Agency Information Collection Activities: Proposed Request and Comment Request, 21291-21294 [2017-09084]

Download as PDF Federal Register / Vol. 82, No. 86 / Friday, May 5, 2017 / Notices those that may be withheld from the public in accordance with the provisions of 5 U.S.C. 552, will be available for Web site viewing and printing in the Commission’s Public Reference Room, 100 F Street NE., Washington, DC 20549, on official business days between the hours of 10:00 a.m. and 3:00 p.m. Copies of the filing also will be available for inspection and copying at the principal office of 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–MIAX– 2017–16 and should be submitted on or before May 26, 2017. For the Commission, by the Division of Trading and Markets, pursuant to delegated authority.16 Eduardo A. Aleman, Assistant Secretary. [FR Doc. 2017–09062 Filed 5–4–17; 8:45 am] BILLING CODE 8011–01–P address listed above or other locally announced locations. The following areas have been determined to be adversely affected by the disaster: Primary Counties: Payette, Washington Contiguous Counties: Idaho: Adams, Canyon, Gem Oregon: Baker, Malheur The Interest Rates are: Percent Businesses and Small Agricultural Cooperatives without Credit Available Elsewhere .................. Non Profit Organizations without Credit Available Elsewhere ....... 3.125 The number assigned to this disaster for economic injury is 151230. The States which received an EIDL Declaration # are IDAHO, OREGON. (Catalog of Federal Domestic Assistance Number 59008) Dated: April 27, 2017. Linda E. McMahon, Administrator. BILLING CODE 8025–01–P SMALL BUSINESS ADMINISTRATION [Disaster Declaration #15123] SMALL BUSINESS ADMINISTRATION Idaho Disaster #ID–00064 Declaration of Economic Injury [Disaster Declaration #14856] Small Business Administration. ACTION: Notice. This is a notice of an Economic Injury Disaster Loan (EIDL) declaration for the State of IDAHO, dated 04/27/2017. Incident: Severe Winter Storms. Incident Period: 12/22/2016 through 01/19/2017. DATES: Effective 04/27/2017. EIDL Loan Application Deadline Date: 01/29/2018. ADDRESSES: Submit completed loan applications to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155. FOR FURTHER INFORMATION CONTACT: Alan Escobar, Office of Disaster Assistance, U.S. Small Business Administration, 409 3rd Street SW., Suite 6050, Washington, DC 20416, (202) 205–6734. SUPPLEMENTARY INFORMATION: Notice is hereby given that as a result of the Administrator’s EIDL declaration, applications for economic injury disaster loans may be filed at the SRADOVICH on DSK3GMQ082PROD with NOTICES SUMMARY: 16 17 CFR 200.30–3(a)(12). VerDate Sep<11>2014 17:43 May 04, 2017 Jkt 241001 Montana Disaster #MT–00099 Declaration of Economic Injury U.S. Small Business Administration. ACTION: Amendment 1. AGENCY: This is an amendment of the Economic Injury Disaster Loan (EIDL) declaration for the State of Montana, dated 09/20/2016. Incident: River Conditions Resulting in the Closure of the Yellowstone River. Incident Period: 08/19/2016 through 09/22/2016. Effective Date: 04/28/2017. EIDL Loan Application Deadline Date: 06/20/2017. ADDRESSES: Submit completed loan applications to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155. FOR FURTHER INFORMATION CONTACT: A. Escobar, Office of Disaster Assistance, U.S. Small Business Administration, 409 3rd Street SW., Suite 6050, Washington, DC 20416, (202) 205–6734. SUPPLEMENTARY INFORMATION: The notice of an Economic Injury declaration for the State of MONTANA dated 09/20/ 2016 is hereby amended to establish the incident period for this disaster as SUMMARY: PO 00000 Frm 00106 Fmt 4703 Sfmt 4703 beginning 08/19/2016 and continuing through 09/22/2016. All other information in the original declaration remains unchanged. (Catalog of Federal Domestic Assistance Number 59008) Dated: April 28, 2017. Linda E. McMahon, Administrator. [FR Doc. 2017–09064 Filed 5–4–17; 8:45 am] BILLING CODE 8025–01–P SOCIAL SECURITY ADMINISTRATION [Docket No: SSA–2017–0023] 2.500 [FR Doc. 2017–09066 Filed 5–4–17; 8:45 am] AGENCY: 21291 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– 2017–0023]. I. The information collection below is pending at SSA. SSA will submit it 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 July 5, 2017. Individuals can obtain copies of the collection instruments by writing to the above email address. E:\FR\FM\05MYN1.SGM 05MYN1 21292 Federal Register / Vol. 82, No. 86 / Friday, May 5, 2017 / Notices in the IAR agreement for the purposes of SSA verifying transactions covered under the agreement. • Third Party Disclosure Requirements (j)—Each participating IAR agency agrees to send written notices from the IAR agency to the recipient regarding payment amounts and appeal rights. • Periodic Review of Agency Accounting Process (k–m)—The IAR agency makes the IAR accounting records of paid cases available for SSA review and verification. SSA conducts reviews either onsite or through the mail of the authorization forms, notices to the claimant and accounting forms. Upon completion of the review, SSA provides a written report of findings to the IAR agency director. The respondents are State IAR officers. Type of Request: Revision of an OMBapproved information collection. agreement with SSA need to meet the following requirements: • Reporting Requirements—Each IAR agency agrees to: Æ (a) Notify SSA of receipt of an authorization for initial claims or cases they are appealing, and (b) submit a copy of that authorization either through a manual or electronic process; Æ (c) inform SSA of the amount of reimbursement; Æ (d) submit a written request for dispute resolution on a determination; Æ (e) notify SSA of interim assistance paid (using the SSA–8125 or the SSA– L8125–F6); Æ (f) inform SSA of any deceased claimants who participate in the IAR program and; Æ (g) review and sign an agreement with SSA. • Recordkeeping Requirements (h & i)—The IAR agencies agree to retain all notices, agreement, authorizations, and accounting forms for the period defined SSI Notice of Interim Assistance Reimbursement (IAR)—0960–0546. Section 1631(g) of the Social Security Act (Act) authorizes SSA to reimburse an IAR agency from an individual’s retroactive Supplemental Security Income (SSI) payment for assistance the IAR agency gave the individual for meeting basic needs while an SSI claim was pending or SSI payments were suspended or terminated. The State or local agency needs an IAR agreement with SSA to participate in the IAR program. The individual receiving the IAR payment signs an authorization form with an IAR agency to allow SSA to repay the IAR agency for funds paid in advance prior to SSA’s determination on the individual’s claim. The authorization represents the individual’s intent to file for SSI, if they did not file an application prior to SSA receiving the authorization. Agencies who wish to enter into an IAR REPORTING REQUIREMENTS Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Number of responses Estimated total annual burden (hours) (a) State notification of receipt of authorization (Electronic Process). (b) State submission of copy of authorization (Manual Process). (c) State submission of amount of IA paid to recipients (using eIAR). (d) State request for determination—dispute resolution. (e) State computation of reimbursement due form SSA using paper Form SSA–L8125–F6. (f) State notification to SSA of deceased claimant 11 Once per SSI claimant 97,330 1 1,622 27 Once per SSI claimant 68,405 3 3,420 38 Once per SSI claimant 101,352 8 13,514 ( 1) As needed .................... 2 30 1 38 Once per SSI claimant 1,524 30 762 20 40 15 10 (g) State reviewing/signing of IAR Agreement ..... 38 As needed when SSI claimant dies while claim is pending. Once during life of the IAR agreement. 38 2 12 456 3 165,735 3 8,287 101,352 3 5,068 101,352 7 11,824 12 3 36 12 16 192 6 4 24 Recordkeeping Requirements (h) Maintenance of authorization forms ................ 38 (i) Maintenance of accounting forms and notices 38 One form per SSI claimant. One form per SSI claimant. Third Party Disclosure Requirements (j) Written notice from State to recipient regarding amount of payment. 38 Once per SSI claimant SRADOVICH on DSK3GMQ082PROD with NOTICES Periodic Review of Agency Accounting Process (k) Retrieve and consolidate authorization and accounting forms. 12 (l) Participate in periodic review ........................... 12 (m) Correct administrative and accounting discrepancies. 6 VerDate Sep<11>2014 17:43 May 04, 2017 Jkt 241001 PO 00000 Frm 00107 One set of forms per SSI claimant for review by SSA once every 2 to 3 years. For review by SSA once every 2 to 3 years. To correct errors discovered by SSA in periodic review. Fmt 4703 Sfmt 4703 E:\FR\FM\05MYN1.SGM 05MYN1 21293 Federal Register / Vol. 82, No. 86 / Friday, May 5, 2017 / Notices REPORTING REQUIREMENTS—Continued Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Number of responses Estimated total annual burden (hours) Total Administrative Burden Totals ............................................................. II. SSA submitted the information collections below to OMB for clearance. Your comments regarding these 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 June 5, 2017. Individuals can obtain copies of the OMB clearance packages by writing to OR.Reports.Clearance@ssa.gov. 1. Statement Regarding Marriage—20 CFR 404.726—0960–0017. According to Section 216(h)(1)(A) of the Act, SSA 38 ....................................... must apply state law when determining an individual’s marital status. Some state laws recognize marriages without a ceremony (i.e., common-law marriages). In such cases, SSA provides the same spouse or widow(er) benefits to the common-law spouses as it does to ceremonially married spouses. To determine common-law spouses, SSA must elicit information from blood relatives or other persons who are knowledgeable about the alleged common-law relationship. SSA uses Form SSA–753, Statement Regarding Marriage, to collect information from Number of respondents Modality of completion SSA–753 .......................................................................................................... 2. Statement of Income and Resources—20 CFR 416.207, 146.301– 416.310, 416.704, and 416.708—0960– 0124. SSA collects information about income and resources for SSI claims and redeterminations on the SSA–8010–BK. Number of respondents SRADOVICH on DSK3GMQ082PROD with NOTICES SSA–8010–BK ................................................................................................. 3. Claimant’s Work Background—20 CFR 404.1512(a); 404.1520(a)(4); 404.1565(b); 416.912(a); 416.920(a)(4); 416.965(b)—0960–0300. Sections 205(a) and 1631(e) of the Act provide the Commissioner of Social Security with the authority to establish procedures for determining if a claimant is entitled to disability benefits. The administrative law judge (ALJ) may ask individuals to provide background information on Form HA–4633 about work they performed in the past 15 years. When a 1 Average of about 2 States per year. VerDate Sep<11>2014 17:43 May 04, 2017 Jkt 241001 2 Hours. PO 00000 Frm 00108 1 Sfmt 4703 45,216 Estimated total annual burden (hours) 9 6,000 available) to SSI applicants or recipients. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Frequency of response 1 26 Estimated total annual burden (hours) 147,767 provide a reference for the ALJ to discuss the claimant’s work history. The ALJ makes the completed HA–4633 part of the documentary evidence of record. The respondents are claimants for disability benefits under Title II or Title XVI who requested a hearing before an ALJ after SSA denied their application for disability payment. Type of Request: Revision of an OMBapproved information collection. 3 Includes Fmt 4703 Average burden per response (minutes) Frequency of response 341,000 claimant requests a hearing before an ALJ to establish an entitlement to disability benefits, the ALJ may request that the claimant provide a work history to assist the ALJ in fully inquiring into statutory issues related to the disability. The ALJ uses the information collected from the claimants on Form HA–4633 to: (1) Identify the claimant’s relevant work history; (2) decide if SSA requires expert vocational testimony and, if so, have a vocational expert available to testify during the hearing; and (3) ........................ third parties to verify the applicant’s statements about intent, cohabitation, and holding out to the public as married, which are the basic tenets of a common-law marriage. SSA uses the information to determine if a valid marital relationship exists, and if the common-law spouse is entitled to Social Security spouse or widow(er) benefits. The respondents are third parties who can confirm or deny the alleged common-law marriage. Type of Request: Revision of an OMBapproved information collection. 40,000 SSA uses the information to make initial or continuing eligibility determinations for SSI claimants or recipients who are subject to deeming. The respondents are people whose income and resources SSA may deem (consider to be Modality of completion 639,160 E:\FR\FM\05MYN1.SGM both denied and approved SSI claims. 05MYN1 21294 Federal Register / Vol. 82, No. 86 / Friday, May 5, 2017 / Notices Number of respondents Modality of completion Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) HA–4633—PDF/paper version ........................................................................ Electronic Records Express ............................................................................ 20,000 180,000 1 1 15 15 5,000 45,000 Total .......................................................................................................... 200,000 ........................ ........................ 50,000 4. Social Security Administration Eligible Non-Attorney Representative— 20 CFR 404.1717, 404.1745–404.1799, 416.1517, and 416.1545–416.1599— 0960–0699. Section 3 of the Social Security Disability Applicants Access to Professional Representation Act (PRA) of 2010, Public Law 111–142, permanently extends the direct payment provision of Section 303 of the Social Security Protection Act (SSPA) of 2004, Public Law 108–203. The PRA permits SSA to extend direct payment of approved fees from claimants’ past-due benefits to certain non-attorney representatives. Prior to the enactment of the SSPA and PRA, only attorneys could receive direct payment of SSAapproved fees. Under the PRA, nonattorneys must meet certain prerequisites to be eligible for direct payment of fees. These prerequisites include: (1) A bachelor’s degree from an accredited institution of higher education, or four years of relevant professional experience and a high school diploma or General Education Development certificate; (2) passing a written examination administered by SSA testing the knowledge of relevant provisions of the Act under Titles II and XVI; (3) securing and maintaining continuous professional liability insurance, or equivalent, to protect claimants from malpractice; (4) passing a criminal background check; (5) demonstrating ongoing completion of continuing education courses. The PRA requires SSA to collect the information needed to determine if applicants have satisfied these prerequisites. SSA uses the information we collect on Form Number of respondents Modality of completion New Respondents—Paper Application (complete and submit)— 404.1717(b)&(c); 416.1517(b)&(c) ............................................................... New Respondents Examination—404.1717(a)(5); 416.1517(a)(5) ................. New Respondents—Submission of proof of Bachelor’s Degree or Equivalent Qualifications—404.1717(a)(3); 416.1517(a)(3) .................................... New and Existing Respondents—CE Submission via email/mail/or FAX of training courses taken as prescribed by SSA—404.1717(a)(7); 416.1517(a)(7) .............................................................................................. New and Existing Respondents—Proof of Continuous Professional or Business Liability Insurance Coverage (Scan and Email)—404.1717(a)(6); 416.1517(a)(6) .............................................................................................. New and Existing Respondents—Proof of Continuous Professional or Business Liability Insurance Coverage (Copy and Mail)—404.1717(a)(6); 416.1517(a)(6) .............................................................................................. New and Existing Respondents—Written Protests—404.1717(d); 416.1517(d) .................................................................................................. Totals ........................................................................................................ SRADOVICH on DSK3GMQ082PROD with NOTICES Dated: May 2, 2017. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2017–09084 Filed 5–4–17; 8:45 am] BILLING CODE 4191–02–P 45 120 150 400 200 1 10 33 710 1 20 237 672 1 10 112 38 1 15 10 45 1 45 34 2,065 ........................ ........................ 976 [Public Notice: 9974] 30-Day Notice of Proposed Information Collection: Evacuee Manifest and Promissory Note Notice of request for public comment and submission to OMB of proposed collection of information. The Department of State has submitted the information collection 17:43 May 04, 2017 Jkt 241001 PO 00000 Frm 00109 Fmt 4703 Sfmt 4703 Estimated total annual burden (hours) 1 1 ACTION: VerDate Sep<11>2014 Average burden per response (minutes) Frequency of response 200 200 DEPARTMENT OF STATE SUMMARY: SSA–1691 to determine whether an applicant has fulfilled the statutory prerequisites and regulatory requirements as listed above. To verify this information, we also request the five required items listed above from each new applicant, and we request items #3 and #5 from all non-attorney representatives (new and existing) on a yearly basis. Every year, SSA evaluates the applications, conducts verification investigations, and issues recommendations regarding applicants’ eligibility to sit for the examination and eligibility to receive direct payment. The respondents are non-attorneys who want to receive direct payment of their fees for representational services before SSA Type of Request: Revision of an OMBapproved information collection. described below to the Office of Management and Budget (OMB) for approval. 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 30 days for public comment. DATES: Submit comments directly to the Office of Management and Budget (OMB) up to June 5, 2017. ADDRESSES: E:\FR\FM\05MYN1.SGM 05MYN1

Agencies

[Federal Register Volume 82, Number 86 (Friday, May 5, 2017)]
[Notices]
[Pages 21291-21294]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-09084]


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-----------------------------------------------------------------------

SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2017-0023]


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-2017-0023].
    I. The information collection below is pending at SSA. SSA will 
submit it 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 July 
5, 2017. Individuals can obtain copies of the collection instruments by 
writing to the above email address.

[[Page 21292]]

    SSI Notice of Interim Assistance Reimbursement (IAR)--0960-0546. 
Section 1631(g) of the Social Security Act (Act) authorizes SSA to 
reimburse an IAR agency from an individual's retroactive Supplemental 
Security Income (SSI) payment for assistance the IAR agency gave the 
individual for meeting basic needs while an SSI claim was pending or 
SSI payments were suspended or terminated. The State or local agency 
needs an IAR agreement with SSA to participate in the IAR program. The 
individual receiving the IAR payment signs an authorization form with 
an IAR agency to allow SSA to repay the IAR agency for funds paid in 
advance prior to SSA's determination on the individual's claim. The 
authorization represents the individual's intent to file for SSI, if 
they did not file an application prior to SSA receiving the 
authorization. Agencies who wish to enter into an IAR agreement with 
SSA need to meet the following requirements:
     Reporting Requirements--Each IAR agency agrees to:
    [cir] (a) Notify SSA of receipt of an authorization for initial 
claims or cases they are appealing, and (b) submit a copy of that 
authorization either through a manual or electronic process;
    [cir] (c) inform SSA of the amount of reimbursement;
    [cir] (d) submit a written request for dispute resolution on a 
determination;
    [cir] (e) notify SSA of interim assistance paid (using the SSA-8125 
or the SSA-L8125-F6);
    [cir] (f) inform SSA of any deceased claimants who participate in 
the IAR program and;
    [cir] (g) review and sign an agreement with SSA.
     Recordkeeping Requirements (h & i)--The IAR agencies agree 
to retain all notices, agreement, authorizations, and accounting forms 
for the period defined in the IAR agreement for the purposes of SSA 
verifying transactions covered under the agreement.
     Third Party Disclosure Requirements (j)--Each 
participating IAR agency agrees to send written notices from the IAR 
agency to the recipient regarding payment amounts and appeal rights.
     Periodic Review of Agency Accounting Process (k-m)--The 
IAR agency makes the IAR accounting records of paid cases available for 
SSA review and verification. SSA conducts reviews either onsite or 
through the mail of the authorization forms, notices to the claimant 
and accounting forms. Upon completion of the review, SSA provides a 
written report of findings to the IAR agency director.
    The respondents are State IAR officers.
    Type of Request: Revision of an OMB-approved information 
collection.

                                             Reporting Requirements
----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
    Modality of completion         Number of      Frequency of       Number of     per response    total annual
                                  respondents       response         responses       (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
(a) State notification of                   11  Once per SSI              97,330               1           1,622
 receipt of authorization                        claimant.
 (Electronic Process).
(b) State submission of copy                27  Once per SSI              68,405               3           3,420
 of authorization (Manual                        claimant.
 Process).
(c) State submission of amount              38  Once per SSI             101,352               8          13,514
 of IA paid to recipients                        claimant.
 (using eIAR).
(d) State request for                    (\1\)  As needed.......               2              30               1
 determination--dispute
 resolution.
(e) State computation of                    38  Once per SSI               1,524              30             762
 reimbursement due form SSA                      claimant.
 using paper Form SSA-L8125-F6.
(f) State notification to SSA               20  As needed when                40              15              10
 of deceased claimant.                           SSI claimant
                                                 dies while
                                                 claim is
                                                 pending.
(g) State reviewing/signing of              38  Once during life              38          \2\ 12             456
 IAR Agreement.                                  of the IAR
                                                 agreement.
----------------------------------------------------------------------------------------------------------------
                                           Recordkeeping Requirements
----------------------------------------------------------------------------------------------------------------
(h) Maintenance of                          38  One form per SSI     \3\ 165,735               3           8,287
 authorization forms.                            claimant.
(i) Maintenance of accounting               38  One form per SSI         101,352               3           5,068
 forms and notices.                              claimant.
----------------------------------------------------------------------------------------------------------------
                                       Third Party Disclosure Requirements
----------------------------------------------------------------------------------------------------------------
(j) Written notice from State               38  Once per SSI             101,352               7          11,824
 to recipient regarding amount                   claimant.
 of payment.
----------------------------------------------------------------------------------------------------------------
                                  Periodic Review of Agency Accounting Process
----------------------------------------------------------------------------------------------------------------
(k) Retrieve and consolidate                12  One set of forms              12               3              36
 authorization and accounting                    per SSI
 forms.                                          claimant for
                                                 review by SSA
                                                 once every 2 to
                                                 3 years.
(l) Participate in periodic                 12  For review by                 12              16             192
 review.                                         SSA once every
                                                 2 to 3 years.
(m) Correct administrative and               6  To correct                     6               4              24
 accounting discrepancies.                       errors
                                                 discovered by
                                                 SSA in periodic
                                                 review.
----------------------------------------------------------------------------------------------------------------

[[Page 21293]]

 
                                           Total Administrative Burden
----------------------------------------------------------------------------------------------------------------
    Totals....................              38  ................         639,160  ..............          45,216
----------------------------------------------------------------------------------------------------------------

     
---------------------------------------------------------------------------

    \1\ Average of about 2 States per year.
    \2\ Hours.
    \3\ Includes both denied and approved SSI claims.
---------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding these 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 June 5, 2017. Individuals can obtain copies of the 
OMB clearance packages by writing to OR.Reports.Clearance@ssa.gov.
    1. Statement Regarding Marriage--20 CFR 404.726--0960-0017. 
According to Section 216(h)(1)(A) of the Act, SSA must apply state law 
when determining an individual's marital status. Some state laws 
recognize marriages without a ceremony (i.e., common-law marriages). In 
such cases, SSA provides the same spouse or widow(er) benefits to the 
common-law spouses as it does to ceremonially married spouses. To 
determine common-law spouses, SSA must elicit information from blood 
relatives or other persons who are knowledgeable about the alleged 
common-law relationship. SSA uses Form SSA-753, Statement Regarding 
Marriage, to collect information from third parties to verify the 
applicant's statements about intent, cohabitation, and holding out to 
the public as married, which are the basic tenets of a common-law 
marriage. SSA uses the information to determine if a valid marital 
relationship exists, and if the common-law spouse is entitled to Social 
Security spouse or widow(er) benefits. The respondents are third 
parties who can confirm or deny the alleged common-law marriage.
    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-753.........................................          40,000               1               9           6,000
----------------------------------------------------------------------------------------------------------------

    2. Statement of Income and Resources--20 CFR 416.207, 146.301-
416.310, 416.704, and 416.708--0960-0124. SSA collects information 
about income and resources for SSI claims and redeterminations on the 
SSA-8010-BK. SSA uses the information to make initial or continuing 
eligibility determinations for SSI claimants or recipients who are 
subject to deeming. The respondents are people whose income and 
resources SSA may deem (consider to be available) to SSI applicants or 
recipients.
    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-8010-BK.....................................         341,000               1              26         147,767
----------------------------------------------------------------------------------------------------------------

    3. Claimant's Work Background--20 CFR 404.1512(a); 404.1520(a)(4); 
404.1565(b); 416.912(a); 416.920(a)(4); 416.965(b)--0960-0300. Sections 
205(a) and 1631(e) of the Act provide the Commissioner of Social 
Security with the authority to establish procedures for determining if 
a claimant is entitled to disability benefits. The administrative law 
judge (ALJ) may ask individuals to provide background information on 
Form HA-4633 about work they performed in the past 15 years. When a 
claimant requests a hearing before an ALJ to establish an entitlement 
to disability benefits, the ALJ may request that the claimant provide a 
work history to assist the ALJ in fully inquiring into statutory issues 
related to the disability. The ALJ uses the information collected from 
the claimants on Form HA-4633 to: (1) Identify the claimant's relevant 
work history; (2) decide if SSA requires expert vocational testimony 
and, if so, have a vocational expert available to testify during the 
hearing; and (3) provide a reference for the ALJ to discuss the 
claimant's work history. The ALJ makes the completed HA-4633 part of 
the documentary evidence of record. The respondents are claimants for 
disability benefits under Title II or Title XVI who requested a hearing 
before an ALJ after SSA denied their application for disability 
payment.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 21294]]



----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
HA-4633--PDF/paper version......................          20,000               1              15           5,000
Electronic Records Express......................         180,000               1              15          45,000
                                                 ---------------------------------------------------------------
    Total.......................................         200,000  ..............  ..............          50,000
----------------------------------------------------------------------------------------------------------------

    4. Social Security Administration Eligible Non-Attorney 
Representative--20 CFR 404.1717, 404.1745-404.1799, 416.1517, and 
416.1545-416.1599--0960-0699. Section 3 of the Social Security 
Disability Applicants Access to Professional Representation Act (PRA) 
of 2010, Public Law 111-142, permanently extends the direct payment 
provision of Section 303 of the Social Security Protection Act (SSPA) 
of 2004, Public Law 108-203. The PRA permits SSA to extend direct 
payment of approved fees from claimants' past-due benefits to certain 
non-attorney representatives. Prior to the enactment of the SSPA and 
PRA, only attorneys could receive direct payment of SSA-approved fees. 
Under the PRA, non-attorneys must meet certain prerequisites to be 
eligible for direct payment of fees. These prerequisites include: (1) A 
bachelor's degree from an accredited institution of higher education, 
or four years of relevant professional experience and a high school 
diploma or General Education Development certificate; (2) passing a 
written examination administered by SSA testing the knowledge of 
relevant provisions of the Act under Titles II and XVI; (3) securing 
and maintaining continuous professional liability insurance, or 
equivalent, to protect claimants from malpractice; (4) passing a 
criminal background check; (5) demonstrating ongoing completion of 
continuing education courses. The PRA requires SSA to collect the 
information needed to determine if applicants have satisfied these 
prerequisites. SSA uses the information we collect on Form SSA-1691 to 
determine whether an applicant has fulfilled the statutory 
prerequisites and regulatory requirements as listed above. To verify 
this information, we also request the five required items listed above 
from each new applicant, and we request items #3 and #5 from all non-
attorney representatives (new and existing) on a yearly basis. Every 
year, SSA evaluates the applications, conducts verification 
investigations, and issues recommendations regarding applicants' 
eligibility to sit for the examination and eligibility to receive 
direct payment. The respondents are non-attorneys who want to receive 
direct payment of their fees for representational services before SSA
    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)
----------------------------------------------------------------------------------------------------------------
New Respondents--Paper Application (complete and             200               1              45             150
 submit)--404.1717(b)&(c); 416.1517(b)&(c)......
New Respondents Examination--404.1717(a)(5);                 200               1             120             400
 416.1517(a)(5).................................
New Respondents--Submission of proof of                      200               1              10              33
 Bachelor's Degree or Equivalent Qualifications--
 404.1717(a)(3); 416.1517(a)(3).................
New and Existing Respondents--CE Submission via              710               1              20             237
 email/mail/or FAX of training courses taken as
 prescribed by SSA--404.1717(a)(7);
 416.1517(a)(7).................................
New and Existing Respondents--Proof of                       672               1              10             112
 Continuous Professional or Business Liability
 Insurance Coverage (Scan and Email)--
 404.1717(a)(6); 416.1517(a)(6).................
New and Existing Respondents--Proof of                        38               1              15              10
 Continuous Professional or Business Liability
 Insurance Coverage (Copy and Mail)--
 404.1717(a)(6); 416.1517(a)(6).................
New and Existing Respondents--Written Protests--              45               1              45              34
 404.1717(d); 416.1517(d).......................
                                                 ---------------------------------------------------------------
    Totals......................................           2,065  ..............  ..............             976
----------------------------------------------------------------------------------------------------------------


    Dated: May 2, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2017-09084 Filed 5-4-17; 8:45 am]
 BILLING CODE 4191-02-P