Agency Information Collection Activities: Proposed Request and Comment Request, 23623-23627 [2019-10670]
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Federal Register / Vol. 84, No. 99 / Wednesday, May 22, 2019 / Notices
Economic Injury (EIDL) Loan
Application Deadline Date: 10/23/2019.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW, Suite 6050,
Washington, DC 20416, (202) 205–6734.
SUPPLEMENTARY INFORMATION: The notice
of an Administrative declaration for the
State of Louisiana, dated 01/23/2019, is
hereby amended to establish the
incident period for this disaster as
beginning 12/26/2018 and continuing
through 02/07/2019.
All other information in the original
declaration remains unchanged.
(Catalog of Federal Domestic Assistance
Number 59008)
Dated: May 14, 2019.
Christopher M. Pilkerton,
Acting Administrator.
[FR Doc. 2019–10613 Filed 5–21–19; 8:45 am]
BILLING CODE 8025–01–P
SMALL BUSINESS ADMINISTRATION
[Disaster Declaration #15958 and #15959;
OKLAHOMA Disaster Number OK–00129]
Administrative Declaration of a
Disaster for the State of Oklahoma
U.S. Small Business
Administration.
ACTION: Notice.
This is a notice of an
Administrative declaration of a disaster
for the State of Oklahoma dated 05/15/
2019.
Incident: Tornadoes, Severe Storms,
Straight-line Winds and Flooding.
Incident Period: 04/30/2019 through
05/10/2019.
DATES: Issued on 05/15/2019.
Physical Loan Application Deadline
Date: 07/15/2019.
Economic Injury (EIDL) Loan
Application Deadline Date: 02/18/2020.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street, SW, Suite 6050,
Washington, DC 20416, (202) 205–6734.
SUPPLEMENTARY INFORMATION: Notice is
hereby given that as a result of the
Administrator’s disaster declaration,
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Percent
For Physical Damage:
Homeowners with Credit Available Elsewhere ......................
Homeowners without Credit
Available Elsewhere ..............
Businesses with Credit Available Elsewhere ......................
Businesses
without
Credit
Available Elsewhere ..............
Non-Profit Organizations with
Credit Available Elsewhere ...
Non-Profit Organizations without Credit Available Elsewhere .....................................
For Economic Injury:
Businesses & Small Agricultural
Cooperatives without Credit
Available Elsewhere ..............
Non-Profit Organizations without Credit Available Elsewhere .....................................
3.875
1.938
8.000
4.000
2.750
2.750
4.000
2.750
The number assigned to this disaster
for physical damage is 15958 B and for
economic injury is 15959 0.
The States which received an EIDL
Declaration # are Oklahoma, Texas.
AGENCY:
SUMMARY:
applications for disaster loans may be
filed at the address listed above or other
locally announced locations.
The following areas have been
determined to be adversely affected by
the disaster:
Primary Counties: Bryan, Pittsburg
Contiguous Counties:
Oklahoma: Atoka, Choctaw, Coal,
Haskell, Hughes, Johnston, Latimer,
Marshall, Mcintosh, Pushmataha.
Texas: Fannin, Grayson, Lamar.
The Interest Rates are:
(Catalog of Federal Domestic Assistance
Number 59008)
Dated: May 15, 2019.
Christopher M. Pilkerton,
Acting Administrator.
[FR Doc. 2019–10595 Filed 5–21–19; 8:45 am]
BILLING CODE 8025–01–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2019–0020]
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
by the Office of Management and
Budget (OMB) in compliance with
Public Law 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes revisions
of OMB-approved information
collections.
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23623
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–
2019–0020].
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 July 22, 2019.
Individuals can obtain copies of the
collection instruments by writing to the
above email address.
1. Representative Payee Evaluation
Report—20 CFR 404.2065 & 416.665—
0960–0069. Sections 205(j) and
1631(a)(2) of the Social Security Act
(Act) state that SSA may authorize
payment of Social Security benefits or
Supplemental Security Income (SSI)
payments to a representative payee on
behalf of individuals unable to manage,
or direct the management of, those
funds themselves. SSA requires
appointed representative payees to
report once each year on how they used
or conserved those funds. When a
representative payee fails to adequately
report to SSA as required, SSA conducts
a face-to-face interview with the payee
and completes Form SSA–624–F5,
Representative Payee Evaluation Report,
to determine the continued suitability of
the representative payee to serve as a
payee. In addition to interviewing the
representative payee, we also interview
the recipient, and custodian (if other
than the payee), to confirm the
information the payee provides, and to
ensure the payee is meeting the
recipient’s current needs. The
respondents are individuals or
organizations serving as representative
payees for individuals receiving Title II
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Federal Register / Vol. 84, No. 99 / Wednesday, May 22, 2019 / Notices
benefits or Title XVI payments, and who
fail to comply with SSA’s statutory
annual reporting requirement, and the
recipients for whom they act as payee.
Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency of
response
Estimated
total annual
burden
(hours)
SSA–624–F5—Individuals ...............................................................................
SSA–624–F5—State and Local Government ..................................................
SSA–624–F5—Businesses ..............................................................................
6,956
40
280
1
1
1
30
30
30
3,478
20
140
Totals ........................................................................................................
7,276
........................
........................
3,638
2. Application for Benefits Under the
Italy-U.S. International Social Security
Agreement—20 CFR 404.1925—0960–
0445. As per the November 1, 1978
agreement between the United States
and Italian Social Security agencies,
residents of Italy filing an application
for U.S. Social Security benefits directly
with one of the Italian Social Security
agencies must complete Form SSA–
2528–IT. SSA uses Form SSA–2528–IT
to establish age, relationship,
citizenship, marriage, death, military
service, or to evaluate a family bible or
other family record when determining
eligibility for U.S. benefits. The Italian
Social Security agencies assist
applicants in completing Form SSA–
2528–IT, and then forward the
application to SSA for processing. The
respondents are individuals living in
Italy who wish to file for U.S. Social
Security benefits.
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–2528–IT ...................................................................................................
300
1
20
100
3. Agency/Employer Government
Pension Offset Questionnaire—20 CFR
404.408(a)—0960–0470. When an
individual is concurrently receiving
Social Security spousal, or surviving
spousal, benefits, and a government
pension, the individual may have the
amount of Social Security benefits
reduced by the government pension
amount. This is the Government
Pension Offset (GPO). SSA uses Form
SSA–L4163 to collect accurate pension
information from the Federal or State
government agency paying the pension
for purposes of applying the pension
offset provision. SSA uses this form
only when: (1) The claimant does not
have the information; and (2) the
pension-paying agency has not
cooperated with the claimant.
Respondents are State government
agencies, which have information SSA
needs to determine if the GPO applies,
and the amount of offset.
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–L4163 ......................................................................................................
2,911
1
3
146
4. Plan to Achieve Self-Support
(PASS)—20 CFR 416.110(e), 416.1180–
1182, 416.1225–1227—0960–0559. The
SSI program encourages recipients to
return to work. One of the program
objectives is to provide incentives and
opportunities that help recipients
toward employment. The PASS
provision allows individuals to use
available income or resources (such as
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Type of Request: Revision of an OMBapproved information collection.
business equipment, education, or
specialized training) to enter or re-enter
the workforce and become selfsupporting. In turn, SSA does not count
the income or resources recipients use
to fund a PASS when determining an
individual’s SSI eligibility or payment
amount. An SSI recipient who wants to
use available income and resources to
obtain education or training to become
self-supporting completes Form SSA–
545. SSA uses the information from the
SSA–545 to evaluate the recipient’s
PASS, and to determine eligibility
under the provisions of the SSI program.
The respondents are SSI recipients who
want to develop a return-to-work plan.
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–545 ..........................................................................................................
7,000
1
120
14,000
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Federal Register / Vol. 84, No. 99 / Wednesday, May 22, 2019 / Notices
5. Complaint Form for Allegations of
Discrimination in Programs or Activities
Conducted by the Social Security
Administration—0960–0585. SSA uses
Form SSA–437 to investigate and
formally resolve complaints of
discrimination based on disability; race;
color; national origin (including limited
English language proficiency); sex
(including sexual orientation and
gender identity); age; religion; or
retaliation for having participated in a
proceeding under this administrative
complaint process in connection with
an SSA program or activity. Individuals
who believe SSA discriminated against
them on any of the above bases may file
a written complaint of discrimination.
SSA uses the information to: (1) Identify
the complaint; (2) identify the alleged
discriminatory act; (3) establish the date
of the alleged action; (4) establish the
identity of any individual(s) with
information about the alleged
discrimination; and (5) establish other
relevant information that would assist
in the investigation and resolution of
the complaint. Respondents are
individuals who believe an SSA
program or activity, or SSA employees,
contractors or agents, discriminated
against them.
Type of Request: Revision on an
OMB-approved information collection.
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–437 ..........................................................................................................
255
1
60
255
6. Supplemental Security Income
Wage Reporting (Telephone and
Mobile)—20 CFR 416.701–732—0960–
0715. SSA requires SSI recipients to
report changes which could affect their
eligibility for, and the amount of, their
SSI payments, such as changes in
income, resources, and living
arrangements. SSA’s SSI Telephone
Wage Reporting (SSITWR) and SSI
Mobile Wage Reporting (SSIMWR)
enable SSI recipients to meet these
requirements via an automated
mechanism to report their monthly
wages by telephone and mobile
application, instead of contacting their
local field offices. The SSITWR allows
callers to report their wages by speaking
their responses through voice
recognition technology, or by keying in
responses using a telephone key pad.
The SSIMWR allows recipients to report
their wages through the mobile wage
reporting application on their
smartphone. SSITWR and SSIMWR
systems collect the same information
Number of
respondents
Modality of completion
Frequency of
response
and send it to SSA over secure
channels. To ensure the security of the
information provided, SSITWR and
SSIMWR ask respondents to provide
information SSA can compare against
our records for authentication purposes.
Once the system authenticates the
identity of the respondents, they can
report their wage data. The respondents
are SSI recipients, deemors, or their
representative payees.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Number of
responses
Estimated
total annual
burden
(hours)
Training/Instruction * .............................................................
SSITWR ...............................................................................
SSIMWR ..............................................................................
103,000
26,000
77,000
1
12
12
103,000
312,000
924,000
35
5
3
60,083
26,000
46,200
Totals ............................................................................
* 103,000
........................
1,339,000
........................
132,283
* Note: The same 103,000 respondents are completing training and a modality of collection, therefore the actual total number of respondents is
still 103,000.
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7. Technical Updates to Applicability
of the Supplemental Security Income
(SSI) Reduced Benefit Rate for
Individuals Residing in Medical
Treatment Facilities—20 CFR
416.708(k)—0960–0758. Section
1611(e)(1)(A) of the Act specifies
residents of public institutions are
ineligible for SSI. However, Sections
1611(e)(1)(B) and (G) of the Act list
certain exceptions to this provision,
making it necessary for SSA to collect
information about SSI recipients who
enter or leave a medical treatment
facility or other public or private
institution. SSA’s regulation 20 CFR
416.708(k) establishes the reporting
guidelines that implement this
legislative requirement. SSA uses this
information collection to determine SSI
eligibility or the benefit amount for SSI
recipients who enter or leave
institutions. SSA personnel collect this
information directly from SSI recipients,
or from someone reporting on their
behalf. An SSI recipient who enters an
institution may be unable to report;
therefore, a family member sometimes
makes this report on behalf of the
recipient. When contacting SSA, the
recipient, or family member of the
recipient, provides the name of the
institution, the date of admission, and
the expected date of discharge. The
respondents are SSI recipients who
enter or leave an institution, or
individuals reporting on their behalf.
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)
Technical Updates Statement .........................................................................
34,200
1
7
3,990
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Federal Register / Vol. 84, No. 99 / Wednesday, May 22, 2019 / Notices
8. Waiver of Supplemental Security
Income Payment Continuation—20 CFR
416.1400–416.1422—0960–0783. SSI
recipients who wish to discontinue their
SSI payments while awaiting a
determination on their appeal complete
Form SSA–263–U2, Waiver of
Supplemental Security Income Payment
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–263–U2 ...................................................................................................
3,000
1
5
250
II. SSA submitted the information
collections below to OMB for clearance.
Your comments regarding these
information collections would be most
useful if OMB and SSA receive them 30
days from the date of this publication.
To be sure we consider your comments,
we must receive them no later than June
21, 2019. Individuals can obtain copies
of the OMB clearance packages by
apply foreign work deductions to the
recipient’s Title II benefits. We collect
the information either annually or every
other year, depending on the
respondent’s country of residence.
Respondents are Social Security
recipients engaged in farming activities
outside the United States.
Type of Request: Revision of an OMBapproved information collection.
writing to OR.Reports.Clearance@
ssa.gov.
1. Supplemental Statement Regarding
Farming Activities of Person Living
Outside the U.S.A.—0960–0103. When a
beneficiary or claimant reports farm
work from outside the United States,
SSA documents this work on Form
SSA–7163A–F4. Specifically, SSA uses
the form to determine if we should
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–7163A–F4 ...............................................................................................
1,000
1
60
1,000
2. Information About Joint Checking/
Savings Account—20 CFR 416.1201 and
416.1208—0960–0461. SSA considers a
person’s resources when evaluating
eligibility for SSI. Generally, we
consider funds in checking and savings
accounts as resources owned by the
individuals whose names appear on the
account. However, individuals applying
for SSI may rebut this assumption of
ownership in a joint account by
submitting certain evidence to establish
the funds do not belong to them. SSA
uses Form SSA–2574 to collect
information from SSI applicants and
recipients who object to the assumption
that they own all or part of the funds in
a joint checking or savings account
bearing their names. SSA collects
information about the account from both
the SSI applicant or recipient and the
other account holder(s). After receiving
Number of
respondents
Modality of completion
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recipients of SSI payments who wish to
discontinue receipt of payment while
awaiting a determination on their
appeal.
Type of Request: Revision of an OMBapproved information collection.
Continuation, to inform SSA of this
decision. SSA collects the information
to determine whether the SSI recipient
meets the provisions of The Social
Security Act regarding waiver of
payment continuation and as proof
respondents no longer want their
payments to continue. Respondents are
the completed form, SSA determines if
we should consider the account to be a
resource for the SSI applicant and
recipient. The respondents are
applicants and recipients of SSI, and
individuals who list themselves as joint
owners of financial accounts with SSI
applicants or recipients.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency of
response
Estimated
total annual
burden
(hours)
SSA–2574—Paper version ..............................................................................
Intranet version (SSI Claims System) .............................................................
50,000
150,000
1
1
7
7
5,833
17,500
Totals ........................................................................................................
200,000
........................
........................
23,333
3. Employer Verification of Earnings
After Death—20 CFR 404.821 and
404.822—0960–0472. When SSA
records show a wage earner is deceased,
and we receive wage reports from an
employer for the wage earner for a year
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17:29 May 21, 2019
Jkt 247001
subsequent to the year of death, SSA
mails the employer Form SSA–L4112
(Employer Verification of Earnings After
Death). SSA uses the information Form
SSA–L4112 provides to verify wage
information previously received from
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the employer is correct for the employee
and the year in question. The
respondents are employers who report
wages for employees who died.
Type of Request: Revision of an OMBapproved information collection.
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Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–L4112 ......................................................................................................
54,998
1
10
9,166
4. Certificate of Election for Reduced
Widow(er)s and Surviving Divorced
Spouse’s Benefits—20 CFR 404.335—
0960–0759. Section 202(q) of the Act
provides SSA the authority to reduce
benefits under certain conditions when
elected by a Title II beneficiary.
However, reduced benefits are not
payable to an already entitled spouse (or
divorced spouse) who:
SSA uses the information collected to
pay a qualified dually entitled
widow(er) (or surviving divorced
spouse) who elects to receive a reduced
widow(er) benefit. The respondents are
qualified dually entitled widow(er)s (or
surviving divorced spouse) who elect to
receive a reduced widow(er) benefit.
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–4111 ........................................................................................................
30,000
1
2
1,000
Dated: May 17, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 2019–10670 Filed 5–21–19; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice: 10773]
Imposition of Nonproliferation
Measures Against Foreign Persons,
Including a Ban on U.S. Government
Procurement
Bureau of International
Security and Nonproliferation,
Department of State.
ACTION: Notice.
AGENCY:
A determination has been
made that a number of foreign persons
have engaged in activities that warrant
the imposition of measures pursuant to
Section 3 of the Iran, North Korea, and
Syria Nonproliferation Act.
DATES: The imposition of measures
pursuant to Section 3 of the Iran, North
Korea, and Syria Nonproliferation Act
described in this notice went into effect
May 14, 2019.
FOR FURTHER INFORMATION CONTACT: On
general issues: Pam Durham, Office of
Missile, Biological, and Chemical
Nonproliferation, Bureau of
International Security and
Nonproliferation, Department of State,
Telephone (202) 647–4930. For U.S.
Government procurement ban issues:
Eric Moore, Office of the Procurement
SUMMARY:
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• Is at least age 62 and under full
retirement age in the month of the
number holder’s death; and
• Is receiving both reduced spouse’s
(or divorced spouse’s) benefits and
either retirement or disability benefits in
the month before the month of the
number holder’s death.
To elect reduced widow(er) benefits,
a recipient completes Form SSA–4111.
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17:29 May 21, 2019
Jkt 247001
Executive, Department of State,
Telephone: (703) 875–4079.
SUPPLEMENTARY INFORMATION: On May
14, 2019, the U.S. Government applied
the measures authorized in Section 3 of
the Iran, North Korea, and Syria
Nonproliferation Act (Pub. L. 109–353)
against the following foreign persons
identified in the report submitted
pursuant to Section 2(a) of the Act:
Abascience Tech Co., Ltd. (China) and
any successor, sub-unit, or subsidiary
thereof;
Emily Liu [a.k.a. Emily Lau, Liu
Baoxia] (Chinese individual);
Hope Wish Technologies Incorporated
(China) and any successor, sub-unit, or
subsidiary thereof;
Jiangsu Tianyuan Metal Powder Co
Ltd (China) and any successor, sub-unit,
or subsidiary thereof;
Li Fangwei [a.k.a. Karl Lee] (Chinese
individual);
Raybeam Optronics Co., Ltd (China)
and any successor, sub-unit, or
subsidiary thereof;
Ruan Runling [a.k.a. Ricky Runling,
Ricky Ruan] (Chinese individual);
Shanghai North Begins (China) and
any successor, sub-unit, or subsidiary
thereof;
Sinotech (Dalian) Carbon and
Graphite Corporation (SCGC) (China)
and any successor, sub-unit, or
subsidiary thereof;
Sun Creative Zhejiang Technologies
Inc (China) and any successor, sub-unit,
or subsidiary thereof;
T-Rubber Co. Ltd (China) and any
successor, sub-unit, or subsidiary
thereof;
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Wuhan Sanjiang Import and Export
Co Ltd (China) and any successor, subunit, or subsidiary thereof;
Yenben Yansong Zaojiu Co Ltd
(China) and any successor, sub-unit, or
subsidiary thereof;
Defense Industries Organization (Iran)
and any successor, sub-unit, or
subsidiary thereof;
Gatchina Surface-to-Air Missile
(SAM) Training Center (Russia) and any
successor, sub-unit, or subsidiary
thereof;
Instrument Design Bureau (KBP) Tula
(Russia) and any successor, sub-unit, or
subsidiary thereof;
Moscow Machine Building Plant
Avangard (MMZ Avangard) (Russia) and
any successor, sub-unit, or subsidiary
thereof;
Army Supply Bureau (ASB) (Syria)
and any successor, sub-unit, or
subsidiary thereof;
Lebanese Hizballah (Syria) and any
successor, sub-unit, or subsidiary
thereof;
Megatrade (Syria) and any successor,
sub-unit, or subsidiary thereof;
Syrian Air Force (Syria) and any
successor, sub-unit, or subsidiary
thereof; and
Syrian Scientific Studies and
Research Center (SSCR) (Syria) and any
successor, sub-unit, or subsidiary
thereof.
The Act provides for penalties on
foreign entities and individuals for the
transfer to or acquisition from Iran since
January 1, 1999; the transfer to or
acquisition from Syria since January 1,
2005; or the transfer to or acquisition
from North Korea since January 1, 2006,
of goods, services, or technology
E:\FR\FM\22MYN1.SGM
22MYN1
]]>Agencies
[Federal Register Volume 84, Number 99 (Wednesday, May 22, 2019)]
[Notices]
[Pages 23623-23627]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-10670]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2019-0020]
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions of OMB-approved information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and ways to minimize burden
on respondents, including the use of automated collection techniques or
other forms of information technology. Mail, email, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer at the following
addresses or fax numbers.
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA, Fax:
202-395-6974, Email address: [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-2019-0020].
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 July
22, 2019. Individuals can obtain copies of the collection instruments
by writing to the above email address.
1. Representative Payee Evaluation Report--20 CFR 404.2065 &
416.665--0960-0069. Sections 205(j) and 1631(a)(2) of the Social
Security Act (Act) state that SSA may authorize payment of Social
Security benefits or Supplemental Security Income (SSI) payments to a
representative payee on behalf of individuals unable to manage, or
direct the management of, those funds themselves. SSA requires
appointed representative payees to report once each year on how they
used or conserved those funds. When a representative payee fails to
adequately report to SSA as required, SSA conducts a face-to-face
interview with the payee and completes Form SSA-624-F5, Representative
Payee Evaluation Report, to determine the continued suitability of the
representative payee to serve as a payee. In addition to interviewing
the representative payee, we also interview the recipient, and
custodian (if other than the payee), to confirm the information the
payee provides, and to ensure the payee is meeting the recipient's
current needs. The respondents are individuals or organizations serving
as representative payees for individuals receiving Title II
[[Page 23624]]
benefits or Title XVI payments, and who fail to comply with SSA's
statutory annual reporting requirement, and the recipients for whom
they act as payee.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-624-F5--Individuals......................... 6,956 1 30 3,478
SSA-624-F5--State and Local Government.......... 40 1 30 20
SSA-624-F5--Businesses.......................... 280 1 30 140
---------------------------------------------------------------
Totals...................................... 7,276 .............. .............. 3,638
----------------------------------------------------------------------------------------------------------------
2. Application for Benefits Under the Italy-U.S. International
Social Security Agreement--20 CFR 404.1925--0960-0445. As per the
November 1, 1978 agreement between the United States and Italian Social
Security agencies, residents of Italy filing an application for U.S.
Social Security benefits directly with one of the Italian Social
Security agencies must complete Form SSA-2528-IT. SSA uses Form SSA-
2528-IT to establish age, relationship, citizenship, marriage, death,
military service, or to evaluate a family bible or other family record
when determining eligibility for U.S. benefits. The Italian Social
Security agencies assist applicants in completing Form SSA-2528-IT, and
then forward the application to SSA for processing. The respondents are
individuals living in Italy who wish to file for U.S. Social Security
benefits.
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-2528-IT................................. 300 1 20 100
----------------------------------------------------------------------------------------------------------------
3. Agency/Employer Government Pension Offset Questionnaire--20 CFR
404.408(a)--0960-0470. When an individual is concurrently receiving
Social Security spousal, or surviving spousal, benefits, and a
government pension, the individual may have the amount of Social
Security benefits reduced by the government pension amount. This is the
Government Pension Offset (GPO). SSA uses Form SSA-L4163 to collect
accurate pension information from the Federal or State government
agency paying the pension for purposes of applying the pension offset
provision. SSA uses this form only when: (1) The claimant does not have
the information; and (2) the pension-paying agency has not cooperated
with the claimant. Respondents are State government agencies, which
have information SSA needs to determine if the GPO applies, and the
amount of offset.
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-L4163................................... 2,911 1 3 146
----------------------------------------------------------------------------------------------------------------
4. Plan to Achieve Self-Support (PASS)--20 CFR 416.110(e),
416.1180-1182, 416.1225-1227--0960-0559. The SSI program encourages
recipients to return to work. One of the program objectives is to
provide incentives and opportunities that help recipients toward
employment. The PASS provision allows individuals to use available
income or resources (such as business equipment, education, or
specialized training) to enter or re-enter the workforce and become
self-supporting. In turn, SSA does not count the income or resources
recipients use to fund a PASS when determining an individual's SSI
eligibility or payment amount. An SSI recipient who wants to use
available income and resources to obtain education or training to
become self-supporting completes Form SSA-545. SSA uses the information
from the SSA-545 to evaluate the recipient's PASS, and to determine
eligibility under the provisions of the SSI program. The respondents
are SSI recipients who want to develop a return-to-work plan.
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-545..................................... 7,000 1 120 14,000
----------------------------------------------------------------------------------------------------------------
[[Page 23625]]
5. Complaint Form for Allegations of Discrimination in Programs or
Activities Conducted by the Social Security Administration--0960-0585.
SSA uses Form SSA-437 to investigate and formally resolve complaints of
discrimination based on disability; race; color; national origin
(including limited English language proficiency); sex (including sexual
orientation and gender identity); age; religion; or retaliation for
having participated in a proceeding under this administrative complaint
process in connection with an SSA program or activity. Individuals who
believe SSA discriminated against them on any of the above bases may
file a written complaint of discrimination. SSA uses the information
to: (1) Identify the complaint; (2) identify the alleged discriminatory
act; (3) establish the date of the alleged action; (4) establish the
identity of any individual(s) with information about the alleged
discrimination; and (5) establish other relevant information that would
assist in the investigation and resolution of the complaint.
Respondents are individuals who believe an SSA program or activity, or
SSA employees, contractors or agents, discriminated against them.
Type of Request: Revision on 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-437..................................... 255 1 60 255
----------------------------------------------------------------------------------------------------------------
6. Supplemental Security Income Wage Reporting (Telephone and
Mobile)--20 CFR 416.701-732--0960-0715. SSA requires SSI recipients to
report changes which could affect their eligibility for, and the amount
of, their SSI payments, such as changes in income, resources, and
living arrangements. SSA's SSI Telephone Wage Reporting (SSITWR) and
SSI Mobile Wage Reporting (SSIMWR) enable SSI recipients to meet these
requirements via an automated mechanism to report their monthly wages
by telephone and mobile application, instead of contacting their local
field offices. The SSITWR allows callers to report their wages by
speaking their responses through voice recognition technology, or by
keying in responses using a telephone key pad. The SSIMWR allows
recipients to report their wages through the mobile wage reporting
application on their smartphone. SSITWR and SSIMWR systems collect the
same information and send it to SSA over secure channels. To ensure the
security of the information provided, SSITWR and SSIMWR ask respondents
to provide information SSA can compare against our records for
authentication purposes. Once the system authenticates the identity of
the respondents, they can report their wage data. The respondents are
SSI recipients, deemors, or their representative payees.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of Number of burden per total annual
Modality of completion respondents response responses response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Training/Instruction *.......... 103,000 1 103,000 35 60,083
SSITWR.......................... 26,000 12 312,000 5 26,000
SSIMWR.......................... 77,000 12 924,000 3 46,200
-------------------------------------------------------------------------------
Totals...................... * 103,000 .............. 1,339,000 .............. 132,283
----------------------------------------------------------------------------------------------------------------
* Note: The same 103,000 respondents are completing training and a modality of collection, therefore the actual
total number of respondents is still 103,000.
7. Technical Updates to Applicability of the Supplemental Security
Income (SSI) Reduced Benefit Rate for Individuals Residing in Medical
Treatment Facilities--20 CFR 416.708(k)--0960-0758. Section
1611(e)(1)(A) of the Act specifies residents of public institutions are
ineligible for SSI. However, Sections 1611(e)(1)(B) and (G) of the Act
list certain exceptions to this provision, making it necessary for SSA
to collect information about SSI recipients who enter or leave a
medical treatment facility or other public or private institution.
SSA's regulation 20 CFR 416.708(k) establishes the reporting guidelines
that implement this legislative requirement. SSA uses this information
collection to determine SSI eligibility or the benefit amount for SSI
recipients who enter or leave institutions. SSA personnel collect this
information directly from SSI recipients, or from someone reporting on
their behalf. An SSI recipient who enters an institution may be unable
to report; therefore, a family member sometimes makes this report on
behalf of the recipient. When contacting SSA, the recipient, or family
member of the recipient, provides the name of the institution, the date
of admission, and the expected date of discharge. The respondents are
SSI recipients who enter or leave an institution, or individuals
reporting on their behalf.
Type of Request: Extension of an OMB-approved information
collection.
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Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Technical Updates Statement................. 34,200 1 7 3,990
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[[Page 23626]]
8. Waiver of Supplemental Security Income Payment Continuation--20
CFR 416.1400-416.1422--0960-0783. SSI recipients who wish to
discontinue their SSI payments while awaiting a determination on their
appeal complete Form SSA-263-U2, Waiver of Supplemental Security Income
Payment Continuation, to inform SSA of this decision. SSA collects the
information to determine whether the SSI recipient meets the provisions
of The Social Security Act regarding waiver of payment continuation and
as proof respondents no longer want their payments to continue.
Respondents are recipients of SSI payments who wish to discontinue
receipt of payment while awaiting a determination on their appeal.
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-263-U2.................................. 3,000 1 5 250
----------------------------------------------------------------------------------------------------------------
II. SSA submitted the information collections below to OMB for
clearance. Your comments regarding these information collections would
be most useful if OMB and SSA receive them 30 days from the date of
this publication. To be sure we consider your comments, we must receive
them no later than June 21, 2019. Individuals can obtain copies of the
OMB clearance packages by writing to [email protected].
1. Supplemental Statement Regarding Farming Activities of Person
Living Outside the U.S.A.--0960-0103. When a beneficiary or claimant
reports farm work from outside the United States, SSA documents this
work on Form SSA-7163A-F4. Specifically, SSA uses the form to determine
if we should apply foreign work deductions to the recipient's Title II
benefits. We collect the information either annually or every other
year, depending on the respondent's country of residence. Respondents
are Social Security recipients engaged in farming activities outside
the United States.
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-7163A-F4................................ 1,000 1 60 1,000
----------------------------------------------------------------------------------------------------------------
2. Information About Joint Checking/Savings Account--20 CFR
416.1201 and 416.1208--0960-0461. SSA considers a person's resources
when evaluating eligibility for SSI. Generally, we consider funds in
checking and savings accounts as resources owned by the individuals
whose names appear on the account. However, individuals applying for
SSI may rebut this assumption of ownership in a joint account by
submitting certain evidence to establish the funds do not belong to
them. SSA uses Form SSA-2574 to collect information from SSI applicants
and recipients who object to the assumption that they own all or part
of the funds in a joint checking or savings account bearing their
names. SSA collects information about the account from both the SSI
applicant or recipient and the other account holder(s). After receiving
the completed form, SSA determines if we should consider the account to
be a resource for the SSI applicant and recipient. The respondents are
applicants and recipients of SSI, and individuals who list themselves
as joint owners of financial accounts with SSI applicants or
recipients.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2574--Paper version......................... 50,000 1 7 5,833
Intranet version (SSI Claims System)............ 150,000 1 7 17,500
---------------------------------------------------------------
Totals...................................... 200,000 .............. .............. 23,333
----------------------------------------------------------------------------------------------------------------
3. Employer Verification of Earnings After Death--20 CFR 404.821
and 404.822--0960-0472. When SSA records show a wage earner is
deceased, and we receive wage reports from an employer for the wage
earner for a year subsequent to the year of death, SSA mails the
employer Form SSA-L4112 (Employer Verification of Earnings After
Death). SSA uses the information Form SSA-L4112 provides to verify wage
information previously received from the employer is correct for the
employee and the year in question. The respondents are employers who
report wages for employees who died.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 23627]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L4112................................... 54,998 1 10 9,166
----------------------------------------------------------------------------------------------------------------
4. Certificate of Election for Reduced Widow(er)s and Surviving
Divorced Spouse's Benefits--20 CFR 404.335--0960-0759. Section 202(q)
of the Act provides SSA the authority to reduce benefits under certain
conditions when elected by a Title II beneficiary. However, reduced
benefits are not payable to an already entitled spouse (or divorced
spouse) who:
Is at least age 62 and under full retirement age in the
month of the number holder's death; and
Is receiving both reduced spouse's (or divorced spouse's)
benefits and either retirement or disability benefits in the month
before the month of the number holder's death.
To elect reduced widow(er) benefits, a recipient completes Form
SSA-4111. SSA uses the information collected to pay a qualified dually
entitled widow(er) (or surviving divorced spouse) who elects to receive
a reduced widow(er) benefit. The respondents are qualified dually
entitled widow(er)s (or surviving divorced spouse) who elect to receive
a reduced widow(er) benefit.
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-4111.................................... 30,000 1 2 1,000
----------------------------------------------------------------------------------------------------------------
Dated: May 17, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-10670 Filed 5-21-19; 8:45 am]
BILLING CODE 4191-02-P
