Agency Information Collection Activities: Proposed Request and Comment Request, 29136-29140 [2017-13331]

Download as PDF 29136 Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices Economic Injury (EIDL) Loan Application Deadline Date: 03/20/2018. Submit completed loan applications to: U.S. Small Business Administration, Processing and Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155. ADDRESSES: A. Escobar, Office of Disaster Assistance, U.S. Small Business Administration, 409 3rd Street SW., Suite 6050, Washington, DC 20416, (202) 205–6734. FOR FURTHER INFORMATION CONTACT: SMALL BUSINESS ADMINISTRATION [Disaster Declaration #15181 and #15182; Texas Disaster #TX–00482] Non-Profit Organizations without Credit Available Elsewhere ..................................... Administrative Declaration of a Disaster for the State of Texas U.S. Small Business Administration. ACTION: Notice. AGENCY: This is a notice of an Administrative declaration of a disaster for the State of Texas dated 06/20/2017. SUPPLEMENTARY INFORMATION: Notice is Incident: Severe Storms. hereby given that as a result of the Incident Period: 04/17/2017 through Administrator’s disaster declaration, 04/20/2017. applications for disaster loans may be DATES: Effective 06/20/2017. filed at the address listed above or other Physical Loan Application Deadline locally announced locations. Date: 08/21/2017. Economic Injury (EIDL) Loan The following areas have been Application Deadline Date: 03/20/2018. determined to be adversely affected by ADDRESSES: Submit completed loan the disaster: applications to: U.S. Small Business Primary Counties: Austin Administration, Processing and Contiguous Counties: Disbursement Center, 14925 Kingsport Road, Fort Worth, TX 76155. Texas: Colorado, Fayette, Fort Bend, FOR FURTHER INFORMATION CONTACT: A. Waller, Washington, Wharton. Escobar, Office of Disaster Assistance, The Interest Rates are: U.S. Small Business Administration, 409 3rd Street SW., Suite 6050, Percent Washington, DC 20416, (202) 205–6734. SUPPLEMENTARY INFORMATION: Notice is For Physical Damage: hereby given that as a result of the Homeowners with Credit Available Elsewhere ...................... 3.875 Administrator’s disaster declaration, applications for disaster loans may be Homeowners without Credit Available Elsewhere .............. 1.938 filed at the address listed above or other Businesses with Credit Availlocally announced locations. able Elsewhere ...................... 6.430 The following areas have been Businesses without Credit determined to be adversely affected by Available Elsewhere .............. 3.215 the disaster: Non-Profit Organizations with Credit Available Elsewhere ... 2.500 Primary Counties: Brazoria Contiguous Counties: Non-Profit Organizations withTexas: Fort Bend, Galveston, Harris, out Credit Available ElseMatagorda, Wharton. where ..................................... 2.500 For Economic Injury: The Interest Rates are: Businesses & Small Agricultural Cooperatives without Credit Available Elsewhere .............. Non-Profit Organizations without Credit Available Elsewhere ..................................... 3.215 2.500 mstockstill on DSK30JT082PROD with NOTICES The number assigned to this disaster for physical damage is 15179 B and for economic injury is 15180 0. The State which received an EIDL Declaration # is Texas. (Catalog of Federal Domestic Assistance Number 59008) Dated: June 20, 2017. Linda E. McMahon, Administrator. [FR Doc. 2017–13367 Filed 6–26–17; 8:45 am] BILLING CODE 8025–01–P VerDate Sep<11>2014 18:33 Jun 26, 2017 SUMMARY: Jkt 241001 For Physical Damage: Homeowners with Credit Available Elsewhere ...................... Homeowners without Credit Available Elsewhere .............. Businesses with Credit Available Elsewhere ...................... Businesses without Credit Available Elsewhere .............. Non-Profit Organizations with Credit Available Elsewhere ... Non-Profit Organizations without Credit Available Elsewhere ..................................... For Economic Injury: Businesses & Small Agricultural Cooperatives without Credit Available Elsewhere .............. PO 00000 Frm 00115 Fmt 4703 Sfmt 4703 Percent 2.500 The number assigned to this disaster for physical damage is 15181 B and for economic injury is 15182 0. The State which received an EIDL Declaration # is Texas (Catalog of Federal Domestic Assistance Number 59008) Dated: June 20, 2017. Linda E. McMahon, Administrator. [FR Doc. 2017–13366 Filed 6–26–17; 8:45 am] BILLING CODE 8025–01–P SOCIAL SECURITY ADMINISTRATION [Docket No. SSA–2017–0033] 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 Percent collection(s) to the OMB Desk Officer and SSA Reports Clearance Officer at the following addresses or fax numbers. 3.875 (OMB), Office of Management and Budget, Attn: Desk Officer for SSA, 1.938 Fax: 202–395–6974, Email address: OIRA_Submission@omb.eop.gov 6.430 (SSA), Social Security Administration, OLCA, Attn: Reports Clearance 3.215 Director, 3100 West High Rise, 6401 2.500 Security Blvd., Baltimore, MD 21235. Fax: 410–966–2830. Email address: OR.Reports.Clearance@ssa.gov. 2.500 Or you may submit your comments online through www.regulations.gov, referencing Docket ID Number [SSA– 3.215 2017–0033]. E:\FR\FM\27JNN1.SGM 27JNN1 29137 Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices 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 August 28, 2017. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Public Information Campaign— 0960–0544. Periodically, SSA sends various public information materials, including public service announcements; news releases; and educational tapes, to public broadcasting systems so they can inform the public about various programs and activities SSA conducts. SSA frequently sends follow-up business reply cards for these public information materials to obtain suggestions for improving them. The respondents are broadcast sources. Type of Request: Revision of an OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Radio Survey ................................................................................................... 5,000 2 1 167 2. Medical Permit Parking Application—41 CFR 102–71.20 and 102–74.305—0960–0624. SSA employees and contractors with a qualifying medical condition who park at SSA-owned and leased facilities may apply to receive a medical parking permit. SSA uses three forms for this program: (1) SSA–3192, the Application and Statement which an individual completes when first applying for the medical parking space; (2) SSA–3193, the Physician’s Report, which the applicant’s physician completes to verify the medical condition; and (3) SSA–3194, Renewal Certification, which medical parking permit holders complete to verify their continued need for the permit. The respondents are SSA employees and contractors seeking Number of respondents Modality of completion medical parking permits and their physicians. Note: Because SSA employees are Federal workers exempt from the requirements of the Paperwork Reduction Act, the burden below is only for SSA contractors and physicians (of both SSA employees and contractors). Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–3192 ........................................................................................................ SSA–3193 ........................................................................................................ SSA–3194 ........................................................................................................ 390 465 82 1 1 1 30 90 5 195 698 7 Totals ........................................................................................................ 937 ........................ ........................ 900 3. Electronic Records Express (Third Parties)—20 CFR 404.1700–404.1715— 0960–0767. Electronic Records Express (ERE) is an online system which enables medical providers and various third party representatives to download and submit disability claimant information electronically to SSA as part of the disability application process. To ensure only authorized people access ERE, SSA requires third parties to complete a unique registration process if they wish to use this system. This information collection request (ICR) includes the third-party registration process; the burden for submitting evidence to SSA is part of other, various ICRs. The respondents are third party representatives of disability applicants or recipients who want to use ERE to electronically access clients’ disability files online and submit information to SSA. Type of Request: Revision of an OMBapproved information collection. Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) ERE—Third Parties ......................................................................................... mstockstill on DSK30JT082PROD with NOTICES Modality of completion 10,413 319 1 55,362 4. Screen Pop—20 CFR 401.45—0960– 0790. Section 205(a) of the Social Security Act (Act) requires SSA to verify the identity of individuals who request a record or information pertaining to themselves, and to establish procedures for disclosing personal information. SSA established Screen Pop, an automated telephone process, to speed up verification for such individuals. Accessing Screen Pop, callers enter their VerDate Sep<11>2014 18:33 Jun 26, 2017 Jkt 241001 Social Security number (SSN) using their telephone keypad or speech technology prior to speaking with a National 800 Number Network (N8NN) agent. The automated Screen Pop application collects the SSN and routes it to the ‘‘Start New Call’’ Customer Help and Information (CHIP) screen. Functionality for the Screen Pop application ends once the SSN connects to the CHIP screen and the SSN routes PO 00000 Frm 00116 Fmt 4703 Sfmt 4703 to the agent’s screen. When the call connects to the N8NN agent, the agent can use the SSN to access the caller’s record as needed. The respondents for this collection are individuals who contact SSA’s N8NN to speak with an agent. Type of Request: Revision of an OMBapproved information collection. E:\FR\FM\27JNN1.SGM 27JNN1 29138 Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Screen Pop ...................................................................................................... 53,394,811 1 1 889,914 5. Incoming and Outgoing Intergovernmental Personnel Act Assignment Agreement—5 CFR 334— 0960–0792. The Intergovernmental Personnel Act (IPA) mobility program provides for the temporary assignment of civilian personnel between the Federal Government and State and local governments; colleges and universities; Indian tribal governments; Federallyfunded research and development centers; and other eligible organizations. The Office of Personnel Management (OPM) created a generic form, the OF– 69, for agencies to use as a template for incoming employees and the SSA– 188 for outgoing employees. SSA collects information on the SSA–187 and SSA–188 to document the IPA assignment and to act as an agreement between the agencies. Respondents are personnel from State and local governments; colleges and universities; Indian tribal governments; Federallyfunded research and development centers; and other eligible organizations who participate in the IPA exchange with SSA. Type of Request: Revision of an OMBapproved information collection. when collecting information for the IPA assignment. The OF–69 collects specific information about the agreement including: (1) The enrolled employee’s name, Social Security number, job title, salary, classification, and address; (2) the type of assignment; (3) the reimbursement arrangement; and (4) an explanation as to how the assignment benefits both SSA and the non-federal organization involved in the exchange. OPM directs agencies to use their own forms for recording these agreements. Accordingly, SSA modified the OF–69 to meet our needs, creating the SSA–187 Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Non-Federal employee .................................................................................... 10 1 30 5 Non-Federal employer signers ........................................................................ Totals ........................................................................................................ 20 30 1 ........................ 5 ........................ 2 7 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 July 27, 2017. Individuals can obtain copies of the OMB clearance packages by writing to OR.Reports.Clearance@ssa.gov. 1. Disability Report-Appeal—20 CFR 404.1512, 416.912, 404.916(c), 416.1416(c), 422.140, 404.1713, 416.1513, 404.1740(b)(4), 416.1540(b)(4), and 405 Subpart C— 0960–0144. SSA requires disability applicants who wish to appeal an unfavorable disability determination to complete Form SSA–3441–BK; the associated Electronic Disability Collect System (EDCS) interview; or the Internet application, i3441. This allows claimants to disclose any changes to their disability, or resources, which might influence SSA’s unfavorable determination. We may use the information to: (1) Reconsider and review an initial disability determination; (2) review a continuing disability; and (3) evaluate a request for a hearing. This information assists the State Disability Determination Services (DDS) and administrative law judges (ALJ) in preparing for the appeals and hearings, and in issuing a determination or decision on an individual’s Number of respondents mstockstill on DSK30JT082PROD with NOTICES Modality of completion entitlement (initial or continuing) to disability benefits. In addition, the information we collect on the SSA– 3441–BK, or related modalities, facilitates SSA’s collection of medical information to support the applicant’s request for reconsideration; request for benefits cessation appeal; and request for a hearing before an ALJ. Respondents are individuals who appeal denial, reduction, or cessation of Social Security disability benefits and Supplemental Security Income (SSI) payments; individuals who wish to request a hearing before an ALJ; or their representatives. Type of Request: Revision of an OMBapproved information collection. Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–3441–BK ................................................................................................. Electronic Disability Collect System (EDCS) ................................................... i3441 (Internet) ................................................................................................ 2,396 476,771 1,046,938 1 1 1 45 45 28 1,797 357,578 488,571 Totals ........................................................................................................ 1,526,105 ........................ ........................ 847,946 2. Disability Case Development Information Collections By State VerDate Sep<11>2014 18:33 Jun 26, 2017 Jkt 241001 Disability Determination Services On Behalf of SSA—20 CFR, subpart P, PO 00000 Frm 00117 Fmt 4703 Sfmt 4703 404.1503a, 404.1512, 404.1513, 404.1514, 404.1517, 404.1519; 20 CFR E:\FR\FM\27JNN1.SGM 27JNN1 29139 Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices subpart Q, 404.1613, 404.1614, 404.1624; 20 CFR subpart I, 416.903a, 416.912, 416.913, 416.914, 416.917, 416.919 and 20 CFR subpart J, 416.1013, 416.1014, 416.1024—0960–0555. DDSs collect the information necessary to administer the Social Security Disability Insurance and SSI programs. They collect medical evidence from consultative examination (CE) sources; credential information from CE source applicants; and medical evidence of record (MER) from claimants’ medical sources. The DDSs collect information from claimants regarding medical appointments, pain, symptoms, and impairments. The respondents are medical providers, other sources of MER, and disability claimants. Type of Request: Revision of an OMBapproved information collection. CE Collections There are three CE information collections: (a) Medical evidence about claimants’ medical condition(s) that DDS’s use to make disability determinations when the claimant’s own medical sources cannot or will not provide the required information, and proof of credentials from CE providers; (b) CE appointment letters; and (c) CE claimant reports sent to claimants’ doctors. (A) MEDICAL EVIDENCE AND CREDENTIALS FROM CE PROVIDERS Number of respondents Modality of completion Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) CE Paper Submissions .................................................................................... CE Electronic Submissions ............................................................................. CE Credentials ................................................................................................. 1,400,000 296,000 4,000 1 1 1 30 10 15 700,000 49,333 1,000 Totals ........................................................................................................ 1,700,000 ........................ ........................ 750,333 (B) CE APPOINTMENT LETTERS AND (C) CE CLAIMANTS’ REPORT TO MEDICAL PROVIDERS Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) (b) CE Appointment Letters ............................................................................. (c) CE Claimants’ Report to Medical Providers ............................................... 880,000 450,000 1 1 5 5 73,333 37,500 Totals ........................................................................................................ 1,330,000 ........................ ........................ 110,833 Frequency of response Average burden per response (minutes) MER Collections The DDS’s collect MER information from the claimant’s medical sources to determine a claimant’s physical or mental status prior to making a disability determination. Number of respondents Modality of completion Estimated total annual burden (hours) Paper Submissions .......................................................................................... Electronic Submissions .................................................................................... 3,150,000 9,450,000 1 1 20 12 1,050,000 1,890,000 Totals ........................................................................................................ 12,600,000 ........................ ........................ 2,940,000 Pain/Other Symptoms/Impairment Information From Claimants The DDS’s use information about pain/symptoms to determine how pain/ symptoms affect the claimant’s ability to do work-related activities prior to making a disability determination. mstockstill on DSK30JT082PROD with NOTICES Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Pain/Other Symptoms/Impairment Information ................................................ 2,100,000 1 20 700,000 The total estimated annual burden for all categories described in this VerDate Sep<11>2014 18:33 Jun 26, 2017 Jkt 241001 information collection is 4,501,166 hours. PO 00000 Frm 00118 Fmt 4703 Sfmt 4703 3. Authorization to Disclose Information to SSA—20 CFR 404.1512 and 416.912, 45 CFR 160 and 164— E:\FR\FM\27JNN1.SGM 27JNN1 29140 Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices 0960–0623. Sections 223(d)(5)(A) and 1614(a)(3)(H)(i) of the Act require claimants to provide medical and other evidence the Commissioner of Social Security may require to prove they are disabled. SSA must obtain sufficient evidence to make eligibility determinations for Title II and Title XVI payments. Therefore, the applicant must SSA or the State DDS sends the form to the designated source(s) to obtain pertinent records. The respondents are applicants for Title II and Title XVI disability payments. Type of Request: Revision of an OMBapproved information collection. authorize release of information from various sources to SSA. The applicants use Form SSA–827, or the Internet counterpart, i827, to provide consent for the release of medical records, education records, and other information related to their ability to perform tasks. Once the applicant completes Form SSA–827, or the i827, Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) i827 with electronic signature (eAuthorization) ................................................ SSA–827 with wet signature (paper version) .................................................. 4,189,270 1,055,807 1 1 9 10 628,391 175,968 Totals ........................................................................................................ 5,245,077 ........................ ........................ 804,359 Dated: June 21, 2017. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2017–13331 Filed 6–26–17; 8:45 am] BILLING CODE 4191–02–P SURFACE TRANSPORTATION BOARD [Docket No. AB 295 (Sub-No. 9X)] The Indiana Rail Road Company— Discontinuance of Trackage Rights Exemption—in Lawrence, Orange, Washington, Clark and Floyd Counties, Ind. mstockstill on DSK30JT082PROD with NOTICES The Indiana Rail Road Company (INRD) 1 has filed a verified notice of exemption under 49 CFR pt. 1152 subpart F—Exempt Abandonments and Discontinuances of Service to discontinue approximately 71.9 miles of overhead trackage rights over a line of railroad (the Bedford-New Albany line) owned by CSXT, between milepost Q– 245.8 in Bedford and milepost Q–317.7 in New Albany, in Lawrence, Orange, Washington, Clark and Floyd Counties, Ind. (the Bedford trackage rights),2 1 INRD is indirectly controlled by the CSX Transportation, Inc. (CSXT), but operates as an independent Class II rail carrier. See CSX Corp. & CSX Transp.—Control—Ind. R.R., FD 32892 (STB served Nov. 7, 1996). 2 The Board approved INRD’s acquisition of the trackage rights in Ind. R.R.—Acquis.—Soo Line R.R., FD 34783 (STB served Apr. 11, 2006). In 2010, INRD abandoned its connecting line west of Bedford. See Ind. R.R.—Aban. Exemption—in Martin & Lawrence Ctys., AB 295 (Sub-No. 7) (STB served Mar. 26, 2010). According to INRD, the Bedford trackage rights have not been used since that time and are isolated from the main part of INRD’s rail system. At the time of INRD’s abandonment, CSXT obtained authority to discontinue service over most of the Bedford-New Albany line. See CXS Transp.—Discontinuance of Serv. Exemption—in Clark, Floyd, Orange & Washington Ctys., Ind., AB 55 (Sub-No. 698X) (STB served Apr. 7, 2010). CSXT had previously obtained VerDate Sep<11>2014 18:33 Jun 26, 2017 Jkt 241001 pursuant to a letter agreement dated February 24, 2017, between INRD and CSXT. The Bedford trackage rights traverse United States Postal Service Zip Codes 47421, 47446, 47452, 47108, 47167, 47165, 47106, 47143, 47172 and 47150. INRD has certified that (1) no local traffic has moved over the Bedford trackage for at least two years; (2) any overhead traffic can be and has been rerouted over other lines; (3) no formal complaint filed by a user of rail service on the Bedford trackage (or by a state or local government entity acting on behalf of such user) regarding cessation of service on the Bedford trackage is pending either with the Board or with any U.S. District Court or has been decided in favor of complainant within the two-year period; and (4) the requirements at 49 CFR 1105.12 (newspaper publication), and 49 CFR 1152.50(d)(1) (notice to governmental agencies) have been met. As a condition to this exemption, any employee adversely affected by the discontinuance shall be protected under Oregon Short Line Railroad— Abandonment Portion Goshen Branch Between Firth & Ammon, in Bingham & Bonneville Counties, Idaho, 360 I.C.C. 91 (1979). To address whether this condition adequately protects affected employees, a petition for partial revocation under 49 U.S.C. 10502(d) must be filed. Provided no formal expression of intent to file an offer of financial assistance (OFA) to subsidize continued rail service has been received, this discontinuance and abandonment authority for the northern 6.7 miles of the Bedford-New Albany line nearest Bedford with the effectiveness as to abandonment subject to Soo’s (now INRD’s) discontinuing its trackage rights. See CSX Transp.— Aban. & Discontinuance Exemption—in Lawrence Cty., Ind., AB 55 (Sub-No. 495X) (ICC served Jan. 27, 1995). PO 00000 Frm 00119 Fmt 4703 Sfmt 9990 exemption will be effective on July 27, 2017, unless stayed pending reconsideration. Petitions to stay that do not involve environmental issues and formal expressions of intent to file an OFA to subsidize continued rail service under 49 CFR 1152.27(c)(2) 3 must be filed by July 7, 2017.4 Petitions to reopen must be filed by July 14, 2017, with the Surface Transportation Board, 395 E Street SW., Washington, DC 20423–0001. A copy of any petition filed with the Board should be sent to INRD’s representative: Thomas J. Litwiler, Fletcher & Sippel LLC, 29 North Wacker Drive, Suite 920, Chicago, IL 60606. If the verified notice contains false or misleading information, the exemption is void ab initio. Board decisions and notices are available on our Web site at ‘‘WWW.STB.GOV.’’ Decided: June 22, 2017. By the Board, Rachel D. Campbell, Director, Office of Proceedings. Kenyatta Clay, Clearance Clerk. [FR Doc. 2017–13422 Filed 6–26–17; 8:45 am] BILLING CODE 4915–01–P 3 Each OFA must be accompanied by the filing fee, which currently is set at $1,700. See 49 CFR 1002.2(f)(25). 4 Because this is a discontinue proceeding and not an abandonment, interim trail use/rail banking and public use conditions are not appropriate. Because there will be an environmental review during any further abandonment of the BedfordNew Albany line, this discontinuance does not require an environmental review. E:\FR\FM\27JNN1.SGM 27JNN1

Agencies

Social Security Administration

[Federal Register Volume 82, Number 122 (Tuesday, June 27, 2017)]
[Notices]
[Pages 29136-29140]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-13331]

=======================================================================
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SOCIAL SECURITY ADMINISTRATION

[Docket No. SSA-2017-0033]

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-2017-0033].

[[Page 29137]]

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
August 28, 2017. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Public Information Campaign--0960-0544. Periodically, SSA sends
various public information materials, including public service
announcements; news releases; and educational tapes, to public
broadcasting systems so they can inform the public about various
programs and activities SSA conducts. SSA frequently sends follow-up
business reply cards for these public information materials to obtain
suggestions for improving them. The respondents are broadcast sources.
Type of Request: Revision of an OMB-approved information
collection.

2. Medical Permit Parking Application--41 CFR 102-71.20 and 102-
74.305--0960-0624. SSA employees and contractors with a qualifying
medical condition who park at SSA-owned and leased facilities may apply
to receive a medical parking permit. SSA uses three forms for this
program: (1) SSA-3192, the Application and Statement which an
individual completes when first applying for the medical parking space;
(2) SSA-3193, the Physician's Report, which the applicant's physician
completes to verify the medical condition; and (3) SSA-3194, Renewal
Certification, which medical parking permit holders complete to verify
their continued need for the permit. The respondents are SSA employees
and contractors seeking medical parking permits and their physicians.

Note: Because SSA employees are Federal workers exempt from the
requirements of the Paperwork Reduction Act, the burden below is
only for SSA contractors and physicians (of both SSA employees and
contractors).

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-3192........................................ 390 1 30 195
SSA-3193........................................ 465 1 90 698
SSA-3194........................................ 82 1 5 7
---------------------------------------------------------------
Totals...................................... 937 .............. .............. 900
----------------------------------------------------------------------------------------------------------------

3. Electronic Records Express (Third Parties)--20 CFR 404.1700-
404.1715--0960-0767. Electronic Records Express (ERE) is an online
system which enables medical providers and various third party
representatives to download and submit disability claimant information
electronically to SSA as part of the disability application process. To
ensure only authorized people access ERE, SSA requires third parties to
complete a unique registration process if they wish to use this system.
This information collection request (ICR) includes the third-party
registration process; the burden for submitting evidence to SSA is part
of other, various ICRs. The respondents are third party representatives
of disability applicants or recipients who want to use ERE to
electronically access clients' disability files online and submit
information to SSA.
Type of Request: Revision of an OMB-approved information
collection.

----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
ERE--Third Parties.......................... 10,413 319 1 55,362
----------------------------------------------------------------------------------------------------------------

4. Screen Pop--20 CFR 401.45--0960-0790. Section 205(a) of the
Social Security Act (Act) requires SSA to verify the identity of
individuals who request a record or information pertaining to
themselves, and to establish procedures for disclosing personal
information. SSA established Screen Pop, an automated telephone
process, to speed up verification for such individuals. Accessing
Screen Pop, callers enter their Social Security number (SSN) using
their telephone keypad or speech technology prior to speaking with a
National 800 Number Network (N8NN) agent. The automated Screen Pop
application collects the SSN and routes it to the ``Start New Call''
Customer Help and Information (CHIP) screen. Functionality for the
Screen Pop application ends once the SSN connects to the CHIP screen
and the SSN routes to the agent's screen. When the call connects to the
N8NN agent, the agent can use the SSN to access the caller's record as
needed. The respondents for this collection are individuals who contact
SSA's N8NN to speak with an agent.
Type of Request: Revision of an OMB-approved information
collection.

[[Page 29138]]

----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Screen Pop.................................. 53,394,811 1 1 889,914
----------------------------------------------------------------------------------------------------------------

5. Incoming and Outgoing Intergovernmental Personnel Act Assignment
Agreement--5 CFR 334--0960-0792. The Intergovernmental Personnel Act
(IPA) mobility program provides for the temporary assignment of
civilian personnel between the Federal Government and State and local
governments; colleges and universities; Indian tribal governments;
Federally-funded research and development centers; and other eligible
organizations. The Office of Personnel Management (OPM) created a
generic form, the OF-69, for agencies to use as a template when
collecting information for the IPA assignment. The OF-69 collects
specific information about the agreement including: (1) The enrolled
employee's name, Social Security number, job title, salary,
classification, and address; (2) the type of assignment; (3) the
reimbursement arrangement; and (4) an explanation as to how the
assignment benefits both SSA and the non-federal organization involved
in the exchange. OPM directs agencies to use their own forms for
recording these agreements. Accordingly, SSA modified the OF-69 to meet
our needs, creating the SSA-187 for incoming employees and the SSA-188
for outgoing employees. SSA collects information on the SSA-187 and
SSA-188 to document the IPA assignment and to act as an agreement
between the agencies. Respondents are personnel from State and local
governments; colleges and universities; Indian tribal governments;
Federally-funded research and development centers; and other eligible
organizations who participate in the IPA exchange with 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)
----------------------------------------------------------------------------------------------------------------
Non-Federal employee............................ 10 1 30 5
---------------------------------------------------------------
Non-Federal employer signers.................... 20 1 5 2
Totals...................................... 30 .............. .............. 7
----------------------------------------------------------------------------------------------------------------

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 July 27, 2017. Individuals can obtain copies of the
OMB clearance packages by writing to OR.Reports.Clearance@ssa.gov.
1. Disability Report-Appeal--20 CFR 404.1512, 416.912, 404.916(c),
416.1416(c), 422.140, 404.1713, 416.1513, 404.1740(b)(4),
416.1540(b)(4), and 405 Subpart C--0960-0144. SSA requires disability
applicants who wish to appeal an unfavorable disability determination
to complete Form SSA-3441-BK; the associated Electronic Disability
Collect System (EDCS) interview; or the Internet application, i3441.
This allows claimants to disclose any changes to their disability, or
resources, which might influence SSA's unfavorable determination. We
may use the information to: (1) Reconsider and review an initial
disability determination; (2) review a continuing disability; and (3)
evaluate a request for a hearing. This information assists the State
Disability Determination Services (DDS) and administrative law judges
(ALJ) in preparing for the appeals and hearings, and in issuing a
determination or decision on an individual's entitlement (initial or
continuing) to disability benefits. In addition, the information we
collect on the SSA-3441-BK, or related modalities, facilitates SSA's
collection of medical information to support the applicant's request
for reconsideration; request for benefits cessation appeal; and request
for a hearing before an ALJ. Respondents are individuals who appeal
denial, reduction, or cessation of Social Security disability benefits
and Supplemental Security Income (SSI) payments; individuals who wish
to request a hearing before an ALJ; or their representatives.
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-3441-BK..................................... 2,396 1 45 1,797
Electronic Disability Collect System (EDCS)..... 476,771 1 45 357,578
i3441 (Internet)................................ 1,046,938 1 28 488,571
---------------------------------------------------------------
Totals...................................... 1,526,105 .............. .............. 847,946
----------------------------------------------------------------------------------------------------------------

2. Disability Case Development Information Collections By State
Disability Determination Services On Behalf of SSA--20 CFR, subpart P,
404.1503a, 404.1512, 404.1513, 404.1514, 404.1517, 404.1519; 20 CFR

[[Page 29139]]

subpart Q, 404.1613, 404.1614, 404.1624; 20 CFR subpart I, 416.903a,
416.912, 416.913, 416.914, 416.917, 416.919 and 20 CFR subpart J,
416.1013, 416.1014, 416.1024--0960-0555. DDSs collect the information
necessary to administer the Social Security Disability Insurance and
SSI programs. They collect medical evidence from consultative
examination (CE) sources; credential information from CE source
applicants; and medical evidence of record (MER) from claimants'
medical sources. The DDSs collect information from claimants regarding
medical appointments, pain, symptoms, and impairments. The respondents
are medical providers, other sources of MER, and disability claimants.
Type of Request: Revision of an OMB-approved information
collection.

CE Collections

There are three CE information collections: (a) Medical evidence
about claimants' medical condition(s) that DDS's use to make disability
determinations when the claimant's own medical sources cannot or will
not provide the required information, and proof of credentials from CE
providers; (b) CE appointment letters; and (c) CE claimant reports sent
to claimants' doctors.

(A) Medical Evidence and Credentials From CE Providers
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
CE Paper Submissions............................ 1,400,000 1 30 700,000
CE Electronic Submissions....................... 296,000 1 10 49,333
CE Credentials.................................. 4,000 1 15 1,000
---------------------------------------------------------------
Totals...................................... 1,700,000 .............. .............. 750,333
----------------------------------------------------------------------------------------------------------------

(B) CE Appointment Letters and (C) CE Claimants' Report to Medical Providers
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
(b) CE Appointment Letters...................... 880,000 1 5 73,333
(c) CE Claimants' Report to Medical Providers... 450,000 1 5 37,500
---------------------------------------------------------------
Totals...................................... 1,330,000 .............. .............. 110,833
----------------------------------------------------------------------------------------------------------------

MER Collections

The DDS's collect MER information from the claimant's medical
sources to determine a claimant's physical or mental status prior to
making a disability determination.

----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Paper Submissions............................... 3,150,000 1 20 1,050,000
Electronic Submissions.......................... 9,450,000 1 12 1,890,000
---------------------------------------------------------------
Totals...................................... 12,600,000 .............. .............. 2,940,000
----------------------------------------------------------------------------------------------------------------

Pain/Other Symptoms/Impairment Information From Claimants

The DDS's use information about pain/symptoms to determine how
pain/symptoms affect the claimant's ability to do work-related
activities prior to making a disability determination.

The total estimated annual burden for all categories described in
this information collection is 4,501,166 hours.
3. Authorization to Disclose Information to SSA--20 CFR 404.1512
and 416.912, 45 CFR 160 and 164--

[[Page 29140]]

0960-0623. Sections 223(d)(5)(A) and 1614(a)(3)(H)(i) of the Act
require claimants to provide medical and other evidence the
Commissioner of Social Security may require to prove they are disabled.
SSA must obtain sufficient evidence to make eligibility determinations
for Title II and Title XVI payments. Therefore, the applicant must
authorize release of information from various sources to SSA. The
applicants use Form SSA-827, or the Internet counterpart, i827, to
provide consent for the release of medical records, education records,
and other information related to their ability to perform tasks. Once
the applicant completes Form SSA-827, or the i827, SSA or the State DDS
sends the form to the designated source(s) to obtain pertinent records.
The respondents are applicants for Title II and Title XVI disability
payments.
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)
----------------------------------------------------------------------------------------------------------------
i827 with electronic signature (eAuthorization). 4,189,270 1 9 628,391
SSA-827 with wet signature (paper version)...... 1,055,807 1 10 175,968
---------------------------------------------------------------
Totals...................................... 5,245,077 .............. .............. 804,359
----------------------------------------------------------------------------------------------------------------

Dated: June 21, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2017-13331 Filed 6-26-17; 8:45 am]
BILLING CODE 4191-02-P

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