Agency Information Collection Activities: Proposed Request and Comment Request, 23623-23627 [2019-10670]

Download as PDF 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, jbell on DSK3GLQ082PROD with NOTICES VerDate Sep<11>2014 17:29 May 21, 2019 Jkt 247001 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. PO 00000 Frm 00102 Fmt 4703 Sfmt 4703 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 E:\FR\FM\22MYN1.SGM 22MYN1 23624 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 jbell on DSK3GLQ082PROD with NOTICES 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 VerDate Sep<11>2014 17:29 May 21, 2019 Jkt 247001 PO 00000 Frm 00103 Fmt 4703 Sfmt 4703 E:\FR\FM\22MYN1.SGM 22MYN1 23625 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. jbell on DSK3GLQ082PROD with NOTICES 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 VerDate Sep<11>2014 17:29 May 21, 2019 Jkt 247001 PO 00000 Frm 00104 Fmt 4703 Sfmt 4703 E:\FR\FM\22MYN1.SGM 22MYN1 23626 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 jbell on DSK3GLQ082PROD with NOTICES 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 VerDate Sep<11>2014 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 PO 00000 Frm 00105 Fmt 4703 Sfmt 4703 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. E:\FR\FM\22MYN1.SGM 22MYN1 23627 Federal Register / Vol. 84, No. 99 / Wednesday, May 22, 2019 / Notices 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: jbell on DSK3GLQ082PROD with NOTICES • 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. VerDate Sep<11>2014 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; PO 00000 Frm 00106 Fmt 4703 Sfmt 4703 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.

----------------------------------------------------------------------------------------------------------------
                                                                                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
----------------------------------------------------------------------------------------------------------------


[[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