.9
Robert W. Errett,
Deputy Secretary.
• Send paper comments in triplicate
to Brent J. Fields, Secretary, Securities
and Exchange Commission, 100 F Street
NE., Washington, DC 20549–1090.
All submissions should refer to File
Number SR–ISEGemini-2015–13. 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 such
filing also will be available for
inspection and copying at the principal
office of the Exchange. 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
[FR Doc. 2015–18032 Filed 7–22–15; 8:45 am]
BILLING CODE 8011–01–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2015–0046]
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 reinstatements 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,
Number of
respondents
Modality of completion
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–
2015–0046].
I. The information collections below
are pending at SSA. SSA will submit
them to OMB within 60 days from the
date of this notice. To be sure we
consider your comments, we must
receive them no later than September
21, 2015. Individuals can obtain copies
of the collection instruments by writing
to the above email address.
1. Authorization for the Social
Security Administration to Obtain
Account Records from a Financial
Institution—20 CFR 416.200 and
416.203—0960–0293. SSA collects and
verifies financial information from
individuals applying for Supplemental
Security Income (SSI) payments to
determine if the applicant meets the SSI
resource eligibility requirements. If the
SSI claimants provide incomplete,
unavailable, or seemingly altered
records, SSA contacts their financial
institutions to verify the existence,
ownership, and value of accounts
owned. Financial institutions require
individuals to sign Form SSA–4641–F4,
or complete the e4641 electronic
application, to authorize them to
disclose records to SSA. The
respondents are SSI applicants,
recipients, and their deemors.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
252,500
15,747,500
1
1
6
2
25,250
524,917
Totals ........................................................................................................
mstockstill on DSK4VPTVN1PROD with NOTICES
SSA–4641 (paper) ...........................................................................................
e4641 (electronic) ............................................................................................
16,000,000
........................
........................
550,167
2. Site Review Questionnaire for
Volume and Fee-for-Service Payees and
Beneficiary Interview Form—20 CFR
404.2035, 404.2065, 416.665, 416.701,
and 416.708—0960–0633. SSA asks
organizational representative payees to
complete Form SSA–637, the Site
Review Questionnaire for Volume and
Fee-for-Service Payees, to provide
information on how they carry out their
9 17
responsibilities, including how they
manage beneficiary funds. SSA then
obtains information from the
beneficiaries these organizations
represent via Form SSA–639,
Beneficiary Interview Form, to
corroborate the payees’ statements. Due
to the sensitivity of the information,
SSA employees always complete the
forms based on the answers respondents
give during the interview. The
respondents are individuals, State and
local governments, non-profit and forprofit organizations serving as
representative payees, and the
beneficiaries they serve.
Type of Request: Revision of an OMBapproved information collection.
CFR 200.30–3(a)(12).
VerDate Sep<11>2014
18:39 Jul 22, 2015
Jkt 235001
PO 00000
Frm 00124
Fmt 4703
Sfmt 4703
E:\FR\FM\23JYN1.SGM
23JYN1
43829
Federal Register / Vol. 80, No. 141 / Thursday, July 23, 2015 / Notices
Number of
respondents
Modality of completion
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–637 ..........................................................................................................
SSA–639 ..........................................................................................................
1,999
8,293
1
1
120
10
3,998
1,382
Totals ........................................................................................................
10,292
........................
........................
5,380
3. Notification of a Social Security
Number (SSN) To An Employer for
Wage Reporting—20 CFR 422.103(a)—
0960–0778. Individuals applying for
employment must provide a Social
Security number (SSN), or indicate they
have applied for one. However, when an
individual applies for an initial SSN,
there is a delay between the assignment
of the number and the delivery of the
SSN card. At an individual’s request,
SSA uses Form SSA–132 to send the
individual’s SSN to an employer.
Mailing this information to the
employer: (1) ensures the employer has
the correct SSN for the individual; (2)
allows SSA to receive correct earnings
information for wage reporting
purposes; and (3) reduces the delay in
the initial SSN assignment and delivery
of the SSN information directly to the
employer. It also enables SSA to verify
the employer as a safeguard for the
applicant’s personally identifiable
information. The majority of individuals
who take advantage of this option are in
the United States with exchange visitor
and student visas; however, we allow
any applicant for an SSN to use the
SSA–132. The respondents are
individuals applying for an initial SSN
who ask SSA to mail confirmation of
their application or the SSN to their
employers.
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–132 ..........................................................................................................
298,953
1
2
9,965
4. Important Information About Your
Appeal, Waiver Rights, and Repayment
Options—20 CFR 404.502–521—0960–
0779. When SSA accidentally overpays
beneficiaries, the agency informs them
of the following rights: (1) The right to
reconsideration of the overpayment
determination; (2) the right to request a
waiver of recovery and the automatic
scheduling of a personal conference if
SSA cannot approve a request for
waiver; and (3) the availability of a
different rate of withholding when SSA
proposes the full withholding rate. SSA
uses Form SSA–3105, Important
Information About Your Appeal, Waiver
Rights, and Repayment Options, to
explain these rights to overpaid
individuals and allow them to notify
SSA of their decision(s) regarding these
rights. The respondents are overpaid
claimants requesting a waiver of
recovery for the overpayment;
reconsideration of the fact of the
overpayment; or a lesser rate of
withholding of the overpayment.
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–3105 ........................................................................................................
mstockstill on DSK4VPTVN1PROD with NOTICES
Modality of completion
80,000
1
15
20,000
II. SSA submitted the information
collections below to OMB for clearance.
Your comments regarding the
information collections would be most
useful if OMB and SSA receive them 30
days from the date of this publication.
To be sure we consider your comments,
we must receive them no later than
August 24, 2015. Individuals can obtain
copies of the OMB clearance packages
by writing to OR.Reports.Clearance@
ssa.gov.
1. Statement of Funds You Provided
to Another and Statement of Funds You
VerDate Sep<11>2014
18:39 Jul 22, 2015
Jkt 235001
Received—20 CFR 404.1520(b),
404.1571–404.1576, 404.1584–404.1593
and 416.971–416.976—0960–0059. SSA
uses Form SSA–821–BK to collect
recipient employment information to
determine whether recipients worked
after becoming disabled and, if so,
whether the work is substantial gainful
activity. SSA’s field offices use Form
SSA–821–BK to obtain work
information during the initial claims
process, the continuing disability
review process, and for SSI claims
involving work issues. SSA’s processing
PO 00000
Frm 00125
Fmt 4703
Sfmt 4703
centers and the Office of Disability and
International Operations use the form to
obtain post-adjudicative work issue
from recipients. SSA reviews and
evaluates the data to determine if the
applicant or recipient meets the
disability requirements of the law. The
respondents are applicants and
recipients of Title II Social Security and
Title XVI SSI disability payments.
Type of Request: Reinstatement with
change of a previous OMB-approved
information collection.
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43830
Federal Register / Vol. 80, No. 141 / Thursday, July 23, 2015 / Notices
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
SSA–821–BK ...................................................................................................
300,000
1
30
150,000
2. Credit Card Payment Form—0960–
0648. SSA uses Form SSA–1414 to
process: (1) Credit card payments from
former employees and vendors with
outstanding debts to the agency; (2)
advance payments for reimbursable
agreements; and (3) credit card
payments for all Freedom of Information
Act (FOIA) requests requiring payment.
The respondents are former employees
and vendors who have outstanding
debts to the agency, entities who have
Number of
respondents
Modality of completion
SSA–1414 ........................................................................................................
Date: July 19, 2015.
Faye I. Lipsky,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 2015–18040 Filed 7–22–15; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice 9199]
60-Day Notice of Proposed Information
Collection: Iraqi Citizens and Nationals
Employed by Federal Contractors and
Grantees
Notice of request for public
comment.
ACTION:
The Department of State is
seeking Office of Management and
Budget (OMB) approval for the
information collection described below.
In accordance with the Paperwork
Reduction Act of 1995, we are
requesting comments on this collection
from all interested individuals and
organizations. The purpose of this
notice is to allow 60 days for public
comment preceding submission of the
collection to OMB.
DATES: The Department will accept
comments from the public up to
September 21, 2015.
ADDRESSES: You may submit comments
by any of the following methods:
• Web: Persons with access to the
Internet may comment on this notice by
going to www.Regulations.gov. You can
search for the document by entering
‘‘Docket Number: DOS–2015–0031’’ in
the Search field. Then click the
‘‘Comment Now’’ button and complete
the comment form.
• Email: GaoY1@State.gov.
mstockstill on DSK4VPTVN1PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
18:39 Jul 22, 2015
Jkt 235001
• Title of Information Collection: Iraqi
Citizens and Nationals Employed by
Federal Contractors and Grantees.
• OMB Control Number: 1405–0184.
• Type of Request: Revision of a
Currently Approved Collection.
• Originating Office: Bureau of
Population, Refugees, and Migration,
Office of Admissions, PRM/A.
• Form Number: N/A.
• Respondents: Refugee applicants for
the U.S. Refugee Admissions Program.
• Estimated Number of Respondents:
50 Department of State contractors,
grantees, and cooperative agreement
partners.
• Estimated Number of Responses:
200.
• Average Time per Response: 30
minutes.
• Total Estimated Burden Time: 100
hours.
• Frequency: On occasion.
• Obligation to Respond: Required to
Obtain a Benefit.
PO 00000
Frm 00126
Fmt 4703
Sfmt 4703
Frequency of
response
6,000
• Regular Mail: Send written
comments to: Sophie Yan Gao, PRM/
Admissions, 2025 E Street NW., SA–9,
8th Floor, Washington, DC 20522–0908.
• Fax: (202) 453–9393.
You must include the DS form
number (if applicable), information
collection title, and the OMB control
number in any correspondence.
FOR FURTHER INFORMATION CONTACT:
Direct requests for additional
information regarding the collection
listed in this notice, including requests
for copies of the proposed collection
instrument and supporting documents,
to Sophie Yan Gao, PRM/Admissions,
2025 E Street NW., SA–9, 8th Floor,
Washington, DC 20522–0908, who may
be reached on (202) 453–9255 or at
GaoY1@state.gov.
SUPPLEMENTARY INFORMATION:
reimbursable agreements with SSA, and
individuals who request information
through FOIA.
Type of Request: Reinstatement
without change of a previous OMBapproved information collection.
1
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
2
200
We are soliciting public comments to
permit the Department to:
• Evaluate whether the proposed
information collection is necessary for
the proper functions of the Department.
• Evaluate the accuracy of our
estimate of the time and cost burden for
this proposed collection, including the
validity of the methodology and
assumptions used.
• Enhance the quality, utility, and
clarity of the information to be
collected.
• Minimize the reporting burden on
those who are to respond, including the
use of automated collection techniques
or other forms of information
technology.
Please note that comments submitted
in response to this Notice are public
record. Before including any detailed
personal information, you should be
aware that your comments as submitted,
including your personal information,
will be available for public review.
Abstract of Proposed Collection
The information requested will be
used to verify the employment of Iraqi
citizens and nationals for the processing
and adjudication of other refugee,
asylum, special immigrant visa, and
other immigration claims and
applications.
Methodology
The method for the collection of
information will be via electronic
submission. The format for compiling
the information will be the Department
of State’s eForms application which is
currently used by over 36,000
Department users worldwide.
Contracting Officers and Grants Officers
will distribute by email to the
contractors, grantees and cooperative
agreement partners under their
E:\FR\FM\23JYN1.SGM
23JYN1
]]>Agencies
[Federal Register Volume 80, Number 141 (Thursday, July 23, 2015)]
[Notices]
[Pages 43828-43830]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-18040]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2015-0046]
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 reinstatements 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-2015-0046].
I. The information collections below are pending at SSA. SSA will
submit them to OMB within 60 days from the date of this notice. To be
sure we consider your comments, we must receive them no later than
September 21, 2015. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Authorization for the Social Security Administration to Obtain
Account Records from a Financial Institution--20 CFR 416.200 and
416.203--0960-0293. SSA collects and verifies financial information
from individuals applying for Supplemental Security Income (SSI)
payments to determine if the applicant meets the SSI resource
eligibility requirements. If the SSI claimants provide incomplete,
unavailable, or seemingly altered records, SSA contacts their financial
institutions to verify the existence, ownership, and value of accounts
owned. Financial institutions require individuals to sign Form SSA-
4641-F4, or complete the e4641 electronic application, to authorize
them to disclose records to SSA. The respondents are SSI applicants,
recipients, and their deemors.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4641 (paper)................................ 252,500 1 6 25,250
e4641 (electronic).............................. 15,747,500 1 2 524,917
---------------------------------------------------------------
Totals...................................... 16,000,000 .............. .............. 550,167
----------------------------------------------------------------------------------------------------------------
2. Site Review Questionnaire for Volume and Fee-for-Service Payees
and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665,
416.701, and 416.708--0960-0633. SSA asks organizational representative
payees to complete Form SSA-637, the Site Review Questionnaire for
Volume and Fee-for-Service Payees, to provide information on how they
carry out their responsibilities, including how they manage beneficiary
funds. SSA then obtains information from the beneficiaries these
organizations represent via Form SSA-639, Beneficiary Interview Form,
to corroborate the payees' statements. Due to the sensitivity of the
information, SSA employees always complete the forms based on the
answers respondents give during the interview. The respondents are
individuals, State and local governments, non-profit and for-profit
organizations serving as representative payees, and the beneficiaries
they serve.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 43829]]
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-637......................................... 1,999 1 120 3,998
SSA-639......................................... 8,293 1 10 1,382
---------------------------------------------------------------
Totals...................................... 10,292 .............. .............. 5,380
----------------------------------------------------------------------------------------------------------------
3. Notification of a Social Security Number (SSN) To An Employer
for Wage Reporting--20 CFR 422.103(a)--0960-0778. Individuals applying
for employment must provide a Social Security number (SSN), or indicate
they have applied for one. However, when an individual applies for an
initial SSN, there is a delay between the assignment of the number and
the delivery of the SSN card. At an individual's request, SSA uses Form
SSA-132 to send the individual's SSN to an employer. Mailing this
information to the employer: (1) ensures the employer has the correct
SSN for the individual; (2) allows SSA to receive correct earnings
information for wage reporting purposes; and (3) reduces the delay in
the initial SSN assignment and delivery of the SSN information directly
to the employer. It also enables SSA to verify the employer as a
safeguard for the applicant's personally identifiable information. The
majority of individuals who take advantage of this option are in the
United States with exchange visitor and student visas; however, we
allow any applicant for an SSN to use the SSA-132. The respondents are
individuals applying for an initial SSN who ask SSA to mail
confirmation of their application or the SSN to their employers.
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-132..................................... 298,953 1 2 9,965
----------------------------------------------------------------------------------------------------------------
4. Important Information About Your Appeal, Waiver Rights, and
Repayment Options--20 CFR 404.502-521--0960-0779. When SSA accidentally
overpays beneficiaries, the agency informs them of the following
rights: (1) The right to reconsideration of the overpayment
determination; (2) the right to request a waiver of recovery and the
automatic scheduling of a personal conference if SSA cannot approve a
request for waiver; and (3) the availability of a different rate of
withholding when SSA proposes the full withholding rate. SSA uses Form
SSA-3105, Important Information About Your Appeal, Waiver Rights, and
Repayment Options, to explain these rights to overpaid individuals and
allow them to notify SSA of their decision(s) regarding these rights.
The respondents are overpaid claimants requesting a waiver of recovery
for the overpayment; reconsideration of the fact of the overpayment; or
a lesser rate of withholding of the overpayment.
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-3105.................................... 80,000 1 15 20,000
----------------------------------------------------------------------------------------------------------------
II. SSA submitted the information collections below to OMB for
clearance. Your comments regarding the information collections would be
most useful if OMB and SSA receive them 30 days from the date of this
publication. To be sure we consider your comments, we must receive them
no later than August 24, 2015. Individuals can obtain copies of the OMB
clearance packages by writing to OR.Reports.Clearance@ssa.gov.
1. Statement of Funds You Provided to Another and Statement of
Funds You Received--20 CFR 404.1520(b), 404.1571-404.1576, 404.1584-
404.1593 and 416.971-416.976--0960-0059. SSA uses Form SSA-821-BK to
collect recipient employment information to determine whether
recipients worked after becoming disabled and, if so, whether the work
is substantial gainful activity. SSA's field offices use Form SSA-821-
BK to obtain work information during the initial claims process, the
continuing disability review process, and for SSI claims involving work
issues. SSA's processing centers and the Office of Disability and
International Operations use the form to obtain post-adjudicative work
issue from recipients. SSA reviews and evaluates the data to determine
if the applicant or recipient meets the disability requirements of the
law. The respondents are applicants and recipients of Title II Social
Security and Title XVI SSI disability payments.
Type of Request: Reinstatement with change of a previous OMB-
approved information collection.
[[Page 43830]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-821-BK.................................. 300,000 1 30 150,000
----------------------------------------------------------------------------------------------------------------
2. Credit Card Payment Form--0960-0648. SSA uses Form SSA-1414 to
process: (1) Credit card payments from former employees and vendors
with outstanding debts to the agency; (2) advance payments for
reimbursable agreements; and (3) credit card payments for all Freedom
of Information Act (FOIA) requests requiring payment. The respondents
are former employees and vendors who have outstanding debts to the
agency, entities who have reimbursable agreements with SSA, and
individuals who request information through FOIA.
Type of Request: Reinstatement without change of a previous OMB-
approved information collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1414........................................ 6,000 1 2 200
----------------------------------------------------------------------------------------------------------------
Date: July 19, 2015.
Faye I. Lipsky,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-18040 Filed 7-22-15; 8:45 am]
BILLING CODE 4191-02-P
