Agency Information Collection Activities: Proposed Request and Comment Request, 6568-6571 [2016-02353]

Download as PDF 6568 Federal Register / Vol. 81, No. 25 / Monday, February 8, 2016 / Notices 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 should refer to File Number SR– NYSEMKT–2016–16, and should be submitted on or before February 29, 2016. For the Commission, by the Division of Trading and Markets, pursuant to delegated authority.17 Robert W. Errett, Deputy Secretary. [FR Doc. 2016–02330 Filed 2–5–16; 8:45 am] BILLING CODE 8011–01–P SOCIAL SECURITY ADMINISTRATION [Docket No: SSA–2016–0002] 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 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– 2016–0002]. I. The information collections below are pending at SSA. SSA will submit Number of responses Modality of completion 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 April 8, 2016. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Statement for Determining Continuing Eligibility, Supplemental Security Income Payment(s)—20 CFR 416.204—0960–0416. SSA conducts disability redeterminatons to determine if Supplemental Security Income (SSI) recipients (1) met and continue to meet all statutory and regulatory requirements for SSI eligibility and (2) are receiving the correct SSI payment amount. SSA makes these redeterminations through periodic use of Form SSA–8203BK. SSA conducts this legally mandated information collection in field offices via personal contact (face-to-face or telephone interview) using the automated Modernized SSI Claim System (MSSICS). The respondents are SSI recipients or their representative payees. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) 801,789 666,431 135,357 1 1 1 20 19 20 267,263 211,036 45,119 Totals ........................................................................................................ asabaliauskas on DSK5VPTVN1PROD with NOTICES MSSICS ........................................................................................................... MSSICS/Signature Proxy ................................................................................ Paper ............................................................................................................... 1,603,577 ........................ ........................ 523,418 2. Information About Joint Checking/ Savings Account—20 CFR 416.1201 and 416.1208—0960–0461. SSA considers a person’s resources when evaluating eligibility for SSI. Generally, we consider funds in checking and savings accounts as resources owned by the individuals whose names appear on the account. However, individuals applying for SSI may rebut this assumption of ownership in a joint account by 17 17 submitting certain evidence to establish the funds do not belong to them. SSA uses Form SSA–2574 to collect information from SSI applicants and recipients who object to the assumption that they own all or part of the funds in a joint checking or savings account bearing their names. SSA collects information about the account from both the SSI applicant or recipient and the other account holder(s). After receiving the completed form, SSA determines if we should consider the account to be a resource for the SSI applicant and recipient. The respondents are applicants and recipients of SSI, and individuals who list themselves as joint owners of financial accounts with SSI applicants or recipients. Type of Request: Revision of an OMBapproved information collection. CFR 200.30–3(a)(12). VerDate Sep<11>2014 17:51 Feb 05, 2016 Jkt 238001 PO 00000 Frm 00068 Fmt 4703 Sfmt 4703 E:\FR\FM\08FEN1.SGM 08FEN1 6569 Federal Register / Vol. 81, No. 25 / Monday, February 8, 2016 / Notices Number of responses Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–2574 Paper version ................................................................................ Intranet version (MSSICS) ............................................................................... 50,000 150,000 1 1 7 7 5,833 17,500 Totals ........................................................................................................ 200,000 ........................ ........................ 23,333 3. Plan for Achieving Self-Support (PASS)—20 CFR 416.110(e), 416.1180– 416.1182, 416.1225–416.1227—0960– 0559. The SSI program encourages recipients to return to work. One of the program objectives is to provide incentives and opportunities that help recipients toward employment. The PASS provision allows individuals to use available income or resources (such as business equipment, education, or specialized training) to enter or re-enter the workforce and become selfsupporting. In turn, SSA does not count the income or resources recipients use to fund a PASS when determining an individual’s SSI eligibility or payment amount. An SSI recipient who wants to use available income and resources to obtain education or training to become self-supporting completes Form SSA– 545. SSA uses the information from the SSA–545 to evaluate the recipient’s PASS, and to determine eligibility under the provisions of the SSI program. The respondents are SSI recipients who want to develop a return-to-work plan. 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–545 .......................................................................................................... 7,000 1 120 14,000 4. Registration for Appointed Representative Services and Direct Payment—0960–0732. SSA uses Form SSA–1699 to register appointed representatives of claimants before SSA who: • Want to register for direct payment of fees; • Registered for direct payment of fees prior to 10/31/09, but need to update their information; • Registered as appointed representatives on or after 10/31/09, but need to update their information; or • Received a notice from SSA instructing them to complete this form. By registering these individuals, SSA: (1) Authenticates and authorizes them to do business with us; (2) allows them to access our records for the claimants they represent; (3) facilitates direct payment of authorized fees to appointed representatives; and, (4) collects the information we need to meet Internal Revenue Service (IRS) requirements to issue specific IRS forms if we pay an appointed representative in excess of a specific amount ($600). The respondents are appointed representatives who want to use Form SSA–1699 for any of the purposes cited in this Notice. Type of Request: Revision of an OMBapproved information collection. Number of responses Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–1699 ........................................................................................................ asabaliauskas on DSK5VPTVN1PROD with NOTICES Modality of completion 16,000 1 20 5,333 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 March 9, 2016. Individuals can obtain copies of the OMB clearance packages by writing to OR.Reports.Clearance@ ssa.gov. 1. Certificate of Responsibility for Welfare and Care of Child Not in Applicant’s Custody—20 CFR 404.330, 404.339–404.341 and 404.348– 404.349—0960–0019. Under the provisions of the Social Security Act (Act), non-custodial parents who are filing for spouse, mother, or father Social Security benefits based on having the child of a number holder or worker in their care, must meet the in-care requirements the Act discusses. The in- care provision requires claimants to have an entitled child under age 16 or disabled in their care. SSA uses Form SSA–781, Certificate of Responsibility for Welfare and Care of Child in Applicant’s Custody, to determine if claimants meet the requirement. The respondents are applicants for spouse, mother’s or father’s Social Security benefits. 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–781 .......................................................................................................... 14,000 1 10 2,333 VerDate Sep<11>2014 17:51 Feb 05, 2016 Jkt 238001 PO 00000 Frm 00069 Fmt 4703 Sfmt 4703 E:\FR\FM\08FEN1.SGM 08FEN1 6570 Federal Register / Vol. 81, No. 25 / Monday, February 8, 2016 / Notices 2. 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 Title II and Title XVI waiver determinations, as well as those who apply for, or currently receive (in the case of redetermination) Supplemental Security Income (SSI) payments. We require the financial information from these applicants to: (1) Determine the eligibility of the applicant or recipient for Supplemental Security Income (SSI) benefits; or (2) determine if a request to waive a Social Security overpayment defeats the purpose of the Social Security Act. If the Title II and Title XVI waiver applicants, or 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 Number of responses Modality of completion need individuals to sign Form SSA– 4641–F4, or work with SSA staff to complete one of SSA’s electronic applications, e4641 or the Access to Financial Institutions (AFI) screens, to authorize the individual’s financial institution to disclose records to SSA. The respondents are Title II and Title XVI recipients applying for waivers, or SSI applicants, recipients, and their deemors to determine SSI eligibility. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–4641 (paper) ........................................................................................... e4641 and AFI (electronic) .............................................................................. 252,500 15,747,500 1 1 6 2 25,250 524,917 Totals ........................................................................................................ 16,000,000 ........................ ........................ 550,167 3. Request for Change in Time/Place of Disability Hearing—20 CFR 404.914(c)(2) and 416.1414(c)(2)—0960– 0348. At the request of the claimants or their representative, SSA schedules evidentiary hearings at the reconsideration level for claimants of Title II benefits or Title XVI payments when we deny their claims for disability. When claimants or their representatives find they are unable to attend the scheduled hearing, they complete Form SSA–769 to request a change in time or place of the hearing. SSA uses the information as a basis for granting or denying requests for changes and for rescheduling disability hearings. Respondents are claimants or their representatives who wish to request a change in the time or place of their hearing. 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–769–U4 ................................................................................................... 7,483 1 8 998 4. Notice Regarding Substitution of Party Upon Death of Claimant— Reconsideration of Disability Cessation—20 CFR 404.907–404.921 and 416.1407–416.1421—0960–0351. When a claimant dies before we make a determination on that person’s request for reconsideration of a disability cessation, SSA seeks a qualified substitute party to pursue the appeal. If SSA locates a qualified substitute party, the agency uses Form SSA–770 to collect information about whether to pursue or withdraw the reconsideration request. We use this information as the basis for the decision to continue or discontinue with the appeals process. Respondents are substitute applicants who are pursuing a reconsideration request for a deceased claimant. Type of Request: Revision of an OMBapproved information collection. Number of responses Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–770 .......................................................................................................... asabaliauskas on DSK5VPTVN1PROD with NOTICES Modality of completion 1,200 1 5 100 5. Privacy and Disclosure of Official Records and Information; Availability of Information and Records to the Public— 20 CFR 401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185—0960– 0566. SSA established methods for the public to: (1) Access their SSA records; (2) allow SSA to disclose records; (3) correct or amend their SSA records; (4) VerDate Sep<11>2014 17:51 Feb 05, 2016 Jkt 238001 consent to release of their records; (5) request records under the Freedom of Information Act (FOIA); (6) request SSA waive or reduce fees normally charges for release of FOIA; and (7) request access to an extract of their SSN record. SSA often collects the necessary information for these requests through a written letter, with the exception of the PO 00000 Frm 00070 Fmt 4703 Sfmt 4703 consent for release of records, for which we use Form SSA–3288. The respondents are individuals requesting access to, correction of, or disclosure of SSA records. Type of Request: Revision of an OMBapproved information collection. E:\FR\FM\08FEN1.SGM 08FEN1 6571 Federal Register / Vol. 81, No. 25 / Monday, February 8, 2016 / Notices Number of responses Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Access to Records ........................................................................................... Designating a Representative for Disclosure of Records ............................... Amendment of Records ................................................................................... Consent of Release of Records ...................................................................... FOIA Requests for Records ............................................................................ Waiver/Reduction of Fees ............................................................................... Respondents who request access to an extract of their SSN record ............. 10,000 3,000 100 3,000,000 15,000 400 10 1 1 1 1 1 1 1 11 2 10 3 5 5 8.5 1,833 6,000 17 150,000 1,250 33 1 Totals ........................................................................................................ 3,028,510 ........................ ........................ 159,134 6. Beneficiary Interview and Auditor’s Observations Form—0960–0630. SSA’s Office of the Inspector General collects information from Form SSA–322, the Beneficiary Interview and Auditor’s Observation form, to interview beneficiaries or their payees to determine whether they are complying with their duties and responsibilities. The respondents are randomly selected SSI recipients and Social Security beneficiaries who have representative payees. 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–322 .......................................................................................................... 1,000 1 15 250 7. International Direct Deposit—31 CFR 210—0960–0686. SSA’s International Direct Deposit (IDD) Program allows beneficiaries living abroad to receive their payments via direct deposit to an account at a financial institution outside the United States. SSA uses Form SSA–1199- (Country) to enroll Title II beneficiaries residing abroad in IDD, and to obtain the direct deposit information for foreign accounts. Routing account number information varies slightly for each foreign country, so we use a variation of the Treasury Department’s Form SF–1199A for each country. The respondents are Social Security beneficiaries residing abroad who want SSA to deposit their Title II benefit payments directly to a foreign financial institution. 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–1199–(Country) ....................................................................................... 12,500 1 5 1,041 Dated: February 3, 2016. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2016–02353 Filed 2–5–16; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice: 9437] asabaliauskas on DSK5VPTVN1PROD with NOTICES 60-Day Notice of Proposed Information Collection: Overseas Schools Grant Status Report 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 SUMMARY: VerDate Sep<11>2014 17:51 Feb 05, 2016 Jkt 238001 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 April 8, 2016. 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–2015–0066’’ in the Search field. Then click the ‘‘Comment Now’’ button and complete the comment form. • Email: millerkd2@state.gov. • Regular Mail: Send written comments to: Office of Overseas PO 00000 Frm 00071 Fmt 4703 Sfmt 4703 Schools, U.S. Department of State, 2201 C Street NW., Washington, DC 20520. • Fax: 202–261–8224 • Hand Delivery or Courier: same as mail address. You must include the DS form number, 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 Keith Miller, Department of State, Office of Overseas Schools, A/OPR/OS, Room H328, SA–1, Washington, DC 20522–0132, who may be reached on 202–261–8200 or at millerkd2@ state.gov. SUPPLEMENTARY INFORMATION: E:\FR\FM\08FEN1.SGM 08FEN1

Agencies

[Federal Register Volume 81, Number 25 (Monday, February 8, 2016)]
[Notices]
[Pages 6568-6571]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-02353]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2016-0002]


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 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-2016-0002].
    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 
April 8, 2016. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Statement for Determining Continuing Eligibility, Supplemental 
Security Income Payment(s)--20 CFR 416.204--0960-0416. SSA conducts 
disability redeterminatons to determine if Supplemental Security Income 
(SSI) recipients (1) met and continue to meet all statutory and 
regulatory requirements for SSI eligibility and (2) are receiving the 
correct SSI payment amount. SSA makes these redeterminations through 
periodic use of Form SSA-8203BK. SSA conducts this legally mandated 
information collection in field offices via personal contact (face-to-
face or telephone interview) using the automated Modernized SSI Claim 
System (MSSICS). The respondents are SSI recipients or their 
representative payees.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                     responses       response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
MSSICS..........................................         801,789               1              20         267,263
MSSICS/Signature Proxy..........................         666,431               1              19         211,036
Paper...........................................         135,357               1              20          45,119
                                                 ---------------------------------------------------------------
    Totals......................................       1,603,577  ..............  ..............         523,418
----------------------------------------------------------------------------------------------------------------

    2. Information About Joint Checking/Savings Account--20 CFR 
416.1201 and 416.1208--0960-0461. SSA considers a person's resources 
when evaluating eligibility for SSI. Generally, we consider funds in 
checking and savings accounts as resources owned by the individuals 
whose names appear on the account. However, individuals applying for 
SSI may rebut this assumption of ownership in a joint account by 
submitting certain evidence to establish the funds do not belong to 
them. SSA uses Form SSA-2574 to collect information from SSI applicants 
and recipients who object to the assumption that they own all or part 
of the funds in a joint checking or savings account bearing their 
names. SSA collects information about the account from both the SSI 
applicant or recipient and the other account holder(s). After receiving 
the completed form, SSA determines if we should consider the account to 
be a resource for the SSI applicant and recipient. The respondents are 
applicants and recipients of SSI, and individuals who list themselves 
as joint owners of financial accounts with SSI applicants or 
recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 6569]]



----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                     responses       response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2574 Paper version..........................          50,000               1               7           5,833
Intranet version (MSSICS).......................         150,000               1               7          17,500
                                                 ---------------------------------------------------------------
    Totals......................................         200,000  ..............  ..............          23,333
----------------------------------------------------------------------------------------------------------------

    3. Plan for Achieving Self-Support (PASS)--20 CFR 416.110(e), 
416.1180-416.1182, 416.1225-416.1227--0960-0559. The SSI program 
encourages recipients to return to work. One of the program objectives 
is to provide incentives and opportunities that help recipients toward 
employment. The PASS provision allows individuals to use available 
income or resources (such as business equipment, education, or 
specialized training) to enter or re-enter the workforce and become 
self-supporting. In turn, SSA does not count the income or resources 
recipients use to fund a PASS when determining an individual's SSI 
eligibility or payment amount. An SSI recipient who wants to use 
available income and resources to obtain education or training to 
become self-supporting completes Form SSA-545. SSA uses the information 
from the SSA-545 to evaluate the recipient's PASS, and to determine 
eligibility under the provisions of the SSI program. The respondents 
are SSI recipients who want to develop a return-to-work plan.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-545.....................................           7,000                1              120           14,000
----------------------------------------------------------------------------------------------------------------

    4. Registration for Appointed Representative Services and Direct 
Payment--0960-0732. SSA uses Form SSA-1699 to register appointed 
representatives of claimants before SSA who:
     Want to register for direct payment of fees;
     Registered for direct payment of fees prior to 10/31/09, 
but need to update their information;
     Registered as appointed representatives on or after 10/31/
09, but need to update their information; or
     Received a notice from SSA instructing them to complete 
this form.
    By registering these individuals, SSA: (1) Authenticates and 
authorizes them to do business with us; (2) allows them to access our 
records for the claimants they represent; (3) facilitates direct 
payment of authorized fees to appointed representatives; and, (4) 
collects the information we need to meet Internal Revenue Service (IRS) 
requirements to issue specific IRS forms if we pay an appointed 
representative in excess of a specific amount ($600). The respondents 
are appointed representatives who want to use Form SSA-1699 for any of 
the purposes cited in this Notice.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1699....................................          16,000                1               20            5,333
----------------------------------------------------------------------------------------------------------------

    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 March 9, 2016. Individuals can obtain copies of the OMB 
clearance packages by writing to OR.Reports.Clearance@ssa.gov.
    1. Certificate of Responsibility for Welfare and Care of Child Not 
in Applicant's Custody--20 CFR 404.330, 404.339-404.341 and 404.348-
404.349--0960-0019. Under the provisions of the Social Security Act 
(Act), non-custodial parents who are filing for spouse, mother, or 
father Social Security benefits based on having the child of a number 
holder or worker in their care, must meet the in-care requirements the 
Act discusses. The in-care provision requires claimants to have an 
entitled child under age 16 or disabled in their care. SSA uses Form 
SSA-781, Certificate of Responsibility for Welfare and Care of Child in 
Applicant's Custody, to determine if claimants meet the requirement. 
The respondents are applicants for spouse, mother's or father's Social 
Security benefits.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-781.....................................          14,000                1               10            2,333
----------------------------------------------------------------------------------------------------------------


[[Page 6570]]

    2. 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 Title II and Title XVI waiver 
determinations, as well as those who apply for, or currently receive 
(in the case of redetermination) Supplemental Security Income (SSI) 
payments. We require the financial information from these applicants 
to: (1) Determine the eligibility of the applicant or recipient for 
Supplemental Security Income (SSI) benefits; or (2) determine if a 
request to waive a Social Security overpayment defeats the purpose of 
the Social Security Act. If the Title II and Title XVI waiver 
applicants, or 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 need individuals to sign Form SSA-4641-F4, or work with 
SSA staff to complete one of SSA's electronic applications, e4641 or 
the Access to Financial Institutions (AFI) screens, to authorize the 
individual's financial institution to disclose records to SSA. The 
respondents are Title II and Title XVI recipients applying for waivers, 
or SSI applicants, recipients, and their deemors to determine SSI 
eligibility.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                     responses       response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4641 (paper)................................         252,500               1               6          25,250
e4641 and AFI (electronic)......................      15,747,500               1               2         524,917
                                                 ---------------------------------------------------------------
    Totals......................................      16,000,000  ..............  ..............         550,167
----------------------------------------------------------------------------------------------------------------

    3. Request for Change in Time/Place of Disability Hearing--20 CFR 
404.914(c)(2) and 416.1414(c)(2)--0960-0348. At the request of the 
claimants or their representative, SSA schedules evidentiary hearings 
at the reconsideration level for claimants of Title II benefits or 
Title XVI payments when we deny their claims for disability. When 
claimants or their representatives find they are unable to attend the 
scheduled hearing, they complete Form SSA-769 to request a change in 
time or place of the hearing. SSA uses the information as a basis for 
granting or denying requests for changes and for rescheduling 
disability hearings. Respondents are claimants or their representatives 
who wish to request a change in the time or place of their hearing.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-769-U4..................................           7,483                1                8              998
----------------------------------------------------------------------------------------------------------------

    4. Notice Regarding Substitution of Party Upon Death of Claimant--
Reconsideration of Disability Cessation--20 CFR 404.907-404.921 and 
416.1407-416.1421--0960-0351. When a claimant dies before we make a 
determination on that person's request for reconsideration of a 
disability cessation, SSA seeks a qualified substitute party to pursue 
the appeal. If SSA locates a qualified substitute party, the agency 
uses Form SSA-770 to collect information about whether to pursue or 
withdraw the reconsideration request. We use this information as the 
basis for the decision to continue or discontinue with the appeals 
process. Respondents are substitute applicants who are pursuing a 
reconsideration request for a deceased claimant.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-770.....................................           1,200                1                5              100
----------------------------------------------------------------------------------------------------------------

    5. Privacy and Disclosure of Official Records and Information; 
Availability of Information and Records to the Public--20 CFR 
401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185--0960-0566. SSA 
established methods for the public to: (1) Access their SSA records; 
(2) allow SSA to disclose records; (3) correct or amend their SSA 
records; (4) consent to release of their records; (5) request records 
under the Freedom of Information Act (FOIA); (6) request SSA waive or 
reduce fees normally charges for release of FOIA; and (7) request 
access to an extract of their SSN record. SSA often collects the 
necessary information for these requests through a written letter, with 
the exception of the consent for release of records, for which we use 
Form SSA-3288. The respondents are individuals requesting access to, 
correction of, or disclosure of SSA records.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 6571]]



----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total annual
             Modality of completion                  responses       response      per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Access to Records...............................          10,000               1              11           1,833
Designating a Representative for Disclosure of             3,000               1               2           6,000
 Records........................................
Amendment of Records............................             100               1              10              17
Consent of Release of Records...................       3,000,000               1               3         150,000
FOIA Requests for Records.......................          15,000               1               5           1,250
Waiver/Reduction of Fees........................             400               1               5              33
Respondents who request access to an extract of               10               1             8.5               1
 their SSN record...............................
                                                 ---------------------------------------------------------------
    Totals......................................       3,028,510  ..............  ..............         159,134
----------------------------------------------------------------------------------------------------------------

    6. Beneficiary Interview and Auditor's Observations Form--0960-
0630. SSA's Office of the Inspector General collects information from 
Form SSA-322, the Beneficiary Interview and Auditor's Observation form, 
to interview beneficiaries or their payees to determine whether they 
are complying with their duties and responsibilities. The respondents 
are randomly selected SSI recipients and Social Security beneficiaries 
who have representative payees.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-322.....................................           1,000                1               15              250
----------------------------------------------------------------------------------------------------------------

    7. International Direct Deposit--31 CFR 210--0960-0686. SSA's 
International Direct Deposit (IDD) Program allows beneficiaries living 
abroad to receive their payments via direct deposit to an account at a 
financial institution outside the United States. SSA uses Form SSA-
1199-(Country) to enroll Title II beneficiaries residing abroad in IDD, 
and to obtain the direct deposit information for foreign accounts. 
Routing account number information varies slightly for each foreign 
country, so we use a variation of the Treasury Department's Form SF-
1199A for each country. The respondents are Social Security 
beneficiaries residing abroad who want SSA to deposit their Title II 
benefit payments directly to a foreign financial institution.
    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
                                                 responses         response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1199-(Country)..........................          12,500                1                5            1,041
----------------------------------------------------------------------------------------------------------------


    Dated: February 3, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-02353 Filed 2-5-16; 8:45 am]
BILLING CODE 4191-02-P