Agency Information Collection Activities: Proposed Request and Comment Request, 21291-21294 [2017-09084]
Download as PDF
<![CDATA[
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]
=======================================================================
-----------------------------------------------------------------------
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
