Agency Information Collection Activities: Proposed Request and Comment Request, 4722-4725 [2018-01947]
Download as PDF
<![CDATA[
4722
Federal Register / Vol. 83, No. 22 / Thursday, February 1, 2018 / Notices
matching program will be in effect for
a period of 18 months.
ADDRESSES: Interested parties may
comment on this notice by either
telefaxing to (410) 966–0869, writing to
Mary Ann Zimmerman, Acting
Executive Director, Office of Privacy
and Disclosure, Office of the General
Counsel, Social Security
Administration, 617 Altmeyer Building,
6401 Security Boulevard, Baltimore, MD
21235–6401, or emailing
Mary.Ann.Zimmerman@ssa.gov. All
comments received will be available for
public inspection by contacting Ms.
Zimmerman at this street address.
FOR FURTHER INFORMATION CONTACT:
Interested parties may submit general
questions about the matching program
to Mary Ann Zimmerman, Acting
Executive Director, Office of Privacy
and Disclosure, Office of the General
Counsel, by any of the means shown
above.
Mary Ann Zimmerman,
Acting Executive Director, Office of Privacy
and Disclosure, Office of the General Counsel.
Participating Agencies:
SSA and VA/VBA.
Legal authorities for SSA to conduct
this computer matching are sections
1860D–14(a)(3), 1144(a)(1) and (b)(1) of
the Social Security Act (Act) (42 U.S.C.
1395w–114(a)(3), 1320b–14(a)(1) and
(b)(1).
sradovich on DSK3GMQ082PROD with NOTICES
PURPOSE(S):
The purpose of this matching program
is to set forth the conditions under
which VA/VBA will provide SSA with
compensation and pension payment
data. This disclosure will provide SSA
with information necessary to verify an
individual’s self-certification of
eligibility for the Medicare Prescription
Drug (Medicare Part D) subsidy (Extra
Help). It will also enable SSA to identify
individuals who may qualify for Extra
Help as part of the agency’s Medicare
outreach efforts.
SSA will use VA/VBA’s data to
determine an individual’s eligibility for
Extra Help and to identify such
individuals to the state agencies that
administer the Medicare Savings
Program (MSP), unless those
individuals do not consent to share their
information with the state agencies.
Under section 1860D–14 of the Act,
SSA is required to determine the
eligibility of applicants who self-certify
their income, resources, and family size
for Extra Help. SSA is responsible for
verifying, on a pre-enrollment basis, an
applicant’s income and resource
allegations. SSA periodically
20:57 Jan 31, 2018
Jkt 244001
CATEGORIES OF INDIVIDUALS:
The individuals whose information is
involved in this matching program are:
Medicare beneficiaries who are
potentially eligible for Extra Help with
their Medicare prescription drug plan
costs.
CATEGORIES OF RECORDS:
VA/VBA will furnish SSA with an
electronic file containing compensation
and pension payment data monthly. The
actual matching will take place
approximately the first week of every
month.
SSA will conduct the match using the
Social Security number, name, date of
birth, and VA/VBA claim number on
both the file and the Medicare Database
(MDB). SSA will match VA/VBA’s data
with data in SSA’s MDB system of
records, 60–0321 to verify an
individual’s self-certification of
eligibility for Extra Help.
SYSTEM(S) OF RECORDS:
AUTHORITY FOR CONDUCTING THE MATCHING
PROGRAM:
VerDate Sep<11>2014
redetermines the eligibility and subsidy
amounts for these individuals,
thereafter. Also, section 1144 of the Act
requires SSA to conduct outreach efforts
for MSP and subsidized Medicare
prescription drug coverage.
VA/VBA will provide SSA with
electronic files containing compensation
and pension payment data from its SOR
entitled ‘‘Compensation, Pension,
Education, and Vocational
Rehabilitation and Employment
Records—VA’’ (58VA21/22/28),
republished with updated name at 74
FR 14865 (April 1, 2009) and last
amended at 77 FR 42593 (July 19, 2012).
SSA will match the VA/VBA data
with SSA SOR 60–0321, SSA’s MDB
file, last published at 71 FR 42159 (July
25, 2006) and amended at 72 FR 6973
(December 10, 2007).
The systems of records involved in
this matching program have routine
uses permitting the disclosures needed
to conduct this match.
[FR Doc. 2018–01967 Filed 1–31–18; 8:45 am]
BILLING CODE 4191–02–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2018–0002]
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
by the Office of Management and
Budget (OMB) in compliance with
Public Law 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes an
PO 00000
Frm 00093
Fmt 4703
Sfmt 4703
extension of an OMB-approved
information collection, a new
information collection, and 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–
2018–0002].
I. The information collections below
are pending at SSA. SSA will submit
them to OMB within 60 days from the
date of this notice. To be sure we
consider your comments, we must
receive them no later than April 2, 2018.
Individuals can obtain copies of the
collection instruments by writing to the
above email address.
1. Request for Reconsideration—
Disability Cessation—20 CFR 404.909,
416.1409—0960–0349. When SSA
determines that claimants’ disabilities
medically improved; ceased; or are no
longer sufficiently disabling, these
claimants may ask SSA to reconsider
that determination. SSA uses Form
SSA–789–U4 to arrange for a hearing or
to prepare a decision based on the
evidence of record. Specifically,
claimants or their representatives use
Form SSA–789–U4 to: (1) Ask SSA to
reconsider a determination; (2) indicate
if they wish to appear at a disability
hearing; (3) submit any additional
information or evidence for use in the
reconsidered determination; and (4)
indicate if they will need an interpreter
for the hearing. The respondents are
disability claimants for Social Security
benefits or Supplemental Security
Income (SSI) payments, or their
representatives who wish to appeal an
E:\FR\FM\01FEN1.SGM
01FEN1
4723
Federal Register / Vol. 83, No. 22 / Thursday, February 1, 2018 / Notices
unfavorable disability cessation
determination.
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)
SSA–789–U4 ...................................................................................................
30,000
1
13
6,500
2. Waiver of Right to Appear—
Disability Hearing—20 CFR 404.913–
404.914, 404.916(b)(5), 416.1413–
416.1414, 416.1416(b)(5)—0960–0534.
Claimants for Social Security disability
payments or their representatives can
use Form SSA–773–U4 to waive their
right to appear at a disability hearing.
The disability hearing officer uses the
signed form as a basis for not holding
a hearing, and for preparing a written
decision on the claimant’s request for
disability payments based solely on the
evidence of record. The respondents are
disability claimants for Social Security
benefits or SSI payments, or their
representatives, who wish to waive their
right to appear at a disability hearing.
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)
SSA–773–U4 ...................................................................................................
200
1
3
10
3. Social Security Number
Verification Services—20 CFR 401.45—
0960–0660. Internal Revenue Service
regulations require employers to
provide wage and tax data to SSA using
Form W–2, or its electronic equivalent.
As part of this process, the employer
must furnish the employee’s name and
Social Security number (SSN). In
addition, the employee’s name and SSN
must match SSA’s records for SSA to
post earnings to the employee’s earnings
record, which SSA maintains. SSA
offers the Social Security Number
Verification Service (SSNVS), which
allows employers to verify the reported
names and SSNs of their employees
match those in SSA’s records. SSNVS is
a cost-free method for employers to
verify employee information via the
internet. The respondents are employers
who need to verify SSN data using
SSA’s records.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Number of
responses
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSNVS .................................................................................
41,387
60
2,483,220
5
206,935
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
March 5, 2018. Individuals can obtain
copies of the OMB clearance packages
by writing to OR.Reports.Clearance@
ssa.gov.
1. Statement of Interpreter—0960–
NEW. SSA and the Disability
Determination Services (DDS) will use
Form SSA–4321, Statement of
Interpreter, when a person requiring an
interpreter prefers to provide their own
interpreter during an interview or
conversation between the person
requiring an interpreter and SSA or
DDS. SSA will require the interpreter
sign Form SSA–4321, and confirm,
among other things, that they will not
knowingly give false information; they
will act as an interpreter and witness;
and they will accurately interpret the
interview to the best of their ability.
Section 205(a) of the Social Security Act
(Act), as amended (42 U.S.C. 405(a))
authorizes SSA collect this information.
Type of Request: A New Information
Collection Request.
sradovich on DSK3GMQ082PROD with NOTICES
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–4321 ........................................................................................................
5,170,399
1
5
430,867
2. Application for Mother’s or Father’s
Insurance Benefits—20 CFR 404.339–
404.342, 20 CFR 404.601–404.603—
0960–0003. Section 202(g) of the Act
provides for the payment of monthly
VerDate Sep<11>2014
19:34 Jan 31, 2018
Jkt 244001
benefits to the widow or widower of an
insured individual if the surviving
spouse is caring for the deceased
worker’s child (who is entitled to Social
Security benefits). SSA uses the
PO 00000
Frm 00094
Fmt 4703
Sfmt 4703
information on Form SSA–5–BK to
determine an individual’s eligibility for
mother’s or father’s insurance benefits.
The respondents are individuals caring
for a child of the deceased worker who
E:\FR\FM\01FEN1.SGM
01FEN1
4724
Federal Register / Vol. 83, No. 22 / Thursday, February 1, 2018 / Notices
is applying for mother’s or father’s
insurance benefits under the Old Age,
Survivors, and Disability Insurance
program.
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)
SSA–5–F6 (paper) ...........................................................................................
Modernized Claims System .............................................................................
6,542
42,175
1
1
15
15
1,636
10,544
Totals ........................................................................................................
48,717
........................
........................
12,180
3. Statement of Living Arrangements,
In-Kind Support, and Maintenance—20
CFR 416.1130–416.1148—0960–0174.
SSA determines SSI payment amounts
based on applicants’ and recipients’
needs. We measure individuals’ needs,
in part, by the amount of income they
receive, including in-kind support and
maintenance in the form of food and
shelter provided by other people. SSA
uses Form SSA–8006–F4 to determine if
in-kind support and maintenance exists
for SSI applicants and recipients. This
information also assists SSA in
determining the income value of in-kind
support and maintenance SSI applicants
and recipients receive. The respondents
are individuals who apply for SSI
payments, or who complete an SSI
eligibility redetermination.
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)
SSA–8006–F4 ..................................................................................................
173,380
1
7
20,228
4. Statement of Funds You Provided
to Another and Statement of Funds You
Received—20 CFR 416.1103(f)—0960–
0481. SSA uses Forms SSA–2854
(Statement of Funds You Provided to
Another) and SSA–2855 (Statement of
Funds You Received) to gather
information to verify if a loan is bona
fide for SSI recipients. The SSA–2854
asks the lender for details on the
transaction, and Form SSA–2855 asks
the borrower the same basic questions
independently. Agency personnel then
compare the two statements; gather
evidence if needed; and make a decision
on the validity of the bona fide status of
the loan.
For SSI purposes, we consider a loan
bona fide if it meets these requirements:
• Must be between a borrower and
lender with the understanding that the
borrower has an obligation to repay the
money;
• Must be in effect at the time the
cash goes to the borrower, that is, the
agreement cannot come after the cash is
paid; and
• Must be enforceable under State
law, often there are additional
requirements from the State.
SSA collects this information at the
time of initial application for SSI, or at
any point when an individual alleges
being party to an informal loan while
receiving SSI. SSA collects information
on the informal loan through both
interviews and mailed forms. The
agency’s field personnel conduct the
interviews and mail the form(s) for
completion, as needed. The respondents
are SSI recipients and applicants, and
individuals who lend money to them.
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)
SSA–2854 ........................................................................................................
SSA–2855 ........................................................................................................
20,000
20,000
1
1
10
10
3,333
3,333
Totals ........................................................................................................
sradovich on DSK3GMQ082PROD with NOTICES
Modality of completion
40,000
........................
........................
6,666
5. Filing Claims Under the Federal
Tort Claims Act—20 CFR 429.101–
429.110—0960–0667. The Federal Tort
Claims Act is the legal mechanism for
compensating persons injured by
negligent or wrongful acts that occur
during the performance of official duties
by Federal employees. In accordance
with the law, SSA accepts monetary
VerDate Sep<11>2014
19:34 Jan 31, 2018
Jkt 244001
claims filed under the Federal Tort
Claims Act for damages against the
United States, loss of property, personal
injury, or death resulting from an SSA
employee’s wrongful act or omission.
The regulation sections cleared under
this information collection request
require claimants to provide
information SSA can use to investigate
PO 00000
Frm 00095
Fmt 4703
Sfmt 4703
and determine whether to make an
award, compromise, or settlement under
the Federal Tort Claims Act. The
respondents are individuals or entities
making a claim under the Federal Tort
Claims Act.
Type of Request: Extension of an
OMB-approved information collection.
E:\FR\FM\01FEN1.SGM
01FEN1
4725
Federal Register / Vol. 83, No. 22 / Thursday, February 1, 2018 / Notices
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
429.102; 429.103 1 ...........................................................................................
429.104(a) ........................................................................................................
429.104(b) ........................................................................................................
429.104(c) ........................................................................................................
429.106(b) ........................................................................................................
1
11
43
1
8
........................
1
1
1
1
........................
5
5
5
10
1
1
4
0
1
Totals ........................................................................................................
64
........................
........................
7
1 The 1 hour represents a placeholder burden. We are not reporting a burden for this collection because respondents complete OMB-approved
Form SF–95.
6. Application for Extra Help with
Medicare Prescription Drug Plan
Costs—20 CFR 418.3101—0960–0696.
The Medicare Modernization Act of
2003 mandated the creation of the
Medicare Part D prescription drug
coverage program and the provision of
subsidy decision. The respondents are
Medicare beneficiaries applying for the
Part D low-income subsidy.
Type of Request: Revision of an OMBapproved information collection.
subsidies for eligible Medicare
beneficiaries. SSA uses Form SSA–1020
or the internet i1020, the Application
for Extra Help with Medicare
Prescription Drug Plan Costs, to obtain
income and resource information from
Medicare beneficiaries, and to make a
Number of
respondents
Modality of completion
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–1020 ........................................................................................................
(paper application form) ...................................................................................
i1020 ................................................................................................................
(online application) ...........................................................................................
Field office interview ........................................................................................
531,715
1
30
265,858
346,642
108,194
1
1
25
30
144,434
54,097
Totals ........................................................................................................
986,551
........................
........................
464,389
Dated: January 26, 2018.
Naomi R. Sipple,
Reports Clearance Officer, Social Security
Administration.
the rate of productivity growth in 2014
relative to 2013 (1.018). Incorporating
the 2015 value with the values from
2011–2014 period produces a geometric
average productivity growth of 0.994 for
the five-year period 2011–2015, or
-0.6% per year.
[FR Doc. 2018–01947 Filed 1–31–18; 8:45 am]
BILLING CODE 4191–02–P
SURFACE TRANSPORTATION BOARD
Railroad Cost Recovery Procedures—
Productivity Adjustment
Surface Transportation Board.
Adoption of Railroad Cost
Recovery Procedures Productivity
Adjustment.
AGENCY:
ACTION:
In a decision served on
January 29, 2018, the Surface
Transportation Board adopted as final
its calculation of the productivity
adjustment, with the linking factor for
the year 2015, proposed in its
September 29, 2017 decision in the
same docket. See R.R. Cost Recovery
Procedures—Productivity Adjustment,
EP 290 (Sub-No. 4), slip op. at 4 (STB
served Sept. 29, 2017). The productivity
change for 2015, based on changes in
input and output levels from 2014, is
0.939, which is a decrease of 7.8% from
sradovich on DSK3GMQ082PROD with NOTICES
VerDate Sep<11>2014
19:34 Jan 31, 2018
Jkt 244001
Applicability Date: January 29,
Federal Aviation Administration
Public Notice for a Change in Use of
Aeronautical Property at Los Angeles
International Airport, Los Angeles,
California
Federal Aviation
Administration (FAA), DOT.
2018.
AGENCY:
FOR FURTHER INFORMATION CONTACT:
[Docket No. EP 290 (Sub-No. 4)]
SUMMARY:
DATES:
DEPARTMENT OF TRANSPORTATION
ACTION:
Pedro Ramirez, (202) 245–0333. Federal
Information Relay Service (FIRS) for the
hearing impaired, (800) 877–8339.
SUPPLEMENTARY INFORMATION:
Additional information is contained in
the Board’s decision, which is available
on the Board’s website, https://
www.stb.gov. Copies of the decision may
be purchased by contacting the Office of
Public Assistance, Governmental
Affairs, and Compliance at (202) 245–
0238.
Decided: January 25, 2018.
By the Board, Board Members Begeman
and Miller.
Jeffrey Herzig,
Clearance Clerk.
[FR Doc. 2018–01966 Filed 1–31–18; 8:45 am]
BILLING CODE 4915–01–P
PO 00000
Frm 00096
Fmt 4703
Sfmt 4703
Request for public comment.
The Federal Aviation
Administration (FAA) is requesting
public comment on Los Angeles World
Airports’ (LAWA) request to change
approximately 5 acres of airport
property from aeronautical use to nonaeronautical use.
The property is located at the
northeast intersection of Westchester
Parkway and Falmouth Avenue. The
property is currently vacant land with
no structures onsite. LAWA requests to
develop the land with the Argo Drain
Sub-Basin Facility. The Sub-Basin
Facility is primarily an underground
storm water treatment facility designed
to potentially allow open space uses on
the surface. The Sub-Basin Facility also
includes two above-ground elements: A
pump facility and blower building.
SUMMARY:
E:\FR\FM\01FEN1.SGM
01FEN1
]]>Agencies
[Federal Register Volume 83, Number 22 (Thursday, February 1, 2018)]
[Notices]
[Pages 4722-4725]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-01947]
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2018-0002]
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes an extension of an OMB-approved information collection, a new
information collection, and 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: [email protected]
(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: [email protected]
Or you may submit your comments online through www.regulations.gov,
referencing Docket ID Number [SSA-2018-0002].
I. The information collections below are pending at SSA. SSA will
submit them to OMB within 60 days from the date of this notice. To be
sure we consider your comments, we must receive them no later than
April 2, 2018. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Request for Reconsideration--Disability Cessation--20 CFR
404.909, 416.1409--0960-0349. When SSA determines that claimants'
disabilities medically improved; ceased; or are no longer sufficiently
disabling, these claimants may ask SSA to reconsider that
determination. SSA uses Form SSA-789-U4 to arrange for a hearing or to
prepare a decision based on the evidence of record. Specifically,
claimants or their representatives use Form SSA-789-U4 to: (1) Ask SSA
to reconsider a determination; (2) indicate if they wish to appear at a
disability hearing; (3) submit any additional information or evidence
for use in the reconsidered determination; and (4) indicate if they
will need an interpreter for the hearing. The respondents are
disability claimants for Social Security benefits or Supplemental
Security Income (SSI) payments, or their representatives who wish to
appeal an
[[Page 4723]]
unfavorable disability cessation determination.
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)
----------------------------------------------------------------------------------------------------------------
SSA-789-U4.................................. 30,000 1 13 6,500
----------------------------------------------------------------------------------------------------------------
2. Waiver of Right to Appear--Disability Hearing--20 CFR 404.913-
404.914, 404.916(b)(5), 416.1413-416.1414, 416.1416(b)(5)--0960-0534.
Claimants for Social Security disability payments or their
representatives can use Form SSA-773-U4 to waive their right to appear
at a disability hearing. The disability hearing officer uses the signed
form as a basis for not holding a hearing, and for preparing a written
decision on the claimant's request for disability payments based solely
on the evidence of record. The respondents are disability claimants for
Social Security benefits or SSI payments, or their representatives, who
wish to waive their right to appear at a disability hearing.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-773-U4.................................. 200 1 3 10
----------------------------------------------------------------------------------------------------------------
3. Social Security Number Verification Services--20 CFR 401.45--
0960-0660. Internal Revenue Service regulations require employers to
provide wage and tax data to SSA using Form W-2, or its electronic
equivalent. As part of this process, the employer must furnish the
employee's name and Social Security number (SSN). In addition, the
employee's name and SSN must match SSA's records for SSA to post
earnings to the employee's earnings record, which SSA maintains. SSA
offers the Social Security Number Verification Service (SSNVS), which
allows employers to verify the reported names and SSNs of their
employees match those in SSA's records. SSNVS is a cost-free method for
employers to verify employee information via the internet. The
respondents are employers who need to verify SSN data using SSA's
records.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of Number of per response annual burden
respondents response responses (minutes) (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSNVS.............................................................. 41,387 60 2,483,220 5 206,935
--------------------------------------------------------------------------------------------------------------------------------------------------------
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 March 5, 2018. Individuals can obtain copies of the
OMB clearance packages by writing to [email protected].
1. Statement of Interpreter--0960-NEW. SSA and the Disability
Determination Services (DDS) will use Form SSA-4321, Statement of
Interpreter, when a person requiring an interpreter prefers to provide
their own interpreter during an interview or conversation between the
person requiring an interpreter and SSA or DDS. SSA will require the
interpreter sign Form SSA-4321, and confirm, among other things, that
they will not knowingly give false information; they will act as an
interpreter and witness; and they will accurately interpret the
interview to the best of their ability. Section 205(a) of the Social
Security Act (Act), as amended (42 U.S.C. 405(a)) authorizes SSA
collect this information.
Type of Request: A New Information Collection Request.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4321.................................... 5,170,399 1 5 430,867
----------------------------------------------------------------------------------------------------------------
2. Application for Mother's or Father's Insurance Benefits--20 CFR
404.339-404.342, 20 CFR 404.601-404.603--0960-0003. Section 202(g) of
the Act provides for the payment of monthly benefits to the widow or
widower of an insured individual if the surviving spouse is caring for
the deceased worker's child (who is entitled to Social Security
benefits). SSA uses the information on Form SSA-5-BK to determine an
individual's eligibility for mother's or father's insurance benefits.
The respondents are individuals caring for a child of the deceased
worker who
[[Page 4724]]
is applying for mother's or father's insurance benefits under the Old
Age, Survivors, and Disability Insurance program.
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)
----------------------------------------------------------------------------------------------------------------
SSA-5-F6 (paper)............................ 6,542 1 15 1,636
Modernized Claims System.................... 42,175 1 15 10,544
-------------------------------------------------------------------
Totals.................................. 48,717 ............... ............... 12,180
----------------------------------------------------------------------------------------------------------------
3. Statement of Living Arrangements, In-Kind Support, and
Maintenance--20 CFR 416.1130-416.1148--0960-0174. SSA determines SSI
payment amounts based on applicants' and recipients' needs. We measure
individuals' needs, in part, by the amount of income they receive,
including in-kind support and maintenance in the form of food and
shelter provided by other people. SSA uses Form SSA-8006-F4 to
determine if in-kind support and maintenance exists for SSI applicants
and recipients. This information also assists SSA in determining the
income value of in-kind support and maintenance SSI applicants and
recipients receive. The respondents are individuals who apply for SSI
payments, or who complete an SSI eligibility redetermination.
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)
----------------------------------------------------------------------------------------------------------------
SSA-8006-F4................................. 173,380 1 7 20,228
----------------------------------------------------------------------------------------------------------------
4. Statement of Funds You Provided to Another and Statement of
Funds You Received--20 CFR 416.1103(f)--0960-0481. SSA uses Forms SSA-
2854 (Statement of Funds You Provided to Another) and SSA-2855
(Statement of Funds You Received) to gather information to verify if a
loan is bona fide for SSI recipients. The SSA-2854 asks the lender for
details on the transaction, and Form SSA-2855 asks the borrower the
same basic questions independently. Agency personnel then compare the
two statements; gather evidence if needed; and make a decision on the
validity of the bona fide status of the loan.
For SSI purposes, we consider a loan bona fide if it meets these
requirements:
Must be between a borrower and lender with the
understanding that the borrower has an obligation to repay the money;
Must be in effect at the time the cash goes to the
borrower, that is, the agreement cannot come after the cash is paid;
and
Must be enforceable under State law, often there are
additional requirements from the State.
SSA collects this information at the time of initial application
for SSI, or at any point when an individual alleges being party to an
informal loan while receiving SSI. SSA collects information on the
informal loan through both interviews and mailed forms. The agency's
field personnel conduct the interviews and mail the form(s) for
completion, as needed. The respondents are SSI recipients and
applicants, and individuals who lend money to them.
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)
----------------------------------------------------------------------------------------------------------------
SSA-2854.................................... 20,000 1 10 3,333
SSA-2855.................................... 20,000 1 10 3,333
-------------------------------------------------------------------
Totals.................................. 40,000 ............... ............... 6,666
----------------------------------------------------------------------------------------------------------------
5. Filing Claims Under the Federal Tort Claims Act--20 CFR 429.101-
429.110--0960-0667. The Federal Tort Claims Act is the legal mechanism
for compensating persons injured by negligent or wrongful acts that
occur during the performance of official duties by Federal employees.
In accordance with the law, SSA accepts monetary claims filed under the
Federal Tort Claims Act for damages against the United States, loss of
property, personal injury, or death resulting from an SSA employee's
wrongful act or omission. The regulation sections cleared under this
information collection request require claimants to provide information
SSA can use to investigate and determine whether to make an award,
compromise, or settlement under the Federal Tort Claims Act. The
respondents are individuals or entities making a claim under the
Federal Tort Claims Act.
Type of Request: Extension of an OMB-approved information
collection.
[[Page 4725]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
429.102; 429.103 \1\........................ 1 ............... ............... 1
429.104(a).................................. 11 1 5 1
429.104(b).................................. 43 1 5 4
429.104(c).................................. 1 1 5 0
429.106(b).................................. 8 1 10 1
-------------------------------------------------------------------
Totals.................................. 64 ............... ............... 7
----------------------------------------------------------------------------------------------------------------
\1\ The 1 hour represents a placeholder burden. We are not reporting a burden for this collection because
respondents complete OMB-approved Form SF-95.
6. Application for Extra Help with Medicare Prescription Drug Plan
Costs--20 CFR 418.3101--0960-0696. The Medicare Modernization Act of
2003 mandated the creation of the Medicare Part D prescription drug
coverage program and the provision of subsidies for eligible Medicare
beneficiaries. SSA uses Form SSA-1020 or the internet i1020, the
Application for Extra Help with Medicare Prescription Drug Plan Costs,
to obtain income and resource information from Medicare beneficiaries,
and to make a subsidy decision. The respondents are Medicare
beneficiaries applying for the Part D low-income subsidy.
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)
----------------------------------------------------------------------------------------------------------------
SSA-1020.................................... 531,715 1 30 265,858
(paper application form)....................
i1020....................................... 346,642 1 25 144,434
(online application)........................
Field office interview...................... 108,194 1 30 54,097
-------------------------------------------------------------------
Totals.................................. 986,551 ............... ............... 464,389
----------------------------------------------------------------------------------------------------------------
Dated: January 26, 2018.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-01947 Filed 1-31-18; 8:45 am]
BILLING CODE 4191-02-P
