Agency Information Collection Activities: Proposed Request, 25891-25895 [2019-11629]
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Federal Register / Vol. 84, No. 107 / Tuesday, June 4, 2019 / Notices
Reference Room, 100 F Street NE,
Washington, DC 20549 on official
business days between the hours of
10:00 a.m. and 3:00 p.m. Copies of the
filing also will be available for
inspection and copying at the principal
office of the Exchange. All comments
received will be posted without change.
Persons submitting comments are
cautioned that we do not redact or edit
personal identifying information from
comment submissions. You should
submit only information that you wish
to make available publicly. All
submissions should refer to File
Number SR–NYSENAT–2019–13 and
should be submitted on or before June
25, 2019.
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.28
Eduardo A. Aleman,
Deputy Secretary.
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.
Agency Information Collection
Activities: Proposed Request
(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
The Social Security Administration
(SSA) publishes a list of information
Or you may submit your comments
online through www.regulations.gov,
[FR Doc. 2019–11563 Filed 6–3–19; 8:45 am]
BILLING CODE 8011–01–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2019–0023]
Number of
respondents
Modality of completion
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–8—MCS Screens ....................................................................................
SSA–8—Paper Form .......................................................................................
656,623
5,484
1
1
9
10
98,493
914
Totals ........................................................................................................
662,107
........................
........................
99,407
2. Report to United States Social
Security Administration by Person
Receiving Benefits for a Child or for an
Adult Unable to Handle Funds/Report
to the United States Social Security
Administration—0960–0049. Section
203(c) of the Act requires the
Commissioner of SSA to make benefit
deductions, and provides for the
Commissioner to impose penalty
deductions on benefits of individuals
who fail to make timely reports of
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referencing Docket ID Number [SSA–
2019–0023].
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 August 5, 2019. Individuals
can obtain copies of the collection
instruments by writing to the above
email address.
1. Application for Lump Sum Death
Payment—20 CFR 404.390–404.392—
0960–0013. SSA uses Form SSA–8 to
collect information needed to authorize
payment of the lump sum death
payment (LSDP) to a widow, widower,
or children as defined in section 202(i)
of the Social Security Act (Act).
Respondents complete the application
for this one-time payment through use
of the paper form, or person interview
with an SSA employee either via
telephone, or in person in a field office.
For all personal interviews (either
telephone or in-person), we collect the
information in our electronic
Modernized Claim System (MCS).
Respondents are applicants for the
LSDP.
Type of Request: Revision of an OMBapproved information collection.
events, which are cause for deductions.
SSA uses Forms SSA–7161–OCR–SM
and SSA–7162–OCR–SM to: (1)
Determine continuing entitlement to
Social Security benefits; (2) correct
benefit amounts for beneficiaries
outside the United States; and (3)
monitor the performance of
representative payees outside the
United States. This collection is
mandatory as an annual (or every other
year, depending on the country of
Number of
respondents
Modality of completion
SSA–7161–OCR–SM ......................................................................................
SSA–7162–OCR–SM ......................................................................................
28 17
residence) review for fraud prevention.
In addition, the results can affect
benefits by increasing or decreasing
payment amount or by causing SSA to
suspend or terminate benefits. The
respondents are individuals living
outside the United States who are
receiving benefits on their own (or on
behalf of someone else) under Title II of
the Act.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
42,314
426,448
1
1
CFR 200.30–3(a)(12).
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Average
burden per
response
(minutes)
15
5
Estimated
total annual
burden
(hours)
10,579
35,537
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Totals ........................................................................................................
3. Waiver of Your Right to Personal
Appearance before an Administrative
Law Judge—20 CFR 404.948(b)(l)(i) and
416.1448(b)(l)(i)—0960–0284.
Applicants for Social Security, Old Age,
Survivors and Disability Insurance
(OASDI) benefits and Supplemental
Security Income (SSI) payments have
the statutory right to appear in person,
or through a representative, and present
Average
burden per
response
(minutes)
468,762
........................
........................
Estimated
total annual
burden
(hours)
46,116
completed form a part of the
documentary evidence of record by
placing it in the official record of the
proceedings as an exhibit. Respondents
are applicants or claimants for OASDI
and SSI, or their representatives, who
request to waive their right to appear in
person before an ALJ.
Type of Request: Revision of an OMBapproved information collection.
evidence about their claims at a hearing
before an administrative law judge
(ALJ). If claimants wish to waive this
right to appear before an ALJ, they must
do so in writing. Form HA–4608 serves
as a written waiver for the claimant’s
right to a personal appearance before an
ALJ. The ALJ uses the information we
collect on Form HA–4608 to continue
processing the case, and makes the
Modality of completion
Number of
respondents
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
HA–4608 ..........................................................................................................
12,000
1
2
400
4. Statement for Determining
Continuing Eligibility, Supplemental
Security Income Payment(s)—416.204—
0960–0416. To determine whether SSI
recipients (1) have met and continue to
meet all statutory and regulatory
requirements for SSI eligibility, and (2)
are receiving the correct SSI payment
amount, SSA conducts redeterminations
of disability. Periodic collection of this
information using Form SSA–8203–BK
is the only way SSA can make these
redeterminations; and collect the
information as mandatory under the
law. We routinely collect the
information in field offices via personal
Number of
respondents
Modality of completion
contact (face-to-face or telephone
interview) using the automated
Modernized SSI Claim System
(MSSICS). The respondents are SSI
recipients or their representative payees.
Type of Request: Revision of an OMBapproved information collection.
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
MSSICS ...........................................................................................................
Paper ...............................................................................................................
1,468,220
135,357
1
1
19
20
464,936
45,119
Totals ........................................................................................................
1,603,577
........................
........................
510,055
5. Request for Social Security
Statement—20 CFR 404.810—0960–
0466. Section 205(c)(2)(A) of the Act
requires the Commissioner of SSA to
establish and maintain records of wages
paid to, and amounts of selfemployment income derived by, each
individual as well as the periods in
which such wages were paid and such
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Frequency of
response
Number of
respondents
Modality of completion
income derived. An individual may
complete and mail Form SSA–7004 to
SSA to obtain a Statement of Earnings
or Quarters of Coverage. SSA uses the
information Form SSA–7004 collects to
identify respondent’s Social Security
earnings records; extract posted
earnings information; calculate potential
benefit estimates; produce the resulting
Social Security statements; and mail
them to the requesters. The respondents
are Social Security number holders
requesting information about their
Social Security earnings records and
estimates of their potential 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–7004 ........................................................................................................
60,026
1
5
5,002
6. Function Report—Child (Birth to
1st Birthday, Age 1 to 3rd Birthday, Age
3 to 6th Birthday, Age 6 to 12th
Birthday, Age 12 to 18th Birthday)—20
CFR 416.912 and 416.924a(a)(2)—0960–
0542. As part of SSA’s disability
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determination process, we use Forms
SSA–3375–BK through SSA–3379–BK
to request information from a child’s
parent or guardian for children applying
for SSI. The five different versions of the
form contain questions about the child’s
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day-to-day functioning appropriate to a
particular age group; thus, respondents
use only one version of the form for
each child. The adjudicative team
(disability examiners and medical or
psychological consultants) of State
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disability determination services offices
collect the information on the
appropriate version of this form (in
conjunction with medical and other
evidence) to form a complete picture of
the children’s ability to function and
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–3375; SSA–3376; SSA–3377; SSA–3378; SSA–3379 ..........................
579,000
1
20
193,000
7. Private Printing and Modification of
Prescribed Application and Other
Forms—20 CFR 422.527—0960–0663.
20 CFR 422.527 of the Code of Federal
Regulations requires a person,
institution, or organization (third-party
entities) to obtain approval from SSA
prior to reproducing, duplicating, or
privately printing any application or
other form the agency owns. To obtain
SSA’s approval, entities must make
their requests in writing using their
company letterhead, providing the
required information set forth in the
regulation. SSA uses the information to:
(1) Ensure requests comply with the law
and regulations, and (2) process requests
from third-party entities who want to
reproduce, duplicate, or privately print
any SSA application or other SSA form.
SSA employees review the requests and
provide approval via email or mail to
the third-party entities. The respondents
are third-party entities who submit a
request to SSA to reproduce, duplicate,
or privately print an SSA-owned form.
Type of Request: Revision of an OMBapproved information collection.
Regulation section
Number of
respondents
Frequency of
response
Number of
responses
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
20 CFR 422.527 ..................................................................
10
15
150
10
25
8. Letter to Custodian of Birth
Records/Letter to Custodian of School
Records—20 CFR 404.704, 404.716,
416.802, and 422.107—0960–0693.
When individuals need help in
obtaining evidence of their age in
connection with Social Security number
(SSN) card applications and claims for
necessary, the authenticity of the record
submitted by the SSN applicant or
claimant. The respondents are schools,
State and local bureaus of vital
statistics, and religious entities.
benefits, SSA can prepare the SSA–
L106, Letter to Custodian of School
Records, or SSA–L706, Letter to
Custodian of Birth Records. SSA uses
the SSA–L706 to determine the
existence of primary evidence of age for
SSN applicants. SSA uses both letters to
verify with the issuing entity, when
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Modality of completion
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is disabled. The respondents are parents
and guardians of child applicants for
SSI.
their impairment-related limitations.
The adjudicative team uses the
completed profile to determine: (1) If
each child’s impairment(s) results in
marked and severe functional
limitations; and (2) whether each child
Frequency of
response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–L106—Private Sector .............................................................................
SSA–L106—State/Local/Tribal Government ...................................................
SSA–L706—Private Sector .............................................................................
SSA–L706—State/Local/Tribal Government ...................................................
18
14
429
426
1
1
1
1
10
10
10
10
3
2
72
71
Totals ........................................................................................................
887
........................
........................
148
9. Government-to-Government
Services Online Website Registration
Form; Government-to-Government
Services Online Website Account
Modification/Deletion Form—20 CFR
401.45—0960–0757. The Governmentto-Government Services Online (GSO)
Website allows various external
organizations to submit files to a variety
of SSA systems and, in some cases,
receive files in return. The SSA systems
that process data transferred via GSO
include, but are not limited to, systems
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responsible for disability processing and
benefit determination or termination.
SSA uses the information on Form
SSA–159, Government-to-Government
Online Website Registration Form, to
register the requestor to use the GSO
Website. Once we receive the SSA–159,
SSA provides the user with account
information and conducts a
walkthrough of the GSO Website as
necessary. Established organizations
may submit Form SSA–159 to register
additional users as well. The established
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requesting organizations can also
complete Form SSA–160, Governmentto-Government Online Website Account
Modification/Deletion Form, to modify
their online accounts (e.g., address
change). Respondents are State and
local government agencies, and some
private sector business entities.
Type of Request: Revision of an OMBapproved information collection.
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Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–159 ..........................................................................................................
SSA–160 ..........................................................................................................
1,151
410
1
1
15
15
288
103
Totals ........................................................................................................
1,561
........................
........................
391
10. Application Status—20 CFR
401.45—0960–0763. Application Status
provides users with the capability to
check the status of their pending Social
Security claims via the National 800
Number Automated Telephone Service.
Users need their SSN and a
confirmation number to access this
information. SSA systems determine the
type of claim(s) the caller filed based
upon the information provided.
Subsequently, the automated telephone
system provides callers with the option
to choose the claim for which they wish
to obtain status. If the caller applied for
multiple claims, the automated system
allows the caller to select only one
claim at a time. Once callers select the
claim(s) they are calling about, an
automated voice advises them of the
status of their claim. The respondents
are current Social Security claimants
who wish to check on the status of their
claims. Type of Request: Revision 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)
Application Status—Automated Telephone System ........................................
248,485
1
3
12,424
11. Statement for Determining
Continuing Entitlement for Special
Veterans Benefits (SVB)—0960–0782.
Title VIII of the Act provides for the
payment of Special Veterans benefits
(SVB) to certain World War II veterans
who reside outside of the United States.
SSA regularly reviews individuals’
claims for SVB to determine their
continued eligibility and correct
payment amounts. Individuals living
outside the United States receiving SVB
must report to SSA any changes that
may affect their benefits. These include
changes such as: (1) A change in mailing
address or residence; (2) an increase or
decrease in a pension, annuity, or other
recurring benefit; (3) a return or visit to
the United States for a calendar month
or longer; or (4) an inability to manage
benefits. SSA uses Form SSA–2010, to
collect this information. Beneficiaries
under age 90 receive notification of their
benefit review along with the form every
two years, and beneficiaries age 90 or
older have face-face interviews with the
Foreign Service Post every year who
assist them in completing this form.
Currently, the average respondent is
over age 90, and very few respondents
are under age 90. Respondents are
beneficiaries living outside the United
States collecting SVB.
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–2010 ........................................................................................................
382
1
20
127
12. Evidence From Excluded Medical
Sources of Evidence—20 CFR 404.1503b
and 416.903b—0960–0803. Pursuant to
its broad authority to regulate under
sections 205(a), 702(a)(5), and
1631(d)(1) of the Act, SSA implemented
section 223(d)(5)(C), as amended,
through regulations at 20 CFR
404.1503b and 416.903b. These
regulations require excluded medical
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Frequency of
response
sources to self-report their excluded
status in writing each time they submit
evidence related to a claim for benefits
under Titles II or XVI of the Act.
Excluded medical sources’ duty to selfreport their excluded status apply to
evidence they submit to SSA directly or
through a representative, claimant, or
other individual or entity. The
respondents for this collection are
medical sources that: (1) Meet one of the
exclusionary categories set forth in
section 223(d)(5)(C)(i) of the Act, as
amended; and (2) furnish evidence
related to a claim for benefits under
Titles II or XVI of the Act. Type of
Request: Revision of an OMB-approved
information collection.
Regulation section(s)
Number of
respondents
Frequency of
response
Number of
responses
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
404.1503b(c), 416.903b(c) ...................................................
50
60
3,000
20
1,000
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Federal Register / Vol. 84, No. 107 / Tuesday, June 4, 2019 / Notices
Dated: May 30, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 2019–11629 Filed 6–3–19; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice: 10782]
Certification Pursuant to the
Department of State, Foreign
Operations, and Related Programs
Appropriations Act
By virtue of the authority vested in
me as Secretary of State pursuant to
section 7041(a)(1)(2)(B) of the
Department of State, Foreign
Operations, and Related Programs
Appropriations Act, 2019 (Div. K, Pub.
L. 116–6) and similar provisions in prior
year appropriations acts, I hereby certify
that the Government of Egypt has
dismissed the convictions issued by the
Cairo Criminal Court on June 4, 2013, in
‘‘Public Prosecution Case No. 1110 for
the Year 2012’’ and has not subjected
the defendants to further prosecution.
This certification shall be published
in the Federal Register and shall be
reported to Congress, along with the
accompanying Memorandum of
Justification.
Dated: April 22, 2019.
Michael R. Pompeo,
Secretary of State.
[FR Doc. 2019–11612 Filed 6–3–19; 8:45 am]
BILLING CODE 4710–31–P
OFFICE OF THE UNITED STATES
TRADE REPRESENTATIVE
Notice of Product Exclusions: China’s
Acts, Policies, and Practices Related to
Technology Transfer, Intellectual
Property, and Innovation
Office of the United States
Trade Representative.
ACTION: Notice of product exclusions.
AGENCY:
Effective July 6, 2018, the U.S.
Trade Representative (Trade
Representative) imposed additional
duties on goods of China with an annual
trade value of approximately $34 billion
(the $34 billion action) as part of the
action in the Section 301 investigation
of China’s acts, policies, and practices
related to technology transfer,
intellectual property, and innovation.
The Trade Representative’s
determination included a decision to
establish a product exclusion process.
The Trade Representative initiated the
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SUMMARY:
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exclusion process in July 2018, and
stakeholders have submitted requests
for the exclusion of specific products. In
December 2018, March 2019, April
2019, and May 2019, the Trade
Representative granted exclusion
requests. This notice announces the
Trade Representative’s determination to
grant additional exclusion requests, as
specified in the Annex to this notice.
The Trade Representative will continue
to issue decisions on pending requests
on a periodic basis.
DATES: The product exclusions
announced in this notice will apply as
of the July 6, 2018 effective date of the
$34 billion action, and will extend for
one year after the publication of this
notice. U.S. Customs and Border
Protection will issue instructions on
entry guidance and implementation.
FOR FURTHER INFORMATION CONTACT: For
general questions about this notice,
contact Assistant General Counsels
Philip Butler or Megan Grimball, or
Director of Industrial Goods Justin
Hoffmann at (202) 395–5725. For
specific questions on customs
classification or implementation of the
product exclusions identified in the
Annex to this notice, contact
traderemedy@cbp.dhs.gov.
SUPPLEMENTARY INFORMATION:
A. Background
For background on the proceedings in
this investigation, please see the prior
notices issued in the investigation,
including 82 FR 40213 (August 24,
2017), 83 FR 14906 (April 6, 2018), 83
FR 28710 (June 20, 2018), 83 FR 33608
(July 17, 2018), 83 FR 38760 (August 7,
2018), 83 FR 40823 (August 16, 2018),
83 FR 47974 (September 21, 2018), 83
FR 65198 (December 19, 2018), 83 FR
67463 (December 28, 2018), 84 FR 7966
(March 5, 2019), 84 FR 11152 (March
25, 2019), 84 FR 16310 (April 18, 2019),
and 84 FR 21389 (May 14, 2019).
Effective July 6, 2018, the Trade
Representative imposed additional 25
percent duties on goods of China
classified in 818 8-digit subheadings of
the Harmonized Tariff Schedule of the
United States (HTSUS), with an
approximate annual trade value of $34
billion. See 83 FR 28710. The Trade
Representative’s determination included
a decision to establish a process by
which U.S. stakeholders may request
exclusion of particular products
classified within an 8-digit HTSUS
subheading covered by the $34 billion
action from the additional duties. The
Trade Representative issued a notice
setting out the process for the product
exclusions, and opened a public docket.
See 83 FR 32181 (the July 11 notice).
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25895
Under the July 11 notice, requests for
exclusion had to identify the product
subject to the request in terms of the
physical characteristics that distinguish
the product from other products within
the relevant 8-digit subheading covered
by the $34 billion action. Requestors
also had to provide the 10-digit
subheading of the HTSUS most
applicable to the particular product
requested for exclusion, and could
submit information on the ability of U.S.
Customs and Border Protection to
administer the requested exclusion.
Requestors were asked to provide the
quantity and value of the Chinese-origin
product that the requestor purchased in
the last three years. With regard to the
rationale for the requested exclusion,
requests had to address the following
factors:
• Whether the particular product is
available only from China and
specifically whether the particular
product and/or a comparable product is
available from sources in the United
States and/or third countries.
• Whether the imposition of
additional duties on the particular
product would cause severe economic
harm to the requestor or other U.S.
interests.
• Whether the particular product is
strategically important or related to
‘‘Made in China 2025’’ or other Chinese
industrial programs.
The July 11 notice stated that the
Trade Representative would take into
account whether an exclusion would
undermine the objective of the Section
301 investigation.
The July 11 notice required
submission of requests for exclusion
from the $34 billion action no later than
October 9, 2018, and noted that the
Trade Representative would
periodically announce decisions. In
December 2018, the Trade
Representative granted an initial set of
exclusion requests. See 83 FR 67463.
The Trade Representative granted a
second, third, and fourth set of
exclusions in March 2019, April 2019,
and May 2019. See 84 FR 11152, 84 FR
16310, and 84 FR 21389. The Office of
the United States Trade Representative
regularly updates the status of each
pending request and posts the status at
https://ustr.gov/issue-areas/
enforcement/section-301-investigations/
section-301-china/section-301exclusion-process.
B. Determination To Grant Certain
Exclusions
Based on the evaluation of the factors
set out in the July 11 notice, which are
summarized above, pursuant to sections
301(b), 301(c), and 307(a) of the Trade
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]]>Agencies
[Federal Register Volume 84, Number 107 (Tuesday, June 4, 2019)]
[Notices]
[Pages 25891-25895]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-11629]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2019-0023]
Agency Information Collection Activities: Proposed Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions of OMB-approved information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and ways to minimize burden
on respondents, including the use of automated collection techniques or
other forms of information technology. Mail, email, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer at the following
addresses or fax numbers.
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA, Fax:
202-395-6974, Email address: [email protected]
(SSA) Social Security Administration, OLCA, Attn: Reports Clearance
Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD
21235, Fax: 410-966-2830, Email address: [email protected]
Or you may submit your comments online through www.regulations.gov,
referencing Docket ID Number [SSA-2019-0023].
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
August 5, 2019. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application for Lump Sum Death Payment--20 CFR 404.390-404.392--
0960-0013. SSA uses Form SSA-8 to collect information needed to
authorize payment of the lump sum death payment (LSDP) to a widow,
widower, or children as defined in section 202(i) of the Social
Security Act (Act). Respondents complete the application for this one-
time payment through use of the paper form, or person interview with an
SSA employee either via telephone, or in person in a field office. For
all personal interviews (either telephone or in-person), we collect the
information in our electronic Modernized Claim System (MCS).
Respondents are applicants for the LSDP.
Type of Request: Revision 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)
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SSA-8--MCS Screens.............................. 656,623 1 9 98,493
SSA-8--Paper Form............................... 5,484 1 10 914
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Totals...................................... 662,107 .............. .............. 99,407
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2. Report to United States Social Security Administration by Person
Receiving Benefits for a Child or for an Adult Unable to Handle Funds/
Report to the United States Social Security Administration--0960-0049.
Section 203(c) of the Act requires the Commissioner of SSA to make
benefit deductions, and provides for the Commissioner to impose penalty
deductions on benefits of individuals who fail to make timely reports
of events, which are cause for deductions. SSA uses Forms SSA-7161-OCR-
SM and SSA-7162-OCR-SM to: (1) Determine continuing entitlement to
Social Security benefits; (2) correct benefit amounts for beneficiaries
outside the United States; and (3) monitor the performance of
representative payees outside the United States. This collection is
mandatory as an annual (or every other year, depending on the country
of residence) review for fraud prevention. In addition, the results can
affect benefits by increasing or decreasing payment amount or by
causing SSA to suspend or terminate benefits. The respondents are
individuals living outside the United States who are receiving benefits
on their own (or on behalf of someone else) under Title II of the Act.
Type of Request: Revision 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)
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SSA-7161-OCR-SM................................. 42,314 1 15 10,579
SSA-7162-OCR-SM................................. 426,448 1 5 35,537
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[[Page 25892]]
Totals...................................... 468,762 .............. .............. 46,116
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3. Waiver of Your Right to Personal Appearance before an
Administrative Law Judge--20 CFR 404.948(b)(l)(i) and
416.1448(b)(l)(i)--0960-0284. Applicants for Social Security, Old Age,
Survivors and Disability Insurance (OASDI) benefits and Supplemental
Security Income (SSI) payments have the statutory right to appear in
person, or through a representative, and present evidence about their
claims at a hearing before an administrative law judge (ALJ). If
claimants wish to waive this right to appear before an ALJ, they must
do so in writing. Form HA-4608 serves as a written waiver for the
claimant's right to a personal appearance before an ALJ. The ALJ uses
the information we collect on Form HA-4608 to continue processing the
case, and makes the completed form a part of the documentary evidence
of record by placing it in the official record of the proceedings as an
exhibit. Respondents are applicants or claimants for OASDI and SSI, or
their representatives, who request to waive their right to appear in
person before an ALJ.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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HA-4608..................................... 12,000 1 2 400
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4. Statement for Determining Continuing Eligibility, Supplemental
Security Income Payment(s)--416.204--0960-0416. To determine whether
SSI recipients (1) have met and continue to meet all statutory and
regulatory requirements for SSI eligibility, and (2) are receiving the
correct SSI payment amount, SSA conducts redeterminations of
disability. Periodic collection of this information using Form SSA-
8203-BK is the only way SSA can make these redeterminations; and
collect the information as mandatory under the law. We routinely
collect the information in field offices via personal contact (face-to-
face or telephone interview) using the automated Modernized SSI Claim
System (MSSICS). The respondents are SSI recipients or their
representative payees.
Type of Request: Revision 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)
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MSSICS.......................................... 1,468,220 1 19 464,936
Paper........................................... 135,357 1 20 45,119
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Totals...................................... 1,603,577 .............. .............. 510,055
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5. Request for Social Security Statement--20 CFR 404.810--0960-
0466. Section 205(c)(2)(A) of the Act requires the Commissioner of SSA
to establish and maintain records of wages paid to, and amounts of
self-employment income derived by, each individual as well as the
periods in which such wages were paid and such income derived. An
individual may complete and mail Form SSA-7004 to SSA to obtain a
Statement of Earnings or Quarters of Coverage. SSA uses the information
Form SSA-7004 collects to identify respondent's Social Security
earnings records; extract posted earnings information; calculate
potential benefit estimates; produce the resulting Social Security
statements; and mail them to the requesters. The respondents are Social
Security number holders requesting information about their Social
Security earnings records and estimates of their potential benefits.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-7004.................................... 60,026 1 5 5,002
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6. Function Report--Child (Birth to 1st Birthday, Age 1 to 3rd
Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th
Birthday)--20 CFR 416.912 and 416.924a(a)(2)--0960-0542. As part of
SSA's disability determination process, we use Forms SSA-3375-BK
through SSA-3379-BK to request information from a child's parent or
guardian for children applying for SSI. The five different versions of
the form contain questions about the child's day-to-day functioning
appropriate to a particular age group; thus, respondents use only one
version of the form for each child. The adjudicative team (disability
examiners and medical or psychological consultants) of State
[[Page 25893]]
disability determination services offices collect the information on
the appropriate version of this form (in conjunction with medical and
other evidence) to form a complete picture of the children's ability to
function and their impairment-related limitations. The adjudicative
team uses the completed profile to determine: (1) If each child's
impairment(s) results in marked and severe functional limitations; and
(2) whether each child is disabled. The respondents are parents and
guardians of child applicants for SSI.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-3375; SSA-3376; SSA-3377; SSA-3378; SSA- 579,000 1 20 193,000
3379.......................................
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7. Private Printing and Modification of Prescribed Application and
Other Forms--20 CFR 422.527--0960-0663. 20 CFR 422.527 of the Code of
Federal Regulations requires a person, institution, or organization
(third-party entities) to obtain approval from SSA prior to
reproducing, duplicating, or privately printing any application or
other form the agency owns. To obtain SSA's approval, entities must
make their requests in writing using their company letterhead,
providing the required information set forth in the regulation. SSA
uses the information to: (1) Ensure requests comply with the law and
regulations, and (2) process requests from third-party entities who
want to reproduce, duplicate, or privately print any SSA application or
other SSA form. SSA employees review the requests and provide approval
via email or mail to the third-party entities. The respondents are
third-party entities who submit a request to SSA to reproduce,
duplicate, or privately print an SSA-owned form.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Regulation section Number of Frequency of Number of per response annual burden
respondents response responses (minutes) (hours)
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20 CFR 422.527..................................................... 10 15 150 10 25
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8. Letter to Custodian of Birth Records/Letter to Custodian of
School Records--20 CFR 404.704, 404.716, 416.802, and 422.107--0960-
0693. When individuals need help in obtaining evidence of their age in
connection with Social Security number (SSN) card applications and
claims for benefits, SSA can prepare the SSA-L106, Letter to Custodian
of School Records, or SSA-L706, Letter to Custodian of Birth Records.
SSA uses the SSA-L706 to determine the existence of primary evidence of
age for SSN applicants. SSA uses both letters to verify with the
issuing entity, when necessary, the authenticity of the record
submitted by the SSN applicant or claimant. The respondents are
schools, State and local bureaus of vital statistics, and religious
entities.
Type of Request: Revision 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)
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SSA-L106--Private Sector........................ 18 1 10 3
SSA-L106--State/Local/Tribal Government......... 14 1 10 2
SSA-L706--Private Sector........................ 429 1 10 72
SSA-L706--State/Local/Tribal Government......... 426 1 10 71
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Totals...................................... 887 .............. .............. 148
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9. Government-to-Government Services Online Website Registration
Form; Government-to-Government Services Online Website Account
Modification/Deletion Form--20 CFR 401.45--0960-0757. The Government-
to-Government Services Online (GSO) Website allows various external
organizations to submit files to a variety of SSA systems and, in some
cases, receive files in return. The SSA systems that process data
transferred via GSO include, but are not limited to, systems
responsible for disability processing and benefit determination or
termination. SSA uses the information on Form SSA-159, Government-to-
Government Online Website Registration Form, to register the requestor
to use the GSO Website. Once we receive the SSA-159, SSA provides the
user with account information and conducts a walkthrough of the GSO
Website as necessary. Established organizations may submit Form SSA-159
to register additional users as well. The established requesting
organizations can also complete Form SSA-160, Government-to-Government
Online Website Account Modification/Deletion Form, to modify their
online accounts (e.g., address change). Respondents are State and local
government agencies, and some private sector business entities.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 25894]]
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Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
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SSA-159......................................... 1,151 1 15 288
SSA-160......................................... 410 1 15 103
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Totals...................................... 1,561 .............. .............. 391
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10. Application Status--20 CFR 401.45--0960-0763. Application
Status provides users with the capability to check the status of their
pending Social Security claims via the National 800 Number Automated
Telephone Service. Users need their SSN and a confirmation number to
access this information. SSA systems determine the type of claim(s) the
caller filed based upon the information provided. Subsequently, the
automated telephone system provides callers with the option to choose
the claim for which they wish to obtain status. If the caller applied
for multiple claims, the automated system allows the caller to select
only one claim at a time. Once callers select the claim(s) they are
calling about, an automated voice advises them of the status of their
claim. The respondents are current Social Security claimants who wish
to check on the status of their claims. Type of Request: Revision of an
OMB-approved information collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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Application Status--Automated Telephone 248,485 1 3 12,424
System.....................................
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11. Statement for Determining Continuing Entitlement for Special
Veterans Benefits (SVB)--0960-0782. Title VIII of the Act provides for
the payment of Special Veterans benefits (SVB) to certain World War II
veterans who reside outside of the United States. SSA regularly reviews
individuals' claims for SVB to determine their continued eligibility
and correct payment amounts. Individuals living outside the United
States receiving SVB must report to SSA any changes that may affect
their benefits. These include changes such as: (1) A change in mailing
address or residence; (2) an increase or decrease in a pension,
annuity, or other recurring benefit; (3) a return or visit to the
United States for a calendar month or longer; or (4) an inability to
manage benefits. SSA uses Form SSA-2010, to collect this information.
Beneficiaries under age 90 receive notification of their benefit review
along with the form every two years, and beneficiaries age 90 or older
have face-face interviews with the Foreign Service Post every year who
assist them in completing this form. Currently, the average respondent
is over age 90, and very few respondents are under age 90. Respondents
are beneficiaries living outside the United States collecting SVB.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-2010.................................... 382 1 20 127
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12. Evidence From Excluded Medical Sources of Evidence--20 CFR
404.1503b and 416.903b--0960-0803. Pursuant to its broad authority to
regulate under sections 205(a), 702(a)(5), and 1631(d)(1) of the Act,
SSA implemented section 223(d)(5)(C), as amended, through regulations
at 20 CFR 404.1503b and 416.903b. These regulations require excluded
medical sources to self-report their excluded status in writing each
time they submit evidence related to a claim for benefits under Titles
II or XVI of the Act. Excluded medical sources' duty to self-report
their excluded status apply to evidence they submit to SSA directly or
through a representative, claimant, or other individual or entity. The
respondents for this collection are medical sources that: (1) Meet one
of the exclusionary categories set forth in section 223(d)(5)(C)(i) of
the Act, as amended; and (2) furnish evidence related to a claim for
benefits under Titles II or XVI of the Act. Type of Request: Revision
of an OMB-approved information collection.
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Average burden Estimated total
Regulation section(s) Number of Frequency of Number of per response annual burden
respondents response responses (minutes) (hours)
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404.1503b(c), 416.903b(c).......................................... 50 60 3,000 20 1,000
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[[Page 25895]]
Dated: May 30, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-11629 Filed 6-3-19; 8:45 am]
BILLING CODE 4191-02-P
