Agency Information Collection Activities: Proposed Request and Comment Request, 34469-34472 [2019-15249]

Download as PDF Federal Register / Vol. 84, No. 138 / Thursday, July 18, 2019 / Notices 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, 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: Andrew, Atchison, Buchanan, Holt. Percent Contiguous Counties: Missouri: Clinton, DeKalb, Gentry, Nodaway, Platte. Iowa: Fremont, Page. 2.750 Kansas: Atchison, Doniphan. Nebraska: Nemaha, Otoe, Richardson. 2.750 The Interest Rates are: 07/09/2019, Private Non-Profit organizations that provide essential services of a governmental nature may file disaster loan applications 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: Curry, Douglas, Grant, Linn, Umatilla, Wheeler. The Interest Rates are: For Physical Damage: Non-Profit Organizations with Credit Available Elsewhere ..... Non-Profit Organizations without Credit Available Elsewhere ..... For Economic Injury: Non-Profit Organizations without Credit Available Elsewhere ..... 2.750 The number assigned to this disaster for physical damage is 160336 and for economic injury is 160340. (Catalog of Federal Domestic Assistance Number 59008) James Rivera, Associate Administrator for Disaster Assistance. [FR Doc. 2019–15276 Filed 7–17–19; 8:45 am] BILLING CODE 8026–03–P SMALL BUSINESS ADMINISTRATION [Disaster Declaration # 16037 and # 16038; Missouri Disaster Number MO–00096] Administrative Declaration of a Disaster for the State of Missouri U.S. Small Business Administration. ACTION: Notice. AGENCY: This is a notice of an Administrative declaration of a disaster for the State of Missouri dated 07/12/ 2019. Incident: Severe Storms, Straight-line Winds and Flooding. Incident Period: 03/11/2019 through 04/16/2019. DATES: Issued on 07/12/2019. Physical Loan Application Deadline Date: 09/10/2019. Economic Injury (EIDL) Loan Application Deadline Date: 04/13/2020. 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, khammond on DSKBBV9HB2PROD with NOTICES SUMMARY: VerDate Sep<11>2014 17:56 Jul 17, 2019 Jkt 247001 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 ................................... This is an amendment of the Presidential declaration of a major disaster for the State of Iowa (FEMA– 4421–DR), dated 03/23/2019. Incident: Severe Storms and Flooding. Incident Period: 03/12/2019 through 06/15/2019. DATES: Issued on 07/09/2019. Physical Loan Application Deadline Date: 07/16/2019. Economic Injury (EIDL) Loan Application Deadline Date: 12/23/2019. 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. Percent SUPPLEMENTARY INFORMATION: The notice of the President’s major disaster declaration for the State of IOWA, dated 4.125 03/23/2019, is hereby amended to 2.063 include the following areas as adversely affected by the disaster: 8.000 Primary Counties (Physical Damage and Economic Injury Loans): Muscatine. 4.000 All counties contiguous to the above named county have previously been 2.750 declared. All other information in the original 2.750 declaration remains unchanged. 4.000 James Rivera, Associate Administrator for Disaster Assistance. 2.750 [FR Doc. 2019–15275 Filed 7–17–19; 8:45 am] (Catalog of Federal Domestic Assistance Number 59008) Christopher Pilkerton, Acting Administrator. [FR Doc. 2019–15279 Filed 7–17–19; 8:45 am] BILLING CODE 8026–03–P SMALL BUSINESS ADMINISTRATION [Disaster Declaration #15898 and #15899; Iowa Disaster Number IA–00086] Presidential Declaration Amendment of a Major Disaster for the State of Iowa U.S. Small Business Administration. ACTION: Amendment 8. PO 00000 Frm 00138 Fmt 4703 Sfmt 4703 SUMMARY: (Catalog of Federal Domestic Assistance Number 59008) The number assigned to this disaster for physical damage is 16037 6 and for economic injury is 16038 0. The States which received an EIDL Declaration # are Missouri, Iowa, Kansas, Nebraska. AGENCY: 34469 BILLING CODE 8026–03–P SOCIAL SECURITY ADMINISTRATION [Docket No: SSA–2019–0030] 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 one extension, and revisions of OMBapproved 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, E:\FR\FM\18JYN1.SGM 18JYN1 34470 Federal Register / Vol. 84, No. 138 / Thursday, July 18, 2019 / Notices 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– 2019–0030]. I. The information collection below is pending at SSA. SSA will submit it 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 September 16, 2019. Individuals can obtain copies of the collection instruments by writing to the above email address. Work Incentives Planning and Assistance Program—0960–0629. As part of SSA’s strategy to assist Social Security Disability Insurance (SSDI) beneficiaries and Supplemental Security Income (SSI) recipients who wish to return to work and achieve selfsufficiency, SSA established the Work Incentives Planning and Assistance (WIPA) program. This community based, work incentive, planning and assistance project collects identifying claimant information via project sites and community work incentives Number of respondents Modality of completion Small Site (Under 150 beneficiaries served) (SSA–4565; SSA–4566; SSA– 4567) ............................................................................................................ Medium Site (150–599 beneficiaries served) (SSA–4565; SSA–4566; SSA– 4567) ............................................................................................................ Large Site (600 or more beneficiaries served) (SSA–4565; SSA–4566; SSA–4567) ................................................................................................... Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) 4,800 1 20 1,600 7,500 1 20 2,500 17,700 1 20 5,900 Total Sites ................................................................................................. SSDI & SSI Beneficiaries ................................................................................ Help Line .......................................................................................................... 30,000 30,000 30,000 ........................ 1 1 ........................ 25 5 10,000 12,500 2,500 Total .......................................................................................................... 90,000 ........................ ........................ 25,000 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 August 19, 2019. Individuals can obtain copies of the OMB clearance packages by writing to OR.Reports.Clearance@ ssa.gov. khammond on DSKBBV9HB2PROD with NOTICES coordinators (CWIC). SSA uses this information to ensure proper management of the project, with particular emphasis on administration, budgeting, and training. In addition, project sites and CWIC’s collect data from SSDI beneficiaries and SSI recipients on background employment, training, benefits, and work incentives. SSA is interested in identifying SSDI beneficiary and SSI recipient outcomes under the WIPA program, to determine the extent to which beneficiaries with disabilities and SSI recipients achieve their employment, financial, and healthcare goals. SSA will also use the data in its analysis and future planning for SSDI and SSI programs. Respondents are SSDI beneficiaries, SSI recipients, community project sites, and employment advisors. Type of Request: Revision of an OMBapproved information collection. 1. Real Property Current Market Value Estimate—0960–0471. SSA considers an individual’s resources when evaluating eligibility for Supplemental Security Income (SSI) payments. The value of an individual’s resources, including nonhome real property, is one of the eligibility requirements for SSI payments. SSA obtains current market value estimates of the claimant’s real property through Form SSA–L2794. We allow respondents to use readily available records to complete the form, or we can accept their best estimates. We use this form as part of initial applications and in post-entitlement situations. The respondents are small business operators in real estate; state and local government employees tasked with assessing real property values; and other individuals knowledgeable about local real estate values. 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) SSA–L2794 ...................................................................................................... 300 1 20 100 2. Child Care Dropout Questionnaire—20 CFR 404.211(e)(4) —0960–0474. If individuals applying for Title II disability benefits care for their own or their spouse’s children under age 3, and have no steady earnings VerDate Sep<11>2014 17:56 Jul 17, 2019 Jkt 247001 during the time they care for those children, they may exclude that period of care from the disability computation period. We call this the child-care dropout exclusion. SSA uses the information from Form SSA–4162 to PO 00000 Frm 00139 Fmt 4703 Sfmt 4703 determine if an individual qualifies for this exclusion. Respondents are applicants for Title II disability benefits. Type of Request: Revision of an OMBapproved information collection. E:\FR\FM\18JYN1.SGM 18JYN1 34471 Federal Register / Vol. 84, No. 138 / Thursday, July 18, 2019 / Notices Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–4162 ........................................................................................................ 2,000 1 5 167 3. Medical Report on Adult with Allegation of Human Immunodeficiency Virus Infection; Medical Report on Child with Allegation of Human Immunodeficiency Virus Infection—20 CFR 416.933—20 CFR 416.934—0960– 0500. Section 1631(e)(i) of the Social Security Act authorizes the Commissioner of SSA to gather information to make a determination about an applicant’s claim for SSI payments; this procedure is the Presumptive Disability (PD). SSA uses Forms SSA–4814–F5 and SSA–4815–F6 to collect information necessary to determine if an individual with human Number of respondents Modality of completion Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–4814–F5 .................................................................................................. SSA–4815–F6 .................................................................................................. 9,600 80 1 1 8 10 1,280 13 Totals ........................................................................................................ 9,680 ........................ ........................ 1,293 4. Beneficiary Recontact Report—20 CFR 404.703 & 404.705—0960–0502. SSA investigates recipients of disability payments to determine their continuing eligibility for payments. Research indicates recipients may fail to report circumstances that affect their eligibility. Two such cases are: (1) When parents receiving disability benefits for their child marry; and (2) the removal of an entitled child from parents’ care. SSA uses Form SSA–1588–SM to ask mothers or fathers about both their marital status and children under their care, to detect overpayments and avoid continuing payment to those are no longer entitled. Respondents are recipients of mothers’ or fathers’ 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–1588–SM ................................................................................................ 76,944 1 5 6,412 5. Certification of Contents of Document(s) or Record(s)—20 CFR 404.715—0960–0689. SSA established procedures for individuals to provide the evidence necessary to establish their rights to Social Security benefits. Examples of such evidence categories include age, relationship, citizenship, marriage, death, and military service. khammond on DSKBBV9HB2PROD with NOTICES immunodeficiency virus infection, who is applying for SSI disability benefits, meets the requirements for PD. The respondents are the medical sources of the applicants for SSI disability payments. Type of Request: Revision of an OMBapproved information collection. Form SSA–704 allows SSA employees; State record custodians; and other custodians of evidentiary documents to certify and record information from original documents and records under their custodial ownership to establish these types of evidence. SSA uses Form SSA–704 in situations where individuals cannot produce the original evidentiary documentation required to establish benefits eligibility. The respondents are State record custodians and other custodians of evidentiary documents. 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–704 .......................................................................................................... 293 1 10 49 6. Registration for Appointed Representative Services and Direct Payment—0960–0732. SSA uses Form SSA–1699 to register appointed representatives of claimants before SSA who: • Want to register for direct payment of fees; VerDate Sep<11>2014 17:56 Jul 17, 2019 Jkt 247001 • Registered for direct payment of fees prior to 10/31/09, but need to update their information; • Registered as appointed representatives on or after 10/31/09, but need to update their information; or • Received a notice from SSA instructing them to complete this form. PO 00000 Frm 00140 Fmt 4703 Sfmt 4703 By registering these individuals, SSA: (1) Authenticates and authorizes them to do business with us; (2) allows them to access our records for the claimants they represent; (3) facilitates direct payment of authorized fees to appointed representatives; and, (4) collects the information we need to meet Internal Revenue Service (IRS) requirements to E:\FR\FM\18JYN1.SGM 18JYN1 34472 Federal Register / Vol. 84, No. 138 / Thursday, July 18, 2019 / Notices issue specific IRS forms if we pay an appointed representative in excess of a specific amount ($600). The respondents are appointed representatives who want to use Form SSA–1699 for any of the purposes cited in this Notice. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) SSA–1699 ........................................................................................................ 17,700 1 20 5,900 7. Certificate of Incapacity—5 CFR 890.302(d)—0960–0739. Rules governing the Federal Employee Health Benefits (FEHB) plan require a physician to verify the disability of Federal employees’ children ages 26 and over for these children to retain health benefits under their employed parents’ plans. The physician must verify the adult child’s disability: (1) Pre-dates the child’s 26th birthday; (2) is very serious; and (3) will continue for at least one year. Physicians use Form SSA–604, the Certificate of Incapacity, to document and certify this information, and the Social Security Administration uses the information provided to determine the eligibility for these children, ages 26 and over, for coverage under a parent’s FEHB plan. The respondents are physicians of SSA employees’ children ages 26 or over who are seeking to retain health benefits under their parent’s FEHB coverage. 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–604 .......................................................................................................... 50 1 45 38 Dated: July 12, 2019. Naomi Sipple, Reports Clearance Officer, Social Security Administration. (Authority: 41 CFR part 102–3.65) [FR Doc. 2019–15249 Filed 7–17–19; 8:45 am] [FR Doc. 2019–15285 Filed 7–17–19; 8:45 am] On June 28, 2019, Savage Davenport Railroad Company (SDR) filed with the Board a petition under 49 U.S.C. 10502 for an exemption from the prior approval requirements of 49 U.S.C. 10903, to enable SDR to discontinue its operations over a rail line (the Line) owned by the City of Davenport, Iowa (the City), in Scott County, Iowa. The Line is approximately 2.8 miles long, extending from a switch near milepost 191.2 on the main line of a Canadian Pacific Railway subsidiary, west and south to the Davenport Transload Facility owned by the City. The Line traverses U.S. Postal Service Zip Code 52748. According to SDR, the Line was constructed, and is owned, by the City 1 and is subject to a lease between the City and SDR, requiring SDR to provide common carrier rail service over the Line, serving industrial shippers.2 SDR explains that it began operations on the Line in March of 2018, serving one rail customer and the Transload Facility. SDR states that the Transload Facility currently has zero activity. (Pet. 3 n.3.) SDR states that it has advised the City of its desire to discontinue service, and the City has raised no objection provided a suitable replacement is identified. (Id. at 3.) SDR states that, based on the information in SDR’s possession, the Line does not contain federally granted rights-of-way. Any documentation in SDR’s possession will be made available promptly to those requesting it. As a condition to this exemption, any employee adversely affected by the discontinuance of service shall be protected under Oregon Short Line Railroad—Abandonment Portion Goshen Branch Between Firth & Ammon, in Bingham & Bonneville Counties, Idaho, 360 I.C.C. 91 (1979). Because this is a discontinuance proceeding and not an abandonment proceeding, trail use/rail banking and public use conditions are not appropriate. Because there will be an environmental review during any subsequent abandonment proceeding, this discontinuance does not require an 1 See City of Davenport—Construction & Operation Exemption—in Scott Cty., Iowa, FD 35237 (STB served Apr. 6, 2011). 2 See Savage Davenport R.R.—Lease & Operation Exemption—City of Davenport, FD 36142 (STB served Sept. 1, 2017). Christopher M. Herrick, Executive Director, International Security Advisory Board, Department of State. BILLING CODE 4191–02–P BILLING CODE 4710–27–P SURFACE TRANSPORTATION BOARD DEPARTMENT OF STATE [Docket No. AB 1277X] [Public Notice: 10823] Savage Davenport Railroad Company—Discontinuance of Service Exemption—in Scott County, Iowa Renewal of International Security Advisory Board khammond on DSKBBV9HB2PROD with NOTICES Type of Request: Revision of an OMBapproved information collection. The Department of State announces the renewal of the Charter of the International Security Advisory Board (ISAB). The purpose of the ISAB is to provide the Department with a continuing source of independent insight, advice, and innovation on all aspects of arms control, disarmament, nonproliferation, cybersecurity, the national security aspects of emerging technologies, and international security, and related aspects of public diplomacy. The ISAB will remain in existence for two years after the filing date of the Charter unless terminated. For more information, please contact Christopher M. Herrick, Executive Director of the International Security Advisory Board, Department of State, Washington, DC 20520, telephone: (202) 647–9683. VerDate Sep<11>2014 17:56 Jul 17, 2019 Jkt 247001 PO 00000 Frm 00141 Fmt 4703 Sfmt 4703 E:\FR\FM\18JYN1.SGM 18JYN1

Agencies

[Federal Register Volume 84, Number 138 (Thursday, July 18, 2019)]
[Notices]
[Pages 34469-34472]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-15249]


=======================================================================
-----------------------------------------------------------------------

SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2019-0030]


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 one extension, and revisions of OMB-approved information 
collections.
    SSA is soliciting comments on the accuracy of the agency's burden 
estimate; the need for the information; its practical utility; ways to 
enhance its quality, utility, and clarity; and ways to minimize burden 
on respondents,

[[Page 34470]]

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-2019-0030].
    I. The information collection below is pending at SSA. SSA will 
submit it 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 
September 16, 2019. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    Work Incentives Planning and Assistance Program--0960-0629. As part 
of SSA's strategy to assist Social Security Disability Insurance (SSDI) 
beneficiaries and Supplemental Security Income (SSI) recipients who 
wish to return to work and achieve self-sufficiency, SSA established 
the Work Incentives Planning and Assistance (WIPA) program. This 
community based, work incentive, planning and assistance project 
collects identifying claimant information via project sites and 
community work incentives coordinators (CWIC). SSA uses this 
information to ensure proper management of the project, with particular 
emphasis on administration, budgeting, and training. In addition, 
project sites and CWIC's collect data from SSDI beneficiaries and SSI 
recipients on background employment, training, benefits, and work 
incentives. SSA is interested in identifying SSDI beneficiary and SSI 
recipient outcomes under the WIPA program, to determine the extent to 
which beneficiaries with disabilities and SSI recipients achieve their 
employment, financial, and healthcare goals. SSA will also use the data 
in its analysis and future planning for SSDI and SSI programs. 
Respondents are SSDI beneficiaries, SSI recipients, community project 
sites, and employment advisors.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Small Site (Under 150 beneficiaries served) (SSA-          4,800               1              20           1,600
 4565; SSA-4566; SSA-4567)......................
Medium Site (150-599 beneficiaries served) (SSA-           7,500               1              20           2,500
 4565; SSA-4566; SSA-4567)......................
Large Site (600 or more beneficiaries served)             17,700               1              20           5,900
 (SSA-4565; SSA-4566; SSA-4567).................
                                                 ---------------------------------------------------------------
    Total Sites.................................          30,000  ..............  ..............          10,000
SSDI & SSI Beneficiaries........................          30,000               1              25          12,500
Help Line.......................................          30,000               1               5           2,500
                                                 ---------------------------------------------------------------
    Total.......................................          90,000  ..............  ..............          25,000
----------------------------------------------------------------------------------------------------------------

    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 August 19, 2019. Individuals can obtain copies of 
the OMB clearance packages by writing to [email protected].
    1. Real Property Current Market Value Estimate--0960-0471. SSA 
considers an individual's resources when evaluating eligibility for 
Supplemental Security Income (SSI) payments. The value of an 
individual's resources, including non-home real property, is one of the 
eligibility requirements for SSI payments. SSA obtains current market 
value estimates of the claimant's real property through Form SSA-L2794. 
We allow respondents to use readily available records to complete the 
form, or we can accept their best estimates. We use this form as part 
of initial applications and in post-entitlement situations. The 
respondents are small business operators in real estate; state and 
local government employees tasked with assessing real property values; 
and other individuals knowledgeable about local real estate values.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L2794...................................             300                1               20              100
----------------------------------------------------------------------------------------------------------------

    2. Child Care Dropout Questionnaire--20 CFR 404.211(e)(4) --0960-
0474. If individuals applying for Title II disability benefits care for 
their own or their spouse's children under age 3, and have no steady 
earnings during the time they care for those children, they may exclude 
that period of care from the disability computation period. We call 
this the child-care dropout exclusion. SSA uses the information from 
Form SSA-4162 to determine if an individual qualifies for this 
exclusion. Respondents are applicants for Title II disability benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 34471]]



----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4162....................................           2,000                1                5              167
----------------------------------------------------------------------------------------------------------------

    3. Medical Report on Adult with Allegation of Human 
Immunodeficiency Virus Infection; Medical Report on Child with 
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.933--
20 CFR 416.934--0960-0500. Section 1631(e)(i) of the Social Security 
Act authorizes the Commissioner of SSA to gather information to make a 
determination about an applicant's claim for SSI payments; this 
procedure is the Presumptive Disability (PD). SSA uses Forms SSA-4814-
F5 and SSA-4815-F6 to collect information necessary to determine if an 
individual with human immunodeficiency virus infection, who is applying 
for SSI disability benefits, meets the requirements for PD. The 
respondents are the medical sources of the applicants for SSI 
disability payments.
    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-4814-F5.....................................           9,600               1               8           1,280
SSA-4815-F6.....................................              80               1              10              13
                                                 ---------------------------------------------------------------
    Totals......................................           9,680  ..............  ..............           1,293
----------------------------------------------------------------------------------------------------------------

    4. Beneficiary Recontact Report--20 CFR 404.703 & 404.705--0960-
0502. SSA investigates recipients of disability payments to determine 
their continuing eligibility for payments. Research indicates 
recipients may fail to report circumstances that affect their 
eligibility. Two such cases are: (1) When parents receiving disability 
benefits for their child marry; and (2) the removal of an entitled 
child from parents' care. SSA uses Form SSA-1588-SM to ask mothers or 
fathers about both their marital status and children under their care, 
to detect overpayments and avoid continuing payment to those are no 
longer entitled. Respondents are recipients of mothers' or fathers' 
Social Security benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1588-SM.................................          76,944                1                5            6,412
----------------------------------------------------------------------------------------------------------------

    5. Certification of Contents of Document(s) or Record(s)--20 CFR 
404.715--0960-0689. SSA established procedures for individuals to 
provide the evidence necessary to establish their rights to Social 
Security benefits. Examples of such evidence categories include age, 
relationship, citizenship, marriage, death, and military service. Form 
SSA-704 allows SSA employees; State record custodians; and other 
custodians of evidentiary documents to certify and record information 
from original documents and records under their custodial ownership to 
establish these types of evidence. SSA uses Form SSA-704 in situations 
where individuals cannot produce the original evidentiary documentation 
required to establish benefits eligibility. The respondents are State 
record custodians and other custodians of evidentiary documents.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-704.....................................             293                1               10               49
----------------------------------------------------------------------------------------------------------------

    6. Registration for Appointed Representative Services and Direct 
Payment--0960-0732. SSA uses Form SSA-1699 to register appointed 
representatives of claimants before SSA who:
     Want to register for direct payment of fees;
     Registered for direct payment of fees prior to 10/31/09, 
but need to update their information;
     Registered as appointed representatives on or after 10/31/
09, but need to update their information; or
     Received a notice from SSA instructing them to complete 
this form.
    By registering these individuals, SSA: (1) Authenticates and 
authorizes them to do business with us; (2) allows them to access our 
records for the claimants they represent; (3) facilitates direct 
payment of authorized fees to appointed representatives; and, (4) 
collects the information we need to meet Internal Revenue Service (IRS) 
requirements to

[[Page 34472]]

issue specific IRS forms if we pay an appointed representative in 
excess of a specific amount ($600). The respondents are appointed 
representatives who want to use Form SSA-1699 for any of the purposes 
cited in this Notice.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1699....................................          17,700                1               20            5,900
----------------------------------------------------------------------------------------------------------------

    7. Certificate of Incapacity--5 CFR 890.302(d)--0960-0739. Rules 
governing the Federal Employee Health Benefits (FEHB) plan require a 
physician to verify the disability of Federal employees' children ages 
26 and over for these children to retain health benefits under their 
employed parents' plans. The physician must verify the adult child's 
disability: (1) Pre-dates the child's 26th birthday; (2) is very 
serious; and (3) will continue for at least one year. Physicians use 
Form SSA-604, the Certificate of Incapacity, to document and certify 
this information, and the Social Security Administration uses the 
information provided to determine the eligibility for these children, 
ages 26 and over, for coverage under a parent's FEHB plan. The 
respondents are physicians of SSA employees' children ages 26 or over 
who are seeking to retain health benefits under their parent's FEHB 
coverage.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-604.....................................              50                1               45               38
----------------------------------------------------------------------------------------------------------------


    Dated: July 12, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-15249 Filed 7-17-19; 8:45 am]
 BILLING CODE 4191-02-P