Agency Information Collection Activities: Proposed Request and Comment Request, 49965-49969 [2018-21539]
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Federal Register / Vol. 83, No. 192 / Wednesday, October 3, 2018 / Notices
SECURITIES AND EXCHANGE
COMMISSION
[Release No. 34–84313; File No. 10–233]
MIAX EMERALD, LLC; Notice of Filing
of Application for Registration as a
National Securities Exchange Under
Section 6 of the Securities Exchange
Act of 1934
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September 28, 2018.
On August 16, 2018, MIAX
EMERALD, LLC (‘‘EMERALD’’ or
‘‘Applicant’’) submitted to the Securities
and Exchange Commission
(‘‘Commission’’) a Form 1 application
under the Securities Exchange Act of
1934 (‘‘Exchange Act’’), seeking
registration as a national securities
exchange under Section 6 of the
Exchange Act.
The Commission is publishing this
notice to solicit comments on
EMERALD’s Form 1 application. The
Commission will take any comments it
receives into consideration in making its
determination about whether to grant
EMERALD’s request to be registered as
a national securities exchange. The
Commission will grant the registration if
it finds that the requirements of the
Exchange Act and the rules and
regulations thereunder with respect to
EMERALD are satisfied.1
The Applicant’s Form 1 application
provides detailed information on how
EMERALD proposes to satisfy the
requirements of the Exchange Act. The
Form 1 application also provides that
EMERALD would operate a fully
automated electronic trading platform
for the trading of listed options and
would not maintain a physical trading
floor. It also provides that liquidity
would be derived from orders to buy
and orders to sell submitted to
EMERALD electronically by its
registered broker-dealer members, as
well as from quotes submitted
electronically by market makers.
Further, the Form 1 application states
that EMERALD would be wholly-owned
by its parent company, Miami
International Holdings, Inc. (‘‘Miami
Holdings’’), which is also the parent
company of an two existing national
securities exchange, Miami
International Securities Exchange, LLC
and MIAX PEARL, LLC.
A more detailed description of the
manner of operation of EMERALD’s
proposed system can be found in
Exhibit E to EMERALD’s Form 1
application. The proposed rulebook for
the proposed exchange can be found in
Exhibit B to EMERALD’s Form 1
application, and the governing
1 15
U.S.C. 78s(a).
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documents for both EMERALD and
Miami Holdings can be found in Exhibit
A and Exhibit C to EMERALD’s Form 1
application, respectively. A listing of
the officers and directors of EMERALD
can be found in Exhibit J to EMERALD’s
Form 1 application.
EMERALD’s Form 1 application,
including all of the Exhibits referenced
above, is available online at
www.sec.gov/rules/other.shtml as well
as in the Commission’s Public Reference
Room. Interested persons are invited to
submit written data, views, and
arguments concerning EMERALD’s
Form 1, including whether the
application is consistent with the
Exchange Act.
Comments may be submitted by any
of the following methods:
Electronic Comments
• Use the Commission’s internet
comment form (https://www.sec.gov/
rules/other.shtml); or
• Send an email to rule-comments@
sec.gov. Please include File Number 10–
233 on the subject line.
Paper Comments
• Send paper comments in triplicate
to Secretary, Securities and Exchange
Commission, 100 F Street NE,
Washington, DC 20549–1090.
All submissions should refer to File
Number 10–233. This file number
should be included on the subject line
if email is used. To help the
Commission process and review your
comments more efficiently, please use
only one method. The Commission will
post all comments on the Commission’s
internet website (https://www.sec.gov/
rules/other.shtml). Copies of the
submission, all subsequent
amendments, all written statements
with respect to EMERALD’S Form 1
filed with the Commission, and all
written communications relating to the
application between the Commission
and any person, other than those that
may be withheld from the public in
accordance with the provisions of 5
U.S.C. 552, will be available for website
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 a.m. and 3 p.m. All
comments received will be posted
without change. Persons submitting
comments are cautioned that we do not
redact or edit personal identifying
information from comment submissions.
You should submit only information
that you wish to make publicly
available. All submissions should refer
to File Number 10–233 and should be
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49965
submitted on or before November 19,
2018.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.2
Eduardo A. Aleman,
Assistant Secretary.
[FR Doc. 2018–21555 Filed 10–2–18; 8:45 am]
BILLING CODE 8011–01–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2018–0053]
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 extensions
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–
2018–0053].
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 December 3,
2018. Individuals can obtain copies of
the collection instruments by writing to
the above email address.
2 17
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Federal Register / Vol. 83, No. 192 / Wednesday, October 3, 2018 / Notices
1. Response to Notice of Revised
Determination—20 CFR 404.913–
404.914, 404.992(b), 416.1413–416.1414,
and 416.1492(d)—0960–0347. When
SSA determines: (1) Claimants for initial
disability benefits do not actually have
a disability; or (2) current disability
recipients’ records show their disability
ceased, SSA notifies the disability
claimants, or recipients of this decision.
In response to this notice, the affected
claimants and disability recipients have
the following recourse: (1) They may
request a disability hearing to contest
SSA’s decision; and (2) they may submit
additional information or evidence for
SSA to consider. Disability claimants,
recipients, and their representatives use
Form SSA–765 to accomplish these two
actions. If respondents request the first
option, SSA’s Disability Hearings Unit
uses the form to schedule a hearing;
ensure an interpreter is present, if
required; and ensure the disability
recipients or claimants, and their
representatives, receive a notice about
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–765 ..........................................................................................................
1,925
1
30
963
2. Site Review Questionnaire for
Volume and Fee-for-Service Payees and
Beneficiary Interview Form—20 CFR
404.2035, 404.2065, 416.665, 416.701,
and 416.708—0960–0633. SSA asks
organizational representative payees to
complete Form SSA–637, the Site
Review Questionnaire for Volume and
Fee-for-Service Payees, to provide
information on how they carry out their
responsibilities, including how they
manage beneficiary funds. SSA then
obtains information from the
beneficiaries these organizations
represent via Form SSA–639,
Beneficiary Interview Form, to
corroborate the payees’ statements. Due
to the sensitivity of the information,
SSA employees always complete the
forms based on the answers respondents
Number of
respondents
Modality of completion
give during the interview. The
respondents are individuals; State and
local governments; non-profit and forprofit organizations serving as
representative payees; and the
beneficiaries they serve.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–637 ..........................................................................................................
SSA–639 ..........................................................................................................
4,924
21,772
1
1
120
10
9,848
3,629
Totals ........................................................................................................
26,696
........................
........................
13,477
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
November 2, 2018. Individuals can
obtain copies of the OMB clearance
packages by writing to
OR.Reports.Clearance@ssa.gov.
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the place and time of the hearing. If
respondents choose the second option,
SSA uses the form and other evidence
to reevaluate the claimant’s or
recipients’ case, and determine if the
new information or evidence will
change SSA’s decision. The respondents
are disability claimants, current
disability recipients, or their
representatives.
Type of Request: Revision of an OMBapproved information collection.
1. Medical Source Opinion of
Patient’s Capability to Manage Benefits
—20 CFR 404.2015 and 416.615—0960–
0024. SSA appoints a representative
payee in cases where we determine
beneficiaries are not capable of
managing their own benefits. In these
instances, we require medical evidence
to determine the beneficiaries’
capability of managing or directing their
benefit payments. SSA collects medical
evidence on Form SSA–787 to: (1)
Determine beneficiaries’ capability or
inability to handle their own benefits;
and (2) assist in determining the
beneficiaries’ need for a representative
payee. The respondents are the
beneficiary’s physicians, or medical
officers of the institution in which the
beneficiary resides.
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–787 ..........................................................................................................
131,556
1
20
43,852
2. Work Activity Report—Employee—
20 CFR 404.1520(b), 404.1571–404.1576,
404.1584–404.1593, and 416.971–
404.976 —0960–0059. SSA uses the
SSA–821–BK to obtain work
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information during the initial claims
process; the continuing disability
review process; post-adjudicative work
issue actions; and for the Supplemental
Security Income (SSI) claims involving
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work issues. SSA reviews and evaluates
the data to determine if the applicant or
recipient meets the disability
requirements of the law. The
respondents are applicants and
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recipients of Title II Social Security and
Title XVI SSI disability payments.
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–821–BK ...................................................................................................
300,000
1
30
150,000
3. State Supplementation Provisions:
Agreement; Payments—20 CFR
416.2095–416.2099—0960–0240.
Section 1618 of the Social Security Act
(Act) requires those states administering
their own supplementary income
payment program(s) to demonstrate
compliance with the Act by passing
Federal cost-of-living increases on to
individuals who are eligible for state
supplementary payments, and
informing SSA of their compliance. In
general, states report their
supplementary payment information
annually by the maintenance-ofpayment levels method. However, SSA
may ask them to report up to four times
in a year by the total-expenditures
method. Regardless of the method, the
states confirm their compliance with the
requirements, and provide any changes
to their optional supplementary
payment rates. SSA uses the
information to determine each state’s
Number of
respondents
Modality of completion
Number of
respondents
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
Total Expenditures ...............................................................
Maintenance of Payment Levels .........................................
7
26
4
1
28
26
60
60
28
26
Total ..............................................................................
33
........................
54
........................
54
4. Appointment of Representative—20
CFR 404.1707, 404.1720, 408.1101,
416.1507, and 416.1520—0960–0527.
Individuals claiming rights or benefits
under the Act must notify SSA in
writing when they appoint an
individual to represent them in dealing
with SSA. In addition, SSA requires
representatives to sign the notice of
appointment, or submit the equivalent
in writing, if the representative is not an
attorney. Recipients use Form SSA–
1696–U4 to appoint a representative to
handle their claim before SSA, and their
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Frequency
of response
compliance or noncompliance with the
pass-along requirements of the Act to
determine eligibility for Medicaid
reimbursement. If a state fails to keep
payments at the required level, it
becomes ineligible for Medicaid
reimbursement under Title XIX of the
Act. Respondents are state agencies
administering supplemental programs.
Type of Request: Extension of an
OMB-approved information collection.
appointed representative uses the SSA–
1696–U4 to indicate whether they will
charge a fee, and to show their
eligibility for direct fee payment. In
addition, representatives also use the
SSA–1696–U4 to inform SSA of their
disbarment; suspension from a court or
bar in which they previously admitted
to practice; or their disqualification
from participating in or appearing
before a Federal program or agency.
Finally, SSA requires non-attorney
appointed representatives to sign the
SSA–1696–U4, or an equivalent written
statement. SSA uses the information on
the SSA–1696–U4 to document the
appointment of the representative.
Respondents are applicants for, or
recipients of, Social Security disability
benefits (SSDI) or SSI payments who are
notifying SSA they have appointed a
person to represent them in their
dealings with SSA, and their nonattorney representatives who need to
sign the form.
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–1696–U4 .................................................................................................
800,000
1
13
173,333
5. Representative Payee Report of
Benefits and Dedicated Account —20
CFR 416.546, 416.635, 416.640, and
416.665—0960–0576. SSA requires
representative payees (RPs) to submit a
written report accounting for the use of
money paid to Social Security or SSI
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recipients, and to establish and
maintain a dedicated account for these
payments. SSA uses Form SSA–6233 to:
(1) Ensure the RPs use the payments for
the recipient’s current maintenance and
personal needs; and (2) confirm the
expenditures of funds from the
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dedicated account remain in
compliance with the law. Respondents
are RPs for SSI and Social Security
recipients.
Type of Request: Revision of an OMBapproved information collection.
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Federal Register / Vol. 83, No. 192 / Wednesday, October 3, 2018 / Notices
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–6233 ........................................................................................................
36,228
1
20
12,076
6. Testimony by Employees and the
Production of Records and Information
in Legal Proceedings—20 CFR 403.100–
403.155 —0960–0619. Regulations at 20
CFR 403.100–403.155 of the Code of
Federal Regulations establish SSA’s
policies and procedures for an
individual; organization; or government
entity to request official agency
interest to provide the testimony; and
(4) provide the date, time, and place for
the testimony. Respondents are
individuals or entities who request
testimony from SSA employees in
connection with a legal proceeding.
Type of Request: Extension of an
OMB-approved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
20 CFR 403.100–403.155 ...............................................................................
100
1
60
100
7. Certification of Prisoner Identity
Information—20 CFR 422.107—0960–
0688. Inmates of Federal, State, or local
prisons may need a Social Security card
as verification of their Social Security
Number (SSN) for school or work
programs, or as proof of employment
eligibility upon release from
incarceration. Before SSA can issue a
replacement Social Security card,
applicants must show SSA proof of their
identity. People who are in prison for an
extended period typically do not have
current identity documents. Therefore,
under formal written agreement with
the correctional institution, SSA allows
prison officials to verify the identity of
certain incarcerated U.S. citizens who
need replacement Social Security cards.
Information prison officials provide
comes from the official prison files, sent
on correctional facility letterhead. SSA
uses this information to establish the
applicant’s identity in the replacement
Social Security card process. The
respondents are prison officials who
certify the identity of prisoners applying
for replacement Social Security cards.
Type of Request: Extension of an
OMB-approved Information Collection.
Modality of completion
Number of
respondents
Frequency
of response
Number of
responses
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
Verification of Prisoner Identity Statements ........................
1,000
200
200,000
3
10,000
8. Notification of a Social Security
Number (SSN) to an Employer for Wage
Reporting—20 CFR 422.103(a)—0960–
0778. Individuals applying for
employment must provide a SSN, or
indicate they have applied for one.
However, when an individual applies
for an initial SSN, there is a delay
between the assignment of the number
and the delivery of the SSN card. At an
individual’s request, SSA uses Form
SSA–132 to send the individual’s SSN
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information, records, or testimony of an
agency employee in a legal proceeding
when the agency is not a party. The
request, which respondents submit in
writing to SSA, must: (1) Fully set out
the nature and relevance of the sought
testimony; (2) explain why the
information is not available by other
means; (3) explain why it is in SSA’s
to an employer. Mailing this
information to the employer: (1) Ensures
the employer has the correct SSN for the
individual; (2) allows SSA to receive
correct earnings information for wage
reporting purposes; and (3) reduces the
delay in the initial SSN assignment and
delivery of the SSN information directly
to the employer. It also enables SSA to
verify the employer as a safeguard for
the applicant’s personally identifiable
information. The majority of individuals
who take advantage of this option are in
the United States with exchange visitor
and student visas; however, we allow
any applicant for an SSN to use the
SSA–132. The respondents are
individuals applying for an initial SSN
who ask SSA to mail confirmation of
their application or the SSN to their
employers.
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–132 ..........................................................................................................
326,000
1
2
10,867
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Federal Register / Vol. 83, No. 192 / Wednesday, October 3, 2018 / Notices
Dated: September 28, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security
Administration.
DEPARTMENT OF STATE
DEPARTMENT OF STATE
[Public Notice: 10573]
Notice of Determinations; Culturally
Significant Objects Imported for
Exhibition—Determinations: ‘‘The
Orle´ans Collection’’ Exhibition
Notice is hereby given of the
following determinations: I hereby
determine that certain objects to be
included in the exhibition ‘‘The Orle´ans
Collection,’’ imported from abroad for
temporary exhibition within the United
States, are of cultural significance. The
objects are imported pursuant to loan
agreements with the foreign owners or
custodians. I also determine that the
exhibition or display of the exhibit
objects at the New Orleans Museum of
Art, in New Orleans, Louisiana, from on
or about October 26, 2018, until on or
about January 27, 2019, and at possible
additional exhibitions or venues yet to
be determined, is in the national
interest. I have ordered that Public
Notice of these determinations be
published in the Federal Register.
SUMMARY:
Julie
Simpson, Attorney-Adviser, Office of
the Legal Adviser, U.S. Department of
State (telephone: 202–632–6471; email:
section2459@state.gov). The mailing
address is U.S. Department of State, L/
PD, SA–5, Suite 5H03, Washington, DC
20522–0505.
FOR FURTHER INFORMATION CONTACT:
The
foregoing determinations were made
pursuant to the authority vested in me
by the Act of October 19, 1965 (79 Stat.
985; 22 U.S.C. 2459), E.O. 12047 of
March 27, 1978, the Foreign Affairs
Reform and Restructuring Act of 1998
(112 Stat. 2681, et seq.; 22 U.S.C. 6501
note, et seq.), Delegation of Authority
No. 234 of October 1, 1999, and
Delegation of Authority No. 236–3 of
August 28, 2000.
daltland on DSKBBV9HB2PROD with NOTICES
Marie Therese Porter Royce,
Assistant Secretary for Educational and
Cultural Affairs, Department of State.
[Public Notice: 10575]
Advisory Committee on International
Economic Policy; Notice of Open
Meeting
BILLING CODE 4191–02–P
SUPPLEMENTARY INFORMATION:
DEPARTMENT OF STATE
[Public Notice: 10572]
[FR Doc. 2018–21539 Filed 10–2–18; 8:45 am]
The Advisory Committee on
International Economic Policy (ACIEP)
will meet from 1:30 until 4:00 p.m.,
Wednesday, October 17 in Washington,
DC at the State Department, 320 21st St.
NW. The meeting will be hosted by the
Assistant Secretary of State for
Economic and Business Affairs,
Manisha Singh, and Committee Chair
Paul R. Charron. The ACIEP serves the
U.S. government in a solely advisory
capacity, and provides advice
concerning topics in international
economic policy. During this meeting,
subcommittees, such as the Stakeholder
Advisory Board, can present updates.
Topics for discussion will include
concerns about Chinese global
investment and the implications for U.S.
business and economic interests’ postBrexit.
This meeting is open to the public,
though seating is limited. Entry to the
building is controlled. To obtain preclearance for entry, members of the
public planning to attend must, no later
than Friday, October 5, provide their
full name and professional affiliation (if
any) to Rima Vydmantas by email:
VydmantasRJ@state.gov. Requests for
reasonable accommodation also should
be made to Rima Vydmantas before
Friday, October 12. Requests made after
that date will be considered, but might
not be possible to fulfill.
This information is being collected
pursuant to 22 U.S.C. 2651a and 22
U.S.C. 4802 for the purpose of screening
and pre-clearing participants to enter
the host venue at the U.S. Department
of State, in line with standard security
procedures for events of this size. The
Department of State will use this
information consistent with the routine
uses set forth in the System of Records
Notices for Protocol Records (STATE–
33) and Security Records (State-36).
Provision of this information is
voluntary, but failure to provide
accurate information may impede your
ability to register for the event.
For additional information, contact
Rima Vydmantas, Bureau of Economic
and Business Affairs, at (202) 647–4301,
or VydmantasRJ@state.gov.
[FR Doc. 2018–21512 Filed 10–2–18; 8:45 am]
Rima J. Vydmantas,
Designated Federal Officer, U.S. Department
of State.
BILLING CODE 4710–05–P
[FR Doc. 2018–21518 Filed 10–2–18; 8:45 am]
BILLING CODE 4710–07–P
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Notice of Determinations; Culturally
Significant Objects Imported for
Exhibition—Determinations:
‘‘Contesting Modernity: Informalism in
Venezuela, 1955–1975’’ Exhibition
Notice is hereby given of the
following determinations: I hereby
determine that certain objects to be
included in the exhibition ‘‘Contesting
Modernity: Informalism in Venezuela,
1955–1975,’’ imported from abroad for
temporary exhibition within the United
States, are of cultural significance. The
objects are imported pursuant to loan
agreements with the foreign owners or
custodians. I also determine that the
exhibition or display of the exhibit
objects at The Museum of Fine Arts,
Houston, in Houston, Texas, from on or
about October 26, 2018, until on or
about January 21, 2019, and at possible
additional exhibitions or venues yet to
be determined, is in the national
interest. I have ordered that Public
Notice of these determinations be
published in the Federal Register.
FOR FURTHER INFORMATION CONTACT: Julie
Simpson, Attorney-Adviser, Office of
the Legal Adviser, U.S. Department of
State (telephone: 202–632–6471; email:
section2459@state.gov). The mailing
address is U.S. Department of State, L/
PD, SA–5, Suite 5H03, Washington, DC
20522–0505.
SUPPLEMENTARY INFORMATION: The
foregoing determinations were made
pursuant to the authority vested in me
by the Act of October 19, 1965 (79 Stat.
985; 22 U.S.C. 2459), E.O. 12047 of
March 27, 1978, the Foreign Affairs
Reform and Restructuring Act of 1998
(112 Stat. 2681, et seq.; 22 U.S.C. 6501
note, et seq.), Delegation of Authority
No. 234 of October 1, 1999, and
Delegation of Authority No. 236–3 of
August 28, 2000.
SUMMARY:
Marie Therese Porter Royce,
Assistant Secretary for Educational and
Cultural Affairs, Department of State.
[FR Doc. 2018–21514 Filed 10–2–18; 8:45 am]
BILLING CODE 4710–05–P
SUSQUEHANNA RIVER BASIN
COMMISSION
Public Hearing
Susquehanna River Basin
Commission.
ACTION: Notice.
AGENCY:
The Susquehanna River Basin
Commission will hold a public hearing
SUMMARY:
E:\FR\FM\03OCN1.SGM
03OCN1
]]>Agencies
[Federal Register Volume 83, Number 192 (Wednesday, October 3, 2018)]
[Notices]
[Pages 49965-49969]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-21539]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2018-0053]
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 extensions 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-2018-0053].
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
December 3, 2018. Individuals can obtain copies of the collection
instruments by writing to the above email address.
[[Page 49966]]
1. Response to Notice of Revised Determination--20 CFR 404.913-
404.914, 404.992(b), 416.1413-416.1414, and 416.1492(d)--0960-0347.
When SSA determines: (1) Claimants for initial disability benefits do
not actually have a disability; or (2) current disability recipients'
records show their disability ceased, SSA notifies the disability
claimants, or recipients of this decision. In response to this notice,
the affected claimants and disability recipients have the following
recourse: (1) They may request a disability hearing to contest SSA's
decision; and (2) they may submit additional information or evidence
for SSA to consider. Disability claimants, recipients, and their
representatives use Form SSA-765 to accomplish these two actions. If
respondents request the first option, SSA's Disability Hearings Unit
uses the form to schedule a hearing; ensure an interpreter is present,
if required; and ensure the disability recipients or claimants, and
their representatives, receive a notice about the place and time of the
hearing. If respondents choose the second option, SSA uses the form and
other evidence to reevaluate the claimant's or recipients' case, and
determine if the new information or evidence will change SSA's
decision. The respondents are disability claimants, current disability
recipients, or their representatives.
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-765..................................... 1,925 1 30 963
----------------------------------------------------------------------------------------------------------------
2. Site Review Questionnaire for Volume and Fee-for-Service Payees
and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665,
416.701, and 416.708--0960-0633. SSA asks organizational representative
payees to complete Form SSA-637, the Site Review Questionnaire for
Volume and Fee-for-Service Payees, to provide information on how they
carry out their responsibilities, including how they manage beneficiary
funds. SSA then obtains information from the beneficiaries these
organizations represent via Form SSA-639, Beneficiary Interview Form,
to corroborate the payees' statements. Due to the sensitivity of the
information, SSA employees always complete the forms based on the
answers respondents give during the interview. The respondents are
individuals; State and local governments; non-profit and for-profit
organizations serving as representative payees; and the beneficiaries
they serve.
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-637......................................... 4,924 1 120 9,848
SSA-639......................................... 21,772 1 10 3,629
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Totals...................................... 26,696 .............. .............. 13,477
----------------------------------------------------------------------------------------------------------------
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 November 2, 2018. Individuals can obtain copies of
the OMB clearance packages by writing to [email protected].
1. Medical Source Opinion of Patient's Capability to Manage
Benefits --20 CFR 404.2015 and 416.615--0960-0024. SSA appoints a
representative payee in cases where we determine beneficiaries are not
capable of managing their own benefits. In these instances, we require
medical evidence to determine the beneficiaries' capability of managing
or directing their benefit payments. SSA collects medical evidence on
Form SSA-787 to: (1) Determine beneficiaries' capability or inability
to handle their own benefits; and (2) assist in determining the
beneficiaries' need for a representative payee. The respondents are the
beneficiary's physicians, or medical officers of the institution in
which the beneficiary resides.
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-787..................................... 131,556 1 20 43,852
----------------------------------------------------------------------------------------------------------------
2. Work Activity Report--Employee--20 CFR 404.1520(b), 404.1571-
404.1576, 404.1584-404.1593, and 416.971-404.976 --0960-0059. SSA uses
the SSA-821-BK to obtain work information during the initial claims
process; the continuing disability review process; post-adjudicative
work issue actions; and for the Supplemental Security Income (SSI)
claims involving work issues. SSA reviews and evaluates the data to
determine if the applicant or recipient meets the disability
requirements of the law. The respondents are applicants and
[[Page 49967]]
recipients of Title II Social Security and Title XVI SSI disability
payments.
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-821-BK.................................. 300,000 1 30 150,000
----------------------------------------------------------------------------------------------------------------
3. State Supplementation Provisions: Agreement; Payments--20 CFR
416.2095-416.2099--0960-0240. Section 1618 of the Social Security Act
(Act) requires those states administering their own supplementary
income payment program(s) to demonstrate compliance with the Act by
passing Federal cost-of-living increases on to individuals who are
eligible for state supplementary payments, and informing SSA of their
compliance. In general, states report their supplementary payment
information annually by the maintenance-of-payment levels method.
However, SSA may ask them to report up to four times in a year by the
total-expenditures method. Regardless of the method, the states confirm
their compliance with the requirements, and provide any changes to
their optional supplementary payment rates. SSA uses the information to
determine each state's compliance or noncompliance with the pass-along
requirements of the Act to determine eligibility for Medicaid
reimbursement. If a state fails to keep payments at the required level,
it becomes ineligible for Medicaid reimbursement under Title XIX of the
Act. Respondents are state agencies administering supplemental
programs.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of Number of per response total annual
respondents response respondents (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Total Expenditures.............. 7 4 28 60 28
Maintenance of Payment Levels... 26 1 26 60 26
-------------------------------------------------------------------------------
Total....................... 33 .............. 54 .............. 54
----------------------------------------------------------------------------------------------------------------
4. Appointment of Representative--20 CFR 404.1707, 404.1720,
408.1101, 416.1507, and 416.1520--0960-0527. Individuals claiming
rights or benefits under the Act must notify SSA in writing when they
appoint an individual to represent them in dealing with SSA. In
addition, SSA requires representatives to sign the notice of
appointment, or submit the equivalent in writing, if the representative
is not an attorney. Recipients use Form SSA-1696-U4 to appoint a
representative to handle their claim before SSA, and their appointed
representative uses the SSA-1696-U4 to indicate whether they will
charge a fee, and to show their eligibility for direct fee payment. In
addition, representatives also use the SSA-1696-U4 to inform SSA of
their disbarment; suspension from a court or bar in which they
previously admitted to practice; or their disqualification from
participating in or appearing before a Federal program or agency.
Finally, SSA requires non-attorney appointed representatives to sign
the SSA-1696-U4, or an equivalent written statement. SSA uses the
information on the SSA-1696-U4 to document the appointment of the
representative. Respondents are applicants for, or recipients of,
Social Security disability benefits (SSDI) or SSI payments who are
notifying SSA they have appointed a person to represent them in their
dealings with SSA, and their non-attorney representatives who need to
sign the form.
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-1696-U4................................. 800,000 1 13 173,333
----------------------------------------------------------------------------------------------------------------
5. Representative Payee Report of Benefits and Dedicated Account --
20 CFR 416.546, 416.635, 416.640, and 416.665--0960-0576. SSA requires
representative payees (RPs) to submit a written report accounting for
the use of money paid to Social Security or SSI recipients, and to
establish and maintain a dedicated account for these payments. SSA uses
Form SSA-6233 to: (1) Ensure the RPs use the payments for the
recipient's current maintenance and personal needs; and (2) confirm the
expenditures of funds from the dedicated account remain in compliance
with the law. Respondents are RPs for SSI and Social Security
recipients.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 49968]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-6233.................................... 36,228 1 20 12,076
----------------------------------------------------------------------------------------------------------------
6. Testimony by Employees and the Production of Records and
Information in Legal Proceedings--20 CFR 403.100-403.155 --0960-0619.
Regulations at 20 CFR 403.100-403.155 of the Code of Federal
Regulations establish SSA's policies and procedures for an individual;
organization; or government entity to request official agency
information, records, or testimony of an agency employee in a legal
proceeding when the agency is not a party. The request, which
respondents submit in writing to SSA, must: (1) Fully set out the
nature and relevance of the sought testimony; (2) explain why the
information is not available by other means; (3) explain why it is in
SSA's interest to provide the testimony; and (4) provide the date,
time, and place for the testimony. Respondents are individuals or
entities who request testimony from SSA employees in connection with a
legal proceeding.
Type of Request: Extension 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)
----------------------------------------------------------------------------------------------------------------
20 CFR 403.100-403.155...................... 100 1 60 100
----------------------------------------------------------------------------------------------------------------
7. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. Inmates of Federal, State, or local prisons may need a
Social Security card as verification of their Social Security Number
(SSN) for school or work programs, or as proof of employment
eligibility upon release from incarceration. Before SSA can issue a
replacement Social Security card, applicants must show SSA proof of
their identity. People who are in prison for an extended period
typically do not have current identity documents. Therefore, under
formal written agreement with the correctional institution, SSA allows
prison officials to verify the identity of certain incarcerated U.S.
citizens who need replacement Social Security cards. Information prison
officials provide comes from the official prison files, sent on
correctional facility letterhead. SSA uses this information to
establish the applicant's identity in the replacement Social Security
card process. The respondents are prison officials who certify the
identity of prisoners applying for replacement Social Security cards.
Type of Request: Extension 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)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Verification of Prisoner Identity Statements....................... 1,000 200 200,000 3 10,000
--------------------------------------------------------------------------------------------------------------------------------------------------------
8. Notification of a Social Security Number (SSN) to an Employer
for Wage Reporting--20 CFR 422.103(a)--0960-0778. Individuals applying
for employment must provide a SSN, or indicate they have applied for
one. However, when an individual applies for an initial SSN, there is a
delay between the assignment of the number and the delivery of the SSN
card. At an individual's request, SSA uses Form SSA-132 to send the
individual's SSN to an employer. Mailing this information to the
employer: (1) Ensures the employer has the correct SSN for the
individual; (2) allows SSA to receive correct earnings information for
wage reporting purposes; and (3) reduces the delay in the initial SSN
assignment and delivery of the SSN information directly to the
employer. It also enables SSA to verify the employer as a safeguard for
the applicant's personally identifiable information. The majority of
individuals who take advantage of this option are in the United States
with exchange visitor and student visas; however, we allow any
applicant for an SSN to use the SSA-132. The respondents are
individuals applying for an initial SSN who ask SSA to mail
confirmation of their application or the SSN to their employers.
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-132..................................... 326,000 1 2 10,867
----------------------------------------------------------------------------------------------------------------
[[Page 49969]]
Dated: September 28, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-21539 Filed 10-2-18; 8:45 am]
BILLING CODE 4191-02-P
