Agency Information Collection Activities: Proposed Request, 56133-56136 [2018-24517]
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56133
Federal Register / Vol. 83, No. 218 / Friday, November 9, 2018 / Notices
U.S. Small Business Administration,
409 3rd Street SW, Suite 6050,
Washington, DC 20416, (202) 205–6734.
SUPPLEMENTARY INFORMATION: The notice
of the President’s major disaster
declaration for Private Non-Profit
organizations in the State of GEORGIA,
dated 11/01/2018, is hereby amended to
establish the incident period for this
disaster as beginning 10/09/2018 and
continuing through 10/23/2018.
All other information in the original
declaration remains unchanged.
(Catalog of Federal Domestic Assistance
Number 59008)
James Rivera,
Associate Administrator for Disaster
Assistance.
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW, Suite 6050,
Washington, DC 20416, (202) 205–6734.
SUPPLEMENTARY INFORMATION: The notice
of the President’s major disaster
declaration for the State of GEORGIA,
dated 10/14/2018, is hereby amended to
establish the incident period for this
disaster as beginning 10/09/2018 and
continuing through 10/23/2018.
All other information in the original
declaration remains unchanged.
(Catalog of Federal Domestic Assistance
Number 59008)
James Rivera,
Associate Administrator for Disaster
Assistance.
[FR Doc. 2018–24565 Filed 11–8–18; 8:45 am]
BILLING CODE 8025–01–P
[FR Doc. 2018–24568 Filed 11–8–18; 8:45 am]
SMALL BUSINESS ADMINISTRATION
[Disaster Declaration #15744 and #15745;
GEORGIA Disaster Number GA–00108]
SOCIAL SECURITY ADMINISTRATION
Presidential Declaration Amendment of
a Major Disaster for the State of
Georgia
U.S. Small Business
Administration.
ACTION: Amendment 3.
AGENCY:
This is an amendment of the
Presidential declaration of a major
disaster for the State of Georgia (FEMA–
4400–DR), dated 10/14/2018.
Incident: Hurricane Michael.
Incident Period: 10/09/2018 through
10/23/2018.
DATES: Issued on 11/02/2018.
Physical Loan Application Deadline
Date: 12/13/2018.
Economic Injury (EIDL) Loan
Application Deadline Date: 07/15/2019.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
SUMMARY:
khammond on DSK30JT082PROD with NOTICES
BILLING CODE 8025–01–P
[Docket No: SSA–2018–0058]
Agency Information Collection
Activities: Proposed 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–
2018–0058].
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 January 8, 2019. Individuals
can obtain copies of the collection
instruments by writing to the above
email address.
1. Certificate of Responsibility for
Welfare and Care of Child Not in
Applicant’s Custody—20 CFR 404.330,
404.339–404.341 and 404.348–
404.349—0960–0019. SSA uses Form
SSA–781 to determine if non-custodial
parents who file for spouse, mother’s,
father’s, or surviving divorced mother’s
or father’s benefits based on having a
child in their care, meet the in-care
requirements. The in-care provision
requires claimants to have an entitled
child under age 16 or disabled in their
care. The respondents are applicants for
spouse; mother’s, father’s, or surviving
divorced mother’s or father’s Social
Security benefits.
Type of Request: Request for a new
information collection.
Modality of completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–781 ..........................................................................................................
14,000
1
10
2,333
2. Farm Self-Employment
Questionnaire—20 CFR 404.1082(c) &
404.1095—0960–0061. SSA collects the
information on Form SSA–7156 on a
voluntary and as-needed basis to
determine the existence of an
agriculture trade or business which may
affect the monthly benefit, or insured
status, of the applicant. SSA requires
the existence of a trade or business
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Jkt 247001
before determining if an individual or
partnership has net earnings from selfemployment. When an applicant
indicates self-employment as a farmer,
SSA uses the SSA–7165 to obtain the
information we need to determine the
existence of an agricultural trade or
business, and subsequent covered
earnings for Social Security entitlement
purposes. As part of the application
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Fmt 4703
Sfmt 4703
process, we conduct a personal
interview, either face-to-face or via
telephone, and document the interview
using Form SSA–7165. We also allow
applicants to complete a fillable version
of the form available on our website,
which they can complete, print, and
sign. The respondents are applicants for
Social Security benefits whose
entitlement depends on whether the
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Federal Register / Vol. 83, No. 218 / Friday, November 9, 2018 / Notices
worker received covered earnings from
self-employment as a farmer.
Modality of completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–7156 ........................................................................................................
47,500
1
10
7,917
3. Child Relationship Statement—20
CFR 404.355 & 404.731—0960–0116. To
help determine a child’s entitlement to
Social Security benefits, SSA uses
criteria under section 216(h)(3) of the
Social Security Act (Act), deemed child
provision. SSA may deem a child to an
insured individual if: (1) The insured
individual presents SSA with
satisfactory evidence of parenthood, and
was living with or contributing to the
child’s support at certain specified
times; or (2) the insured individual (a)
acknowledged the child in writing; (b)
was court decreed as the child’s parent;
or (c) was court ordered to support the
child. To obtain this information, SSA
uses Form SSA–2519, Child
Relationship Statement. The
respondents are people with knowledge
of the relationship between certain
individuals filing for Social Security
benefits and their alleged biological
children.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–2519 ........................................................................................................
50,000
1
15
12,500
4. Pre-1957 Military Service Federal
Benefit Questionnaire—20 CFR
404.1301–404.1371—0960–0120. SSA
may grant gratuitous military wage
credits for active military or naval
service (under certain conditions)
during the period of September 16, 1940
through December 31, 1956, if no other
Federal agency (other than the Veterans
Administration) credited the service for
benefit eligibility or computation
purposes. We use Form SSA–2512 to
collect specific information about other
Federal, military, or civilian benefits the
wage earner may receive when the
applicant indicates both pre-1957
military service and the receipt of a
Federal benefit. SSA uses the data in the
claims adjudication process to grant
gratuitous military wage credits when
applicable, and to solicit sufficient
information to determine eligibility.
Respondents are applicants for Social
Security benefits on a record where the
wage earner claims pre-1957 military
service.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–2512 ........................................................................................................
5,000
1
10
833
5. Authorization for the Social
Security Administration to Obtain
Account Records from a Financial
Institution—20 CFR 416.200, 416.203,
404.508, & 416.553—0960–0293. SSA
collects and verifies financial
information from individuals applying
for Title II and Title XVI waiver
determinations, as well as those who
apply for, or currently receive (in the
case of redetermination), Supplemental
Security Income (SSI) payments. We
require the financial information from
khammond on DSK30JT082PROD with NOTICES
Type of Request: Revision of an OMBapproved information collection.
these applicants to: (1) Determine the
eligibility of the applicant or recipient
for SSI benefits; or (2) determine if a
request to waive a Social Security
overpayment defeats the purpose of the
Act. If the Title II and Title XVI waiver
applicants, or the SSI claimants provide
incomplete, unavailable, or seemingly
altered records, SSA contacts their
financial institutions to verify the
existence, ownership, and value of
accounts owned. Financial institutions
need individuals to sign Form SSA–
Number of
respondents
Modality of completion
4641–F4, or work with SSA staff to
complete one of SSA’s electronic
applications, e4641 or the Access to
Financial Institutions (AFI) screens, to
authorize the individual’s financial
institution to disclose records to SSA.
The respondents are Title II and Title
XVI recipients applying for waivers, or
SSI applicants, recipients, and their
deemors to determine SSI eligibility.
Type of Request: Revision of an OMBapproved information collection.
Average
burden of
response
(minutes)
Frequency of
response
Estimated
total annual
burden
(hours)
SSA–4641 (paper) ...........................................................................................
e4641 and AFI (Internet) .................................................................................
140,000
15,860,000
1
1
6
2
14,000
528,667
Totals ........................................................................................................
16,000,000
........................
........................
542,667
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Sfmt 4703
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Federal Register / Vol. 83, No. 218 / Friday, November 9, 2018 / Notices
6. Vocational Rehabilitation Provider
Claim—20 CFR 404.2108(b),
404.2117(c)(1)&(2), 404.2101(b)&(c),
404.2121(a), 416.2208(b),
416.2217(c)(1)&(2), 416.2201(b)&(c),
416.2221(a)—0960–0310. State
vocational rehabilitation (VR) agencies
submit Form SSA–199 to SSA to obtain
reimbursement of costs incurred for
providing VR services. SSA requires
state VR agencies to submit
reimbursement claims for the following
Modality of
completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Number of
responses
Estimated
total annual
burden
(hours)
SSA–199 CFR 404.2108 & 416.2208 .................................
CFR 404.2117 & 416.2217 Written requests ......................
CFR 404.2121 & 416.2221 Written requests ......................
80
80
80
160
1
2.5
12,800
80
200
23
60
100
4,907
80
333
Total ..............................................................................
80
........................
13,080
........................
5,320
7. Request for Change in Time/Place
of Disability Hearing—20 CFR
404.914(c)(2) and 416.1414(c)(2)—0960–
0348. At the request of the claimants or
their representatives, SSA schedules
evidentiary hearings at the
reconsideration level for claimants of
Title II benefits or Title XVI payments
and for rescheduling disability hearings.
Respondents are claimants or their
representatives who wish to request a
change in the time or place of their
hearing.
when we deny their claims for
disability. When claimants or their
representatives find they are unable to
attend the scheduled hearing, they
complete Form SSA–769 to request a
change in time or place of the hearing.
SSA uses the information as a basis for
granting or denying requests for changes
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–769 ..........................................................................................................
7,483
1
8
998
8. Application for Supplemental
Security Income—20 CFR 416.305–
416.335, Subpart C—0960–0444. SSA
uses Form SSA–8001–BK to determine
an applicant’s eligibility for SSI and SSI
payment amounts. SSA employees also
collect this information during
interviews with members of the public
who wish to file for SSI. SSA uses the
information for two purposes: (1) To
formally deny SSI for nonmedical
reasons when information the applicant
provides results in ineligibility; or (2) to
establish a disability claim, but defer the
Number of
respondents
Modality of completion
khammond on DSK30JT082PROD with NOTICES
approval of the claim for reimbursement
of costs incurred for SSA beneficiaries.
SSA uses the information on the SSA–
199, along with the written
documentation, to determine whether,
and how much, to pay State VR agencies
under SSA’s VR program. Respondents
are State VR agencies offering vocational
and employment services to Social
Security and SSI recipients.
Type of Request: Revision of an OMBapproved information collection.
categories: (1) Claiming reimbursement
for VR services provided; (2) certifying
adherence to cost containment policies
and procedures; and (3) preparing
causality statements. The respondents
provide the information requested
through a web-based Secure Ticket
Portal, in lieu of submitting forms. This
Portal allows VRs to retrieve reports,
and enter and submit information
electronically, minimizing the use of the
paper form to SSA for consideration and
complete development of non-medical
issues until SSA approves the disability.
The respondents are applicants for SSI
payments.
Type of Request: Revision of an OMBapproved information collection.
Average
burden of
response
(minutes)
Frequency of
response
Estimated
total annual
burden
(hours)
SSI Claims System ..........................................................................................
iClaim/SSI Claims System ...............................................................................
SSA–8001–BK (Paper Version) ......................................................................
802,368
168,661
2,588
1
1
1
20
20
20
267,456
56,220
863
Totals ........................................................................................................
973,617
........................
........................
324,539
9. Wage Reports and Pension
Information—20 CFR 422.122(b)—0960–
0547. Pension plan administrators
annually file plan information with the
Internal Revenue Service, which then
forwards the information to SSA. SSA
maintains and organizes this
information by plan number; plan
VerDate Sep<11>2014
17:36 Nov 08, 2018
Jkt 247001
participant’s name; and Social Security
number. Section 1131(a) of the Act
entitles pension plan participants to
request this information from SSA. The
Wage Reports and Pension Information
regulation, 20 CFR 422.122(b) of the
Code of Federal Regulations, requires
requestors submit a written request with
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Frm 00090
Fmt 4703
Sfmt 4703
identifying information to SSA, before
SSA disseminates this information. The
respondents are requestors of pension
plan information.
Type of Request: Revision of an OMBapproved information collection.
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Federal Register / Vol. 83, No. 218 / Friday, November 9, 2018 / Notices
Modality of completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Estimated
total annual
burden
(hours)
Requests for pension plan information ............................................................
580
1
30
290
10. International Direct Deposit—31
CFR 210—0960–0686. SSA’s
International Direct Deposit (IDD)
Program allows beneficiaries living
abroad to receive their payments via
direct deposit to an account at a
financial institution outside the United
States. SSA uses Form SSA–1199–
(Country) to enroll Title II beneficiaries
residing abroad in IDD, and to obtain
the direct deposit information for
foreign accounts. Routing account
number information varies slightly for
each foreign country, so we use a
variation of the Treasury Department’s
Form SF–1199A for each country. The
Modality of completion
Number of
respondents
Frequency of
response
Average
burden of
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–1199–(Country) .......................................................................................
13,750
1
5
1,146
11. Representative Payment Policies
and Administrative Procedures for
Imposing Penalties for False or
Misleading Statements or Withholding
of Information—0960–0740. This
information collection request
comprises several regulation sections
that provide additional safeguards for
Social Security beneficiaries’ whose
representative payees receive their
payment. SSA requires representative
payees to notify them of any event or
change in circumstances that would
affect receipt of benefits or performance
of payee duties. SSA uses the
information to determine continued
Number of
respondents
Modality of completion
eligibility for benefits, the amount of
benefits due and if the payee is suitable
to continue servicing as payee. The
respondents are representative payees
who receive and use benefits on behalf
of Social Security beneficiaries.
Type of Request: Revision of an OMBapproved information collection.
Average
burden of
response
(minutes)
Frequency of
response
Estimated
total annual
burden
(hours)
404.2035(d)—Paper/Mail .................................................................................
404.2035(d)—Office interview/Intranet ............................................................
404.2035(f)—Paper/Mail ..................................................................................
404.2035(f)—Office interview/Intranet .............................................................
416.635(d)—Paper/Mail ...................................................................................
416.635(d)—Office interview/Intranet ..............................................................
416.635(f)—Paper/Mail ....................................................................................
416.635(f)—Office interview/Intranet ...............................................................
29,601
562,419
296
5,624
16,146
296,424
162
3,067
1
1
1
1
1
1
1
1
5
5
5
5
5
5
5
5
2,467
46,868
25
469
1,346
24,702
14
256
Totals ........................................................................................................
913,739
........................
........................
76,147
Dated: November 5, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security
Administration.
California Department of Transportation
(Caltrans).
BILLING CODE 4191–02–P
DEPARTMENT OF TRANSPORTATION
Federal Highway Administration
Notice of Final Federal Agency Actions
on Proposed Highway in California
Federal Highway
Administration (FHWA), DOT.
AGENCY:
Notice of Limitation on Claims
for Judicial Review of Actions by the
ACTION:
VerDate Sep<11>2014
17:36 Nov 08, 2018
Jkt 247001
The FHWA, on behalf of
Caltrans, is issuing this notice to
announce actions taken by Caltrans that
are final. The actions relate to a
proposed highway project on State
Route 133 from just south of El Toro
Road to State Route 73 between Post
Miles 3.1 and R4.1 in the City of Laguna
Beach, State of California. Those actions
grant licenses, permits, and approvals
for the project.
DATES: By this notice, the FHWA, on
behalf of Caltrans, is advising the public
of final agency actions subject to 23
U.S.C. 139(l)(1). A claim seeking
judicial review of the Federal agency
actions on the highway project will be
SUMMARY:
[FR Doc. 2018–24517 Filed 11–8–18; 8:45 am]
khammond on DSK30JT082PROD with NOTICES
respondents are Social Security
beneficiaries residing abroad who want
SSA to deposit their Title II benefit
payments directly to a foreign financial
institution.
Type of Request: Revision of an OMB
approved information collection.
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Frm 00091
Fmt 4703
Sfmt 4703
barred unless the claim is filed on or
before April 8, 2019. If the Federal law
that authorizes judicial review of a
claim provides a time period of less
than 150 days for filing such claim, then
that shorter time period still applies.
For
Caltrans: Smita Deshpande, Senior
Environmental Planner, Caltrans, 1750
East 4th Street, Suite 100, Santa Ana,
California, 92705, (657) 328–6151,
smita.deshpande@dot.ca.gov. For
FHWA: Larry Vinzant at (916) 498–5040
or email larry.vinzant@dot.gov.
FOR FURTHER INFORMATION CONTACT:
Effective
July 1, 2007, the FHWA assigned, and
Caltrans assumed, environmental
responsibilities for this project pursuant
to 23 U.S.C. 327. Notice is hereby given
SUPPLEMENTARY INFORMATION:
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]]>Agencies
[Federal Register Volume 83, Number 218 (Friday, November 9, 2018)]
[Notices]
[Pages 56133-56136]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-24517]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2018-0058]
Agency Information Collection Activities: Proposed 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: [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-2018-0058].
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
January 8, 2019. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Certificate of Responsibility for Welfare and Care of Child Not
in Applicant's Custody--20 CFR 404.330, 404.339-404.341 and 404.348-
404.349--0960-0019. SSA uses Form SSA-781 to determine if non-custodial
parents who file for spouse, mother's, father's, or surviving divorced
mother's or father's benefits based on having a child in their care,
meet the in-care requirements. The in-care provision requires claimants
to have an entitled child under age 16 or disabled in their care. The
respondents are applicants for spouse; mother's, father's, or surviving
divorced mother's or father's Social Security benefits.
Type of Request: Request for a new information collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-781..................................... 14,000 1 10 2,333
----------------------------------------------------------------------------------------------------------------
2. Farm Self-Employment Questionnaire--20 CFR 404.1082(c) &
404.1095--0960-0061. SSA collects the information on Form SSA-7156 on a
voluntary and as-needed basis to determine the existence of an
agriculture trade or business which may affect the monthly benefit, or
insured status, of the applicant. SSA requires the existence of a trade
or business before determining if an individual or partnership has net
earnings from self-employment. When an applicant indicates self-
employment as a farmer, SSA uses the SSA-7165 to obtain the information
we need to determine the existence of an agricultural trade or
business, and subsequent covered earnings for Social Security
entitlement purposes. As part of the application process, we conduct a
personal interview, either face-to-face or via telephone, and document
the interview using Form SSA-7165. We also allow applicants to complete
a fillable version of the form available on our website, which they can
complete, print, and sign. The respondents are applicants for Social
Security benefits whose entitlement depends on whether the
[[Page 56134]]
worker received covered earnings from self-employment as a farmer.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7156.................................... 47,500 1 10 7,917
----------------------------------------------------------------------------------------------------------------
3. Child Relationship Statement--20 CFR 404.355 & 404.731--0960-
0116. To help determine a child's entitlement to Social Security
benefits, SSA uses criteria under section 216(h)(3) of the Social
Security Act (Act), deemed child provision. SSA may deem a child to an
insured individual if: (1) The insured individual presents SSA with
satisfactory evidence of parenthood, and was living with or
contributing to the child's support at certain specified times; or (2)
the insured individual (a) acknowledged the child in writing; (b) was
court decreed as the child's parent; or (c) was court ordered to
support the child. To obtain this information, SSA uses Form SSA-2519,
Child Relationship Statement. The respondents are people with knowledge
of the relationship between certain individuals filing for Social
Security benefits and their alleged biological children.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2519.................................... 50,000 1 15 12,500
----------------------------------------------------------------------------------------------------------------
4. Pre-1957 Military Service Federal Benefit Questionnaire--20 CFR
404.1301-404.1371--0960-0120. SSA may grant gratuitous military wage
credits for active military or naval service (under certain conditions)
during the period of September 16, 1940 through December 31, 1956, if
no other Federal agency (other than the Veterans Administration)
credited the service for benefit eligibility or computation purposes.
We use Form SSA-2512 to collect specific information about other
Federal, military, or civilian benefits the wage earner may receive
when the applicant indicates both pre-1957 military service and the
receipt of a Federal benefit. SSA uses the data in the claims
adjudication process to grant gratuitous military wage credits when
applicable, and to solicit sufficient information to determine
eligibility. Respondents are applicants for Social Security benefits on
a record where the wage earner claims pre-1957 military service.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2512.................................... 5,000 1 10 833
----------------------------------------------------------------------------------------------------------------
5. Authorization for the Social Security Administration to Obtain
Account Records from a Financial Institution--20 CFR 416.200, 416.203,
404.508, & 416.553--0960-0293. SSA collects and verifies financial
information from individuals applying for Title II and Title XVI waiver
determinations, as well as those who apply for, or currently receive
(in the case of redetermination), Supplemental Security Income (SSI)
payments. We require the financial information from these applicants
to: (1) Determine the eligibility of the applicant or recipient for SSI
benefits; or (2) determine if a request to waive a Social Security
overpayment defeats the purpose of the Act. If the Title II and Title
XVI waiver applicants, or the SSI claimants provide incomplete,
unavailable, or seemingly altered records, SSA contacts their financial
institutions to verify the existence, ownership, and value of accounts
owned. Financial institutions need individuals to sign Form SSA-4641-
F4, or work with SSA staff to complete one of SSA's electronic
applications, e4641 or the Access to Financial Institutions (AFI)
screens, to authorize the individual's financial institution to
disclose records to SSA. The respondents are Title II and Title XVI
recipients applying for waivers, or SSI applicants, recipients, and
their deemors to determine SSI eligibility.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of of response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4641 (paper)................................ 140,000 1 6 14,000
e4641 and AFI (Internet)........................ 15,860,000 1 2 528,667
---------------------------------------------------------------
Totals...................................... 16,000,000 .............. .............. 542,667
----------------------------------------------------------------------------------------------------------------
[[Page 56135]]
6. Vocational Rehabilitation Provider Claim--20 CFR 404.2108(b),
404.2117(c)(1)&(2), 404.2101(b)&(c), 404.2121(a), 416.2208(b),
416.2217(c)(1)&(2), 416.2201(b)&(c), 416.2221(a)--0960-0310. State
vocational rehabilitation (VR) agencies submit Form SSA-199 to SSA to
obtain reimbursement of costs incurred for providing VR services. SSA
requires state VR agencies to submit reimbursement claims for the
following categories: (1) Claiming reimbursement for VR services
provided; (2) certifying adherence to cost containment policies and
procedures; and (3) preparing causality statements. The respondents
provide the information requested through a web-based Secure Ticket
Portal, in lieu of submitting forms. This Portal allows VRs to retrieve
reports, and enter and submit information electronically, minimizing
the use of the paper form to SSA for consideration and approval of the
claim for reimbursement of costs incurred for SSA beneficiaries. SSA
uses the information on the SSA-199, along with the written
documentation, to determine whether, and how much, to pay State VR
agencies under SSA's VR program. Respondents are State VR agencies
offering vocational and employment services to Social Security and SSI
recipients.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of Number of of response total annual
respondents response responses (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-199 CFR 404.2108 & 416.2208. 80 160 12,800 23 4,907
CFR 404.2117 & 416.2217 Written 80 1 80 60 80
requests.......................
CFR 404.2121 & 416.2221 Written 80 2.5 200 100 333
requests.......................
-------------------------------------------------------------------------------
Total....................... 80 .............. 13,080 .............. 5,320
----------------------------------------------------------------------------------------------------------------
7. Request for Change in Time/Place of Disability Hearing--20 CFR
404.914(c)(2) and 416.1414(c)(2)--0960-0348. At the request of the
claimants or their representatives, SSA schedules evidentiary hearings
at the reconsideration level for claimants of Title II benefits or
Title XVI payments when we deny their claims for disability. When
claimants or their representatives find they are unable to attend the
scheduled hearing, they complete Form SSA-769 to request a change in
time or place of the hearing. SSA uses the information as a basis for
granting or denying requests for changes and for rescheduling
disability hearings. Respondents are claimants or their representatives
who wish to request a change in the time or place of their hearing.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-769..................................... 7,483 1 8 998
----------------------------------------------------------------------------------------------------------------
8. Application for Supplemental Security Income--20 CFR 416.305-
416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to determine
an applicant's eligibility for SSI and SSI payment amounts. SSA
employees also collect this information during interviews with members
of the public who wish to file for SSI. SSA uses the information for
two purposes: (1) To formally deny SSI for nonmedical reasons when
information the applicant provides results in ineligibility; or (2) to
establish a disability claim, but defer the complete development of
non-medical issues until SSA approves the disability. The respondents
are applicants for SSI payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of of response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSI Claims System............................... 802,368 1 20 267,456
iClaim/SSI Claims System........................ 168,661 1 20 56,220
SSA-8001-BK (Paper Version)..................... 2,588 1 20 863
---------------------------------------------------------------
Totals...................................... 973,617 .............. .............. 324,539
----------------------------------------------------------------------------------------------------------------
9. Wage Reports and Pension Information--20 CFR 422.122(b)--0960-
0547. Pension plan administrators annually file plan information with
the Internal Revenue Service, which then forwards the information to
SSA. SSA maintains and organizes this information by plan number; plan
participant's name; and Social Security number. Section 1131(a) of the
Act entitles pension plan participants to request this information from
SSA. The Wage Reports and Pension Information regulation, 20 CFR
422.122(b) of the Code of Federal Regulations, requires requestors
submit a written request with identifying information to SSA, before
SSA disseminates this information. The respondents are requestors of
pension plan information.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 56136]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Requests for pension plan information....... 580 1 30 290
----------------------------------------------------------------------------------------------------------------
10. International Direct Deposit--31 CFR 210--0960-0686. SSA's
International Direct Deposit (IDD) Program allows beneficiaries living
abroad to receive their payments via direct deposit to an account at a
financial institution outside the United States. SSA uses Form SSA-
1199-(Country) to enroll Title II beneficiaries residing abroad in IDD,
and to obtain the direct deposit information for foreign accounts.
Routing account number information varies slightly for each foreign
country, so we use a variation of the Treasury Department's Form SF-
1199A for each country. The respondents are Social Security
beneficiaries residing abroad who want SSA to deposit their Title II
benefit payments directly to a foreign financial institution.
Type of Request: Revision of an OMB approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1199-(Country).......................... 13,750 1 5 1,146
----------------------------------------------------------------------------------------------------------------
11. Representative Payment Policies and Administrative Procedures
for Imposing Penalties for False or Misleading Statements or
Withholding of Information--0960-0740. This information collection
request comprises several regulation sections that provide additional
safeguards for Social Security beneficiaries' whose representative
payees receive their payment. SSA requires representative payees to
notify them of any event or change in circumstances that would affect
receipt of benefits or performance of payee duties. SSA uses the
information to determine continued eligibility for benefits, the amount
of benefits due and if the payee is suitable to continue servicing as
payee. The respondents are representative payees who receive and use
benefits on behalf of Social Security beneficiaries.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of of response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
404.2035(d)--Paper/Mail......................... 29,601 1 5 2,467
404.2035(d)--Office interview/Intranet.......... 562,419 1 5 46,868
404.2035(f)--Paper/Mail......................... 296 1 5 25
404.2035(f)--Office interview/Intranet.......... 5,624 1 5 469
416.635(d)--Paper/Mail.......................... 16,146 1 5 1,346
416.635(d)--Office interview/Intranet........... 296,424 1 5 24,702
416.635(f)--Paper/Mail.......................... 162 1 5 14
416.635(f)--Office interview/Intranet........... 3,067 1 5 256
---------------------------------------------------------------
Totals...................................... 913,739 .............. .............. 76,147
----------------------------------------------------------------------------------------------------------------
Dated: November 5, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-24517 Filed 11-8-18; 8:45 am]
BILLING CODE 4191-02-P
