Agency Information Collection Activities: Proposed Request, 35371-35374 [2021-14167]
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Federal Register / Vol. 86, No. 125 / Friday, July 2, 2021 / Notices
SMALL BUSINESS ADMINISTRATION
Interest Rates
The Small Business Administration
publishes an interest rate called the
optional ‘‘peg’’ rate (13 CFR 120.214) on
a quarterly basis. This rate is a weighted
average cost of money to the
government for maturities similar to the
average SBA direct loan. This rate may
be used as a base rate for guaranteed
fluctuating interest rate SBA loans. This
rate will be 2.00 percent for the July–
September quarter of FY 2021.
Pursuant to 13 CFR 120.921(b), the
maximum legal interest rate for any
third party lender’s commercial loan
which funds any portion of the cost of
a 504 project (see 13 CFR 120.801) shall
be 6% over the New York Prime rate or,
if that exceeds the maximum interest
rate permitted by the constitution or
laws of a given State, the maximum
interest rate will be the rate permitted
by the constitution or laws of the given
State.
John Wade,
Chief, Secondary Market Division.
[FR Doc. 2021–14248 Filed 7–1–21; 8:45 am]
BILLING CODE P
SMALL BUSINESS ADMINISTRATION
[Disaster Declaration #17003 and #17004;
Kansas Disaster Number KS–00145]
Administrative Declaration of a
Disaster for the State of Kansas
This is a notice of an
Administrative declaration of a disaster
for the State of KANSAS dated 06/28/
2021.
Incident: Flooding.
Incident Period: 05/15/2021 through
05/16/2021.
DATES: Issued on 06/28/2021.
Physical Loan Application Deadline
Date: 08/27/2021.
Economic Injury (EIDL) Loan
Application Deadline Date: 03/28/2022.
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,
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Percent
For Physical Damage:
Homeowners with Credit Available Elsewhere ......................
Homeowners without Credit
Available Elsewhere ..............
Businesses with Credit Available Elsewhere ......................
Businesses
without
Credit
Available Elsewhere ..............
Non-Profit Organizations with
Credit Available Elsewhere ...
Non-Profit Organizations without Credit Available Elsewhere .....................................
For Economic Injury:
Businesses & Small Agricultural
Cooperatives without Credit
Available Elsewhere ..............
Non-Profit Organizations without Credit Available Elsewhere .....................................
3.250
1.625
5.760
2.880
2.000
2.000
2.880
2.000
The number assigned to this disaster
for physical damage is 17003 6 and for
economic injury is 17004 0.
The State which received an EIDL
Declaration # is Kansas.
U.S. Small Business
Administration.
ACTION: Notice.
AGENCY:
SUMMARY:
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: Osborne.
Contiguous Counties: Kansas: Ellis,
Jewell, Lincoln, Mitchell, Rooks,
Russell, Smith.
The Interest Rates are:
(Catalog of Federal Domestic Assistance
Number 59008)
Isabella Guzman,
Administrator.
[FR Doc. 2021–14154 Filed 7–1–21; 8:45 am]
BILLING CODE 8026–03–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2021–0016]
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
PO 00000
Frm 00113
Fmt 4703
Sfmt 4703
35371
1, 1995. This notice includes revisions,
and an extension 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.
Comments: https://www.reginfo.gov/
public/do/PRAMain. Submit your
comments online referencing Docket
ID Number [SSA–2021–0016].
(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 https://www.reginfo.gov/
public/do/PRAMain, referencing Docket
ID Number [SSA–2021–0016].
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 31, 2021. Individuals
can obtain copies of the collection
instruments by writing to the above
email address.
1. Request for Withdrawal of
Application—20 CFR 404.640—0960–
0015. Form SSA–521, Request for
Withdrawal of Application, allows
claimants to specify which application
they want to withdraw and the reason
for the withdrawal. Form SSA–521 is
our preferred instrument for a
withdrawal request; however, any
written request for withdrawal signed
by the claimant or a proper applicant on
the claimant’s behalf will suffice.
Individuals who wish to withdraw their
applications for benefits complete Form
SSA–521, or sign the completed form
for each request to withdraw. SSA uses
the information from Form SSA–521 to
process the request for withdrawal. The
respondents are applicants for
Retirement, Survivors, Disability, and
Health Insurance benefits.
Type of Request: Revision of an OMBapproved information collection.
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Federal Register / Vol. 86, No. 125 / Friday, July 2, 2021 / Notices
Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
Respondents applying for or receiving
Retirement, Survivors, or Health Insurance benefits ........................................
Respondents applying for or receiving
Disability benefits .................................
60,753
1
5
5,063
* $10.95
** $55,440
14,374
1
5
1,198
* 10.95
** 13,118
Totals ................................................
75,127
........................
........................
6,261
........................
** 68,558
* We based this figure on the average DI payments based on SSA’s current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
2. Statement of Employer—20 CFR
404.801–404.803—0960–0030. When
workers report they were paid wages but
cannot provide proof of those earnings,
and the wages do not appear in SSA’s
records of earnings, SSA uses Form
SSA–7011–F4, Statement of Employer,
to document the alleged wages.
Specifically, the agency uses the form to
resolve discrepancies in the individual’s
Social Security earnings record and to
process claims for Social Security
benefits. We only send Form SSA–
7011–F4 to employers if we are unable
able to locate the earnings information
within our own records. The
respondents are employers who can
verify wage allegations made by wage
earners.
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)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
SSA–7011–F4 ..........................................
500
1
30
250
* $27.07
** $6,768
* We based this figure on average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/
oes_nat.htm#00-0000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
3. Statement of Care and
Responsibility for Beneficiary—20 CFR
404.2020, 404.2025, 408.620, 408.625,
416.620, and 416.625—0960–0109. SSA
uses the information from Form SSA–
788, Statement of Care and
Responsibility for Beneficiary, to verify
payee applicants’ statements of concern,
and to identify other potential payees.
SSA is concerned with selecting the
most qualified representative payee who
will use Social Security benefits in the
beneficiary’s best interest. SSA
considers factors such as the payee
applicant’s capacity to perform payee
duties; awareness of the beneficiary’s
situation and needs; demonstration of
past, and current concern for the
beneficiary’s well-being If the payee
applicant does not have custody of the
beneficiary, SSA obtains information
from the custodian for evaluation
against information the applicant
provides. Respondents are individuals
who have custody of the beneficiary in
cases where someone else has filed to be
the beneficiary’s representative payee.
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)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
SSA–788 ..................................................
134,000
1
10
22,333
* $27.07
** $604,554
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* We based this figures on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/
oes_nat.htm#00-00000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
4. Third Party Liability Information
Statement—42 CFR 433.136–433.139—
0960–0323. To reduce Medicaid costs,
Medicaid state agencies identify third
party insurers liable for medical care or
services for Medicaid beneficiaries.
Regulations at 42 CFR 433.136–433.139
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require Medicaid state agencies to
obtain this information on Medicaid
applications and redeterminations as a
condition of Medicaid eligibility. States
may enter into agreements with the
Commissioner of Social Security to
make Medicaid eligibility
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determinations for aged, blind, and
disabled beneficiaries in those states.
Applications for and redeterminations
of Supplemental Security Income (SSI)
eligibility in jurisdictions with such
agreements are applications and
redeterminations of Medicaid eligibility.
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Federal Register / Vol. 86, No. 125 / Friday, July 2, 2021 / Notices
Under these agreements, SSA obtains
third party liability information using
Form SSA–8019–U2, Third Party
Liability Information Statement, and
provides that information to the
Modality of completion
Number of
respondents
Medicaid state agencies. The Medicaid
state agencies use the information to bill
third parties liable for medical care,
support, or services for a beneficiary to
guarantee that Medicaid remains the
Average
burden per
response
(minutes)
Frequency
of response
payer of last resort. The respondents are
SSI claimants and recipients.
Type of Request: Revision of an OMBapproved information collection.
Average
theoretical
hourly cost
amount
(dollars) *
Estimated
total annual
burden
(hours)
Average
wait time in
field office
or for
teleservice
centers
(minutes) **
Total annual
opportunity
cost
(dollars) ***
SSA–8019–U2 (Paper)
SSI Claims System
(Intranet) ...................
200
1
6
20
* $19.01
........................
*** $380
35,257
1
6
3,526
* 19.01
** 21
*** 301,613
Totals ....................
35,457
........................
........................
3,546
........................
........................
*** 301,993
* We based this figure on averaging both the average DI payments based on SSA’s current FY 2021 data (https://www.ssa.gov/legislation/
2021FactSheet.pdf), and the average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
** We based this figure on averaging both the average FY 2021 wait times for field offices and teleservice centers, based on SSA’s current
management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application;
rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual
charge to respondents to complete the application.
age; and (2) no longer caring for a child.
In this situation, spouses who decide to
elect reduced benefits must file Form
SSA–25, Certificate of Election for
Reduced Spouse’s Benefits. SSA uses
the information to pay qualified spouses
who elect to receive reduced benefits.
5. Certificate of Election for Reduced
Spouse’s Benefits—20 CFR 404.421—
0960–0398. SSA cannot pay reduced
Social Security benefits to an already
entitled spouse unless the spouse elects
to receive reduced benefits and is (1) at
least age 62, but under full retirement
Respondents are entitled spouses
seeking reduced Social Security
benefits.
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)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
SSA–25 ....................................................
30,000
1
13
6,500
* $27.07
** $175,955
* We based this figures on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/
oes_nat.htm#00-00000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
lotter on DSK11XQN23PROD with NOTICES1
6. Permanent Residence in the United
States Under Color of Law (PRUCOL)—
20 CFR 416.1615 and 416.1618—0960–
0451. Under 20 CFR 416.1415 and
416.1618, SSA requires claimants or
recipients to submit evidence of their
alien status when they apply for SSI
payments, and periodically thereafter as
part of the eligibility determination
process for SSI. When SSA cannot
verify evidence of alien status through
the regular claimant interview process,
SSA verifies the validity of the evidence
of PRUCOL for grandfathered
nonqualified aliens with the Department
of Homeland Security (DHS) using the
DHS Systemic Alien Verification for
Entitlements (SAVE) program. SSA
determines if the individual qualifies for
PRUCOL status based on the SAVE
program response. SSA does not
maintain any forms or applications for
respondents to use, rather, the
regulations listed in 20 CFR 416.1615
and 416.1618 specify the information
respondents need to submit to SSA to
show evidence of PRUCOL. Without
this information, SSA is unable to
determine whether the PRUCOL
individual is eligible for SSI payments.
Respondents are qualified and
unqualified aliens who apply for SSI
payments under PRUCOL.
Type of Request: Extension of an
OMB-approved information collection.
Modality of completion
Number of
responses
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
Personal Interview ...................................
1,049
1
5
87
* $27.07
** $2,355
* We based this figure on average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/
oes_nat.htm#00-0000).
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Federal Register / Vol. 86, No. 125 / Friday, July 2, 2021 / Notices
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
7. Request for Deceased Individual’s
Social Security Record—20 CFR
402.130—0960–0665. The Freedom of
Information Act (FOIA), at 5 U.S.C.
552(a)(3) of the U.S. Code, provides
instructions for members of the public
to request records from Federal
agencies. When a member of the public
requests an individual’s Social Security
record under FOIA, SSA needs the
Modality of completion
Number of
respondents
name and address of the requestor as
well as a description of the requested
record to process the request. SSA uses
the information the respondent provides
on Form SSA–711, Request for Deceased
Individual’s Social Security Record, or
via an internet request through SSA’s
electronic Freedom of Information Act
(eFOIA) website, to:
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
(1) Verify the wage earner is deceased;
and (2) access the correct Social
Security record. Respondents are
members of the public requesting
deceased individuals’ Social Security
records.
Type of Request: Revision of an OMBapproved information collection.
Average
theoretical
hourly cost
amount
(dollars) *
Average
wait time in
field office
(minutes) **
Total annual
opportunity
cost
(dollars) ***
Internet Request
through eFOIA ..........
SSA–711 (paper) .........
49,800
200
1
1
7
7
5,810
23
* $27.07
* 27.07
........................
** 24
*** $157,277
*** 2,788
Total ......................
50,000
........................
........................
5,833
........................
........................
*** 160,065
* We based this figure on average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/
oes_nat.htm#00-0000).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA’s current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application;
rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual
charge to respondents to complete the application.
8. Request for Business Entity
Taxpayer Information—0960–0731. SSA
requires law firms or other business
entities to complete Form SSA–1694,
Request for Business Entity Taxpayer
Information, if they wish to serve as
appointed representatives and receive
direct payment of fees from SSA. SSA
uses the information to issue a Form
1099–MISC. SSA also uses the
information to allow business entities to
designate individuals to serve as entity
administrators authorized to perform
certain administrative duties on their
behalf, such as providing bank account
information, maintaining entity
Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
information, and updating individual
affiliations. Respondents are law firms
or other business entities with attorneys
or other qualified individuals as
partners or employees who represent
claimants before SSA.
Type of Request: Revision of an OMBapproved information collection.
Estimated
total annual
burden
(hours)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
SSA–1694 (Paper) ...................................
BSO online submission ............................
366
103
1
1
20
20
122
34
* $61.03
* 61.03
** $7,446
** 2,075
Totals ................................................
469
........................
........................
156
........................
** 9,521
* We based this figure on the average legal occupation’s hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/
current/oes_nat.htm#00-00000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
lotter on DSK11XQN23PROD with NOTICES1
Dated: June 29, 2021.
Eric Lowman,
Acting Reports Clearance Officer, Office of
Legislative Development and Operations,
Social Security Administration.
DEPARTMENT OF STATE
[Public Notice: 11456]
[FR Doc. 2021–14167 Filed 7–1–21; 8:45 am]
Renewal of International Security
Advisory Board Charter
BILLING CODE 4191–02–P
SUMMARY:
VerDate Sep<11>2014
17:12 Jul 01, 2021
The Department of State
announces the renewal of the Charter
for the International Security Advisory
Board (ISAB). The purpose of the
Secretary’s International Security
Advisory Board (ISAB) is to provide the
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Department with a continuing source of
independent insight, advice, and
innovation on all aspects of arms
control, disarmament, nonproliferation,
outer space, critical infrastructure,
cybersecurity, the national security
aspects of emerging technologies, and
international security, as well as related
aspects of public diplomacy. The ISAB
will remain in existence for two years
after the filing date of the Charter unless
terminated or renewed.
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]]>Agencies
[Federal Register Volume 86, Number 125 (Friday, July 2, 2021)]
[Notices]
[Pages 35371-35374]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-14167]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2021-0016]
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, and an extension 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.
Comments: https://www.reginfo.gov/public/do/PRAMain. Submit your
comments online referencing Docket ID Number [SSA-2021-0016].
(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 https://www.reginfo.gov/public/do/PRAMain, referencing Docket ID Number [SSA-
2021-0016].
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 31, 2021. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Request for Withdrawal of Application--20 CFR 404.640--0960-
0015. Form SSA-521, Request for Withdrawal of Application, allows
claimants to specify which application they want to withdraw and the
reason for the withdrawal. Form SSA-521 is our preferred instrument for
a withdrawal request; however, any written request for withdrawal
signed by the claimant or a proper applicant on the claimant's behalf
will suffice. Individuals who wish to withdraw their applications for
benefits complete Form SSA-521, or sign the completed form for each
request to withdraw. SSA uses the information from Form SSA-521 to
process the request for withdrawal. The respondents are applicants for
Retirement, Survivors, Disability, and Health Insurance benefits.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 35372]]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated theoretical Total annual
Modality of completion Number of Frequency of per response total annual hourly cost opportunity
respondents response (minutes) burden (hours) amount cost (dollars)
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Respondents applying for or receiving Retirement, 60,753 1 5 5,063 * $10.95 ** $55,440
Survivors, or Health Insurance benefits................
Respondents applying for or receiving Disability 14,374 1 5 1,198 * 10.95 ** 13,118
benefits...............................................
-----------------------------------------------------------------------------------------------
Totals.............................................. 75,127 .............. .............. 6,261 .............. ** 68,558
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
2. Statement of Employer--20 CFR 404.801-404.803--0960-0030. When
workers report they were paid wages but cannot provide proof of those
earnings, and the wages do not appear in SSA's records of earnings, SSA
uses Form SSA-7011-F4, Statement of Employer, to document the alleged
wages. Specifically, the agency uses the form to resolve discrepancies
in the individual's Social Security earnings record and to process
claims for Social Security benefits. We only send Form SSA-7011-F4 to
employers if we are unable able to locate the earnings information
within our own records. The respondents are employers who can verify
wage allegations made by wage earners.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated total theoretical Total annual
Modality of completion Number of Frequency of per response annual burden hourly cost opportunity
respondents response (minutes) (hours) amount cost (dollars)
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-7011-F4....................................... 500 1 30 250 * $27.07 ** $6,768
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-0000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
3. Statement of Care and Responsibility for Beneficiary--20 CFR
404.2020, 404.2025, 408.620, 408.625, 416.620, and 416.625--0960-0109.
SSA uses the information from Form SSA-788, Statement of Care and
Responsibility for Beneficiary, to verify payee applicants' statements
of concern, and to identify other potential payees. SSA is concerned
with selecting the most qualified representative payee who will use
Social Security benefits in the beneficiary's best interest. SSA
considers factors such as the payee applicant's capacity to perform
payee duties; awareness of the beneficiary's situation and needs;
demonstration of past, and current concern for the beneficiary's well-
being If the payee applicant does not have custody of the beneficiary,
SSA obtains information from the custodian for evaluation against
information the applicant provides. Respondents are individuals who
have custody of the beneficiary in cases where someone else has filed
to be the beneficiary's representative payee.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated total theoretical Total annual
Modality of completion Number of Frequency of per response annual burden hourly cost opportunity
respondents response (minutes) (hours) amount cost (dollars)
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-788........................................... 134,000 1 10 22,333 * $27.07 ** $604,554
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figures on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-00000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
4. Third Party Liability Information Statement--42 CFR 433.136-
433.139--0960-0323. To reduce Medicaid costs, Medicaid state agencies
identify third party insurers liable for medical care or services for
Medicaid beneficiaries. Regulations at 42 CFR 433.136-433.139 require
Medicaid state agencies to obtain this information on Medicaid
applications and redeterminations as a condition of Medicaid
eligibility. States may enter into agreements with the Commissioner of
Social Security to make Medicaid eligibility determinations for aged,
blind, and disabled beneficiaries in those states. Applications for and
redeterminations of Supplemental Security Income (SSI) eligibility in
jurisdictions with such agreements are applications and
redeterminations of Medicaid eligibility.
[[Page 35373]]
Under these agreements, SSA obtains third party liability
information using Form SSA-8019-U2, Third Party Liability Information
Statement, and provides that information to the Medicaid state
agencies. The Medicaid state agencies use the information to bill third
parties liable for medical care, support, or services for a beneficiary
to guarantee that Medicaid remains the payer of last resort. The
respondents are SSI claimants and recipients.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average wait
Average time in field Total annual
Number of Frequency of Average burden Estimated theoretical office or for opportunity
Modality of completion respondents response per response total annual hourly cost teleservice cost (dollars)
(minutes) burden (hours) amount centers ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-8019-U2 (Paper)..................... 200 1 6 20 * $19.01 .............. *** $380
SSI Claims System (Intranet)............ 35,257 1 6 3,526 * 19.01 ** 21 *** 301,613
---------------------------------------------------------------------------------------------------------------
Totals.............................. 35,457 .............. .............. 3,546 .............. .............. *** 301,993
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on averaging both the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf), and the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
** We based this figure on averaging both the average FY 2021 wait times for field offices and teleservice centers, based on SSA's current management
information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
5. Certificate of Election for Reduced Spouse's Benefits--20 CFR
404.421--0960-0398. SSA cannot pay reduced Social Security benefits to
an already entitled spouse unless the spouse elects to receive reduced
benefits and is (1) at least age 62, but under full retirement age; and
(2) no longer caring for a child. In this situation, spouses who decide
to elect reduced benefits must file Form SSA-25, Certificate of
Election for Reduced Spouse's Benefits. SSA uses the information to pay
qualified spouses who elect to receive reduced benefits. Respondents
are entitled spouses seeking reduced Social Security benefits.
Type of Request: Revision of an OMB approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated total theoretical Total annual
Modality of completion Number of Frequency of per response annual burden hourly cost opportunity
respondents response (minutes) (hours) amount cost (dollars)
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-25............................................ 30,000 1 13 6,500 * $27.07 ** $175,955
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figures on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-00000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
6. Permanent Residence in the United States Under Color of Law
(PRUCOL)--20 CFR 416.1615 and 416.1618--0960-0451. Under 20 CFR
416.1415 and 416.1618, SSA requires claimants or recipients to submit
evidence of their alien status when they apply for SSI payments, and
periodically thereafter as part of the eligibility determination
process for SSI. When SSA cannot verify evidence of alien status
through the regular claimant interview process, SSA verifies the
validity of the evidence of PRUCOL for grandfathered nonqualified
aliens with the Department of Homeland Security (DHS) using the DHS
Systemic Alien Verification for Entitlements (SAVE) program. SSA
determines if the individual qualifies for PRUCOL status based on the
SAVE program response. SSA does not maintain any forms or applications
for respondents to use, rather, the regulations listed in 20 CFR
416.1615 and 416.1618 specify the information respondents need to
submit to SSA to show evidence of PRUCOL. Without this information, SSA
is unable to determine whether the PRUCOL individual is eligible for
SSI payments. Respondents are qualified and unqualified aliens who
apply for SSI payments under PRUCOL.
Type of Request: Extension of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated total theoretical Total annual
Modality of completion Number of Frequency of per response annual burden hourly cost opportunity
responses response (minutes) (hours) amount cost (dollars)
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Personal Interview................................ 1,049 1 5 87 * $27.07 ** $2,355
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-0000).
[[Page 35374]]
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
7. Request for Deceased Individual's Social Security Record--20 CFR
402.130--0960-0665. The Freedom of Information Act (FOIA), at 5 U.S.C.
552(a)(3) of the U.S. Code, provides instructions for members of the
public to request records from Federal agencies. When a member of the
public requests an individual's Social Security record under FOIA, SSA
needs the name and address of the requestor as well as a description of
the requested record to process the request. SSA uses the information
the respondent provides on Form SSA-711, Request for Deceased
Individual's Social Security Record, or via an internet request through
SSA's electronic Freedom of Information Act (eFOIA) website, to:
(1) Verify the wage earner is deceased; and (2) access the correct
Social Security record. Respondents are members of the public
requesting deceased individuals' Social Security records.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated theoretical Average wait Total annual
Modality of completion Number of Frequency of per response total annual hourly cost time in field opportunity
respondents response (minutes) burden (hours) amount office cost (dollars)
(dollars) * (minutes) ** ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
Internet Request through eFOIA.......... 49,800 1 7 5,810 * $27.07 .............. *** $157,277
SSA-711 (paper)......................... 200 1 7 23 * 27.07 ** 24 *** 2,788
---------------------------------------------------------------------------------------------------------------
Total............................... 50,000 .............. .............. 5,833 .............. .............. *** 160,065
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-0000).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
8. Request for Business Entity Taxpayer Information--0960-0731. SSA
requires law firms or other business entities to complete Form SSA-
1694, Request for Business Entity Taxpayer Information, if they wish to
serve as appointed representatives and receive direct payment of fees
from SSA. SSA uses the information to issue a Form 1099-MISC. SSA also
uses the information to allow business entities to designate
individuals to serve as entity administrators authorized to perform
certain administrative duties on their behalf, such as providing bank
account information, maintaining entity information, and updating
individual affiliations. Respondents are law firms or other business
entities with attorneys or other qualified individuals as partners or
employees who represent claimants before SSA.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated theoretical Total annual
Modality of completion Number of Frequency of per response total annual hourly cost opportunity
respondents response (minutes) burden (hours) amount cost (dollars)
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-1694 (Paper)........................................ 366 1 20 122 * $61.03 ** $7,446
BSO online submission................................... 103 1 20 34 * 61.03 ** 2,075
-----------------------------------------------------------------------------------------------
Totals.............................................. 469 .............. .............. 156 .............. ** 9,521
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average legal occupation's hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-00000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
Dated: June 29, 2021.
Eric Lowman,
Acting Reports Clearance Officer, Office of Legislative Development and
Operations, Social Security Administration.
[FR Doc. 2021-14167 Filed 7-1-21; 8:45 am]
BILLING CODE 4191-02-P
