Agency Information Collection Activities: Proposed Request and Comment Request, 6568-6571 [2016-02353]
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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).
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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
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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)
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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
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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.
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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:
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17:51 Feb 05, 2016
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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
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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:
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]]>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]
=======================================================================
-----------------------------------------------------------------------
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
