Agency Information Collection Activities: Proposed Request, 40221-40224 [2021-15898]
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OMB Control Number: 3245–0018.
Title: Disaster Home Loan
Application.
Description of Respondents: Disaster
Survivors.
Estimated Annual Responses: 34,273.
Estimated Annual Hour Burden:
42,841.
Curtis Rich,
Management Analyst.
[FR Doc. 2021–15937 Filed 7–26–21; 8:45 am]
BILLING CODE 8026–03–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2021–0022]
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.
Modality of completion
Number of
respondents
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–2021–0022].
(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–2021–0022].
Average
burden per
response
(minutes)
Frequency of
response
Estimated total
annual burden
(hours)
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 September 27, 2021.
Individuals can obtain copies of the
collection instruments by writing to the
above email address.
1. Application for Parent’s Insurance
Benefits—20 CFR 404.370, 404.371,
404.373, 404.374 & 404.601–404.603—
0960–0012. Section 202(h) of the Social
Security Act (Act) establishes the
conditions of eligibility a claimant must
meet to receive monthly benefits as a
parent of a deceased worker who was
contributing at least one-half of the
parent’s support at the time of the
worker’s death or when the worker
became disabled. SSA uses information
from Form SSA–7–F6, Application for
Parent’s Insurance Benefits, to
determine if the claimant meets the
eligibility and application criteria. The
respondents are applicants filing for
Parent’s Insurance Benefits.
Type of Request: Revision of an OMBapproved information collection.
Average
theoretical
hourly cost
amount
(dollars) *
Average wait
time in
field office or
for
teleservice
centers
(minutes) **
Total annual
opportunity
cost
(dollars) ***
SSA–7–F6 (Paper) .......
Interview (MCS) ...........
4
325
1
1
15
15
1
81
* $27.07
* 27.07
0
** 21
*** $27
*** 5,279
Totals ....................
329
........................
........................
82
........................
........................
*** 5,306
* We based this figure on 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#00-0000).
** 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.
lotter on DSK11XQN23PROD with NOTICES1
2. Employment Relationship
Questionnaire—20 CFR 404.1007—
0960–0040. When SSA needs
information to determine a worker’s
employment status to maintain a
worker’s earning records, the agency
uses Form SSA–7160, Employment
Relationship Questionnaire, to
determine the existence of an employeremployee relationship. We use the
information to develop the employment
relationship; specifically, to determine
whether a beneficiary is self-employed
or an employee. The respondents are
individuals, households, businesses,
and state or local governments seeking
to establish their status as employees,
and their alleged employers.
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) *
Average wait
time in field
office
(minutes) **
Total annual
opportunity
cost
(dollars) ***
SSA–7160 ....................
45
1
25
19
* $22.14
** 24
*** $820
* We based this figure on the average U.S. worker’s hourly wages of $27.07 (https://www.bls.gov/oes/current/oes_nat.htm); the median hourly
wage of $21.10 for public sector Information and Records Clerks (https://www.bls.gov/oes/current/oes434199.htm); and the median hourly wage
of $18.25 for State and Local government Information and Records Clerks (https://www.bls.gov/oes/current/oes434199.htm), as reported by Bureau of Labor Statistics data. We used the average of these three wages to calculate the combined Average Theoretical Hourly Wage of $22.14.
** We based this figure on the average FY 2021 wait times for field offices, based on SSA’s current management information data.
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*** 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.
year. SSA uses Form SSA–766,
Statement of Self-Employment Income,
to collect the information we need to
determine if the individual earned at
least the minimum amount of SEI
needed for one or more quarters of
coverage in the current year. Based on
the information we obtain, we may
3. Statement of Self-Employment
Income—20 CFR 404.101, 404.110, &
404.1096(a)(d)—0960–0046. To qualify
for insured status, and collect Social
Security benefits, self-employed
individuals must demonstrate they
earned the minimum amount of selfemployment income (SEI) in a current
credit additional quarters of coverage to
give the individual insured status and
expedite benefit payments. Respondents
are self-employed individuals
potentially eligible for 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)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
≤SSA–766 ................................................
910
1
5
76
* $27.07
** $2,057
* 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.
4. Substitution of Party Upon Death of
Claimant—20 CFR 404.957(c)(4) &
416.1457(c)(4)—0960–0288. A judge
may dismiss a request for a hearing on
a pending claim of a deceased
individual for Social Security benefits
or Supplemental Security Income (SSI)
payments. Individuals who believe the
dismissal may adversely affect them
may complete Form HA–539, Notice
Regarding Substitution of Party Upon
Death of Claimant, which allows them
to request to become a substitute party
for the deceased claimant. The judge
and the hearing office support staff use
the information from the HA–539 to: (1)
Maintain a written record of request; (2)
establish the relationship of the
requester to the deceased claimant; (3)
determine the substituted individual’s
wishes regarding an oral hearing or
decision on the record; and (4) admit
the data into the claimant’s official
record as an exhibit. The respondents
are individuals requesting to be
substitute parties for a deceased
claimant.
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) **
HA–539 ....................................................
4,000
1
5
333
* $10.95
** $3,646
* 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.
lotter on DSK11XQN23PROD with NOTICES1
5. Claimant Statement about Loan of
Food or Shelter; Statement about Food
or Shelter Provided to Another—20 CFR
416.1130–416.1148—0960–0529. SSA
bases an SSI claimant’s or recipient’s
eligibility on need, as measured by the
amount of income an individual
receives. Per our calculations, income
includes other people providing in-kind
support and maintenance in the form of
Modality of completion
Number of
respondents
SSA–5062—Paper
Version .....................
SSA–L5063—Paper
Version .....................
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food and shelter to SSI applicants or
recipients. SSA uses Forms SSA–5062,
Claimant Statement about Loan of Food
or Shelter, and SSA–L5063, Statement
about Food or Shelter Provided to
Another, to obtain statements about
food or shelter provided to SSI
claimants or recipients. SSA uses this
information to determine whether the
food or shelter are bona fide loans or
Frequency of
response
Average
burden per
response
(minutes)
Estimated total
annual burden
(hours)
income for SSI purposes. This
determination may affect claimants’ or
recipients’ eligibility for SSI as well as
the amounts of their SSI payments. The
respondents are claimants and
recipients for SSI payments, and
individuals who provide loans of food
or shelter to them.
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) ***
29,026
1
10
4,838
* $19.01
** 24
*** $312,676
29,026
1
10
4,838
* 19.01
** 24
*** 312,676
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Modality of completion
Number of
respondents
Average
burden per
response
(minutes)
Frequency of
response
Estimated total
annual burden
(hours)
Average
theoretical
hourly cost
amount
(dollars) *
Average wait
time in field
office
(minutes) **
Total annual
opportunity
cost
(dollars) ***
SSA–5062—SSI Claims
System ......................
SSA–L5063—SSI
Claims System .........
29,026
1
10
4,838
* 19.01
** 24
*** 312,676
29,026
1
10
4,838
* 19.01
** 24
*** 312,676
Totals ....................
116,104
........................
........................
19,352
........................
........................
*** 1,250,704
* 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 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.
6. Application for Circuit Court Law—
20 CFR 404.985 & 416.1485—0960–
0581. Individuals claiming that an
acquiescence ruling (AR) would change
SSA’s prior determination or decision
must submit a written readjudication
request with specific information. SSA
reviews the information in the requests
to determine if the issues stated in the
AR pertain to the claimant’s case, and
if the claimant is entitled to
readjudication. If readjudication is
appropriate, SSA considers the issues
the AR covers. Any new determination
or decision is subject to administrative
or judicial review as specified in the
regulations, and the claimants must
provide information to request
readjudication. The respondents are
claimants for Social Security benefits
and SSI payments, who request a
readjudication of their claim based on
an AR notice.
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)
Average
theoretical
hourly cost
amount
(dollars) *
Total annual
opportunity
cost
(dollars) **
AR-based Readjudication Requests ........
10,000
1
17
2,833
* $10.95
** $31,021
* 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.
lotter on DSK11XQN23PROD with NOTICES1
7. Social Security Administration
Health IT Partner Program
Assessment—Participating Facilities
and Available Content Form—20 CFR
404.1614 & 416.1014—0960–0798. The
Health Information Technology for
Economic and Clinical Health (HITECH)
Act promotes the adoption and
meaningful use of health information
technology (IT), particularly in the
context of working with government
agencies. Similarly, section 3004 of the
Public Health Service Act requires
health care providers or health
insurance issuers with government
contracts to implement, acquire, or
upgrade their health IT systems and
products to meet adopted standards and
implementation specifications. To
support expansion of SSA’s health IT
initiative as defined under HITECH,
SSA developed Form SSA–680, the
Health IT Partner Program
Assessment—Participating Facilities
and Available Content Form. The SSA–
680 allows healthcare providers to
provide the information SSA needs to
determine their ability to exchange
health information with the agency
electronically. We evaluate potential
partners (i.e., healthcare providers and
organizations) on: (1) The accessibility
of health information they possess; and
(2) the content value of their electronic
health records’ systems for our
disability adjudication processes. SSA
reviews the completeness of
organizations’ SSA–680 responses as
one part of our careful analysis of their
readiness to enter into a health IT
partnership with us. The respondents
are healthcare providers and
organizations exchanging information
with the agency.
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–680 ..................................................
30
1
300
150
* $41.30
** $6,195
* We based this figures on average Healthcare Practitioners and Technical Occupations, 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.
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Federal Register / Vol. 86, No. 141 / Tuesday, July 27, 2021 / Notices
8. Authorization for the Social
Security Administration to Obtain
Personal Information—20 CFR 404.704,
404.820 404.823, 404.1926, 416.203, &
418.3001—0960–0801. SSA uses Form
SSA–8510, Authorization for the Social
Security Administration to Obtain
Personal Information, to contact a
public or private custodian of records
on behalf of an applicant or recipient of
an SSA program to request evidence
information or proofs, which may
support a benefit application or
payment continuation. SSA also uses
this form to obtain evidence or proofs to
determine the claimant’s payment
amount. We ask for information such as
the following:
• Age requirements (e.g., birth
certificate, court documents)
Modality of completion
Number of
respondents
Paper SSA-8510 for
general evidence purposes ........................
Personal Information
Authorization Intranet
Screens for general
evidence purposes
(SSI Claims System)
Totals ....................
• Insured status (e.g., earnings,
employer verification)
• Marriage or divorce
• Pension offsets
• Wages verification
• Annuities
• Dividends, royalties, or other
similar payments
• Property information
• Benefit verification from a State
agency or third party
• Immigration status (rare instances)
• Income verification from public
agencies or private individuals
• Unemployment benefits
• Insurance policies
• Alimony or Child Support
payments.
If the custodian of the records
requires a signed authorization from the
individual(s) whose information SSA
requests, SSA may provide the
Average
burden per
response
(minutes)
Frequency of
response
Estimated
total annual
burden
(hours)
custodian with a copy of the SSA–8510.
Once the respondent completes the
SSA–8510, either using the paper form
or using the Personal Information
Authorization Intranet version, SSA
uses the form as the authorization to
obtain personal information regarding
the respondent from third parties until
the authorizing person (respondent)
withdraws their claim or revokes the
permission of its use. The collection is
voluntary; however, failure to verify the
individuals’ eligibility can prevent SSA
from making an accurate and timely
decision for their benefits. The
respondents are individuals who may
file for, or currently receive, Social
Security benefits, SSI payments, or
Medicare Part D subsidies.
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) ***
8,226
1
5
686
* $19.01
** 24
*** $75,584
192,235
200,461
1
........................
5
........................
16,020
16,706
* 19.01
........................
** 24
........................
*** 1,766,295
*** 1,841,879
* 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 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.
Dated: July 21, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security
Administration.
Contemporary Art San Diego, La Jolla,
California, and at possible additional
exhibitions or venues yet to be
determined, are of cultural significance,
and, further, that their temporary
exhibition or display within the United
States as aforementioned is in the
national interest. I have ordered that
Public Notice of these determinations be
published in the Federal Register.
[FR Doc. 2021–15898 Filed 7–26–21; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice: 11472]
Chi
D. Tran, Program Administrator, Office
of the Legal Adviser, U.S. Department of
State (telephone: 202–632–6471; email:
section2459@state.gov). The mailing
address is U.S. Department of State, L/
PD, 2200 C Street NW (SA–5), Suite
5H03, Washington, DC 20522–0505.
FOR FURTHER INFORMATION CONTACT:
Notice of Determinations; Culturally
Significant Objects Being Imported for
Exhibition—Determinations: ‘‘Niki de
Saint Phalle in the 1960s’’ Exhibition
Notice is hereby given of the
following determinations: I hereby
determine that certain objects being
imported from abroad pursuant to
agreements with their foreign owners or
custodians for temporary display in the
exhibition ‘‘Niki de Saint Phalle in the
1960s’’ at The Menil Collection,
Houston, Texas, the Museum of
lotter on DSK11XQN23PROD with NOTICES1
SUMMARY:
VerDate Sep<11>2014
17:07 Jul 26, 2021
Jkt 253001
Affairs Reform and Restructuring Act of
1998 (112 Stat. 2681, et seq.; 22 U.S.C.
6501 note, et seq.), Delegation of
Authority No. 234 of October 1, 1999,
and Delegation of Authority No. 236–3
of August 28, 2000.
Matthew R. Lussenhop,
Acting Assistant Secretary, Bureau of
Educational and Cultural Affairs, Department
of State.
[FR Doc. 2021–15959 Filed 7–26–21; 8:45 am]
BILLING CODE 4710–05–P
The
foregoing determinations were made
pursuant to the authority vested in me
by the Act of October 19, 1965 (79 Stat.
985; 22 U.S.C. 2459), Executive Order
12047 of March 27, 1978, the Foreign
SUPPLEMENTARY INFORMATION:
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]]>Agencies
[Federal Register Volume 86, Number 141 (Tuesday, July 27, 2021)]
[Notices]
[Pages 40221-40224]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-15898]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2021-0022]
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-2021-0022].
(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-2021-0022].
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
September 27, 2021. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application for Parent's Insurance Benefits--20 CFR 404.370,
404.371, 404.373, 404.374 & 404.601-404.603--0960-0012. Section 202(h)
of the Social Security Act (Act) establishes the conditions of
eligibility a claimant must meet to receive monthly benefits as a
parent of a deceased worker who was contributing at least one-half of
the parent's support at the time of the worker's death or when the
worker became disabled. SSA uses information from Form SSA-7-F6,
Application for Parent's Insurance Benefits, to determine if the
claimant meets the eligibility and application criteria. The
respondents are applicants filing for Parent's Insurance Benefits.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average wait
Average Average time in field Total annual
Number of Frequency of burden per Estimated theoretical office or for opportunity
Modality of completion respondents response response total annual hourly cost teleservice cost (dollars)
(minutes) burden (hours) amount centers ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-7-F6 (Paper)........................ 4 1 15 1 * $27.07 0 *** $27
Interview (MCS)......................... 325 1 15 81 * 27.07 ** 21 *** 5,279
---------------------------------------------------------------------------------------------------------------
Totals.............................. 329 .............. .............. 82 .............. .............. *** 5,306
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on 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#00-0000).
** 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.
2. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. When SSA needs information to determine a worker's employment
status to maintain a worker's earning records, the agency uses Form
SSA-7160, Employment Relationship Questionnaire, to determine the
existence of an employer-employee relationship. We use the information
to develop the employment relationship; specifically, to determine
whether a beneficiary is self-employed or an employee. The respondents
are individuals, households, businesses, and state or local governments
seeking to establish their status as employees, and their alleged
employers.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated total theoretical Average wait Total annual
Modality of completion Number of Frequency of per response annual burden hourly cost time in field opportunity
respondents response (minutes) (hours) amount office cost (dollars)
(dollars) * (minutes) ** ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-7160......................... 45 1 25 19 * $22.14 ** 24 *** $820
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average U.S. worker's hourly wages of $27.07 (https://www.bls.gov/oes/current/oes_nat.htm); the median hourly wage of
$21.10 for public sector Information and Records Clerks (https://www.bls.gov/oes/current/oes434199.htm); and the median hourly wage of $18.25 for
State and Local government Information and Records Clerks (https://www.bls.gov/oes/current/oes434199.htm), as reported by Bureau of Labor Statistics
data. We used the average of these three wages to calculate the combined Average Theoretical Hourly Wage of $22.14.
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
[[Page 40222]]
*** 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 Self-Employment Income--20 CFR 404.101, 404.110, &
404.1096(a)(d)--0960-0046. To qualify for insured status, and collect
Social Security benefits, self-employed individuals must demonstrate
they earned the minimum amount of self-employment income (SEI) in a
current year. SSA uses Form SSA-766, Statement of Self-Employment
Income, to collect the information we need to determine if the
individual earned at least the minimum amount of SEI needed for one or
more quarters of coverage in the current year. Based on the information
we obtain, we may credit additional quarters of coverage to give the
individual insured status and expedite benefit payments. Respondents
are self-employed individuals potentially eligible for 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-766.......................................... 910 1 5 76 * $27.07 ** $2,057
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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.
4. Substitution of Party Upon Death of Claimant--20 CFR
404.957(c)(4) & 416.1457(c)(4)--0960-0288. A judge may dismiss a
request for a hearing on a pending claim of a deceased individual for
Social Security benefits or Supplemental Security Income (SSI)
payments. Individuals who believe the dismissal may adversely affect
them may complete Form HA-539, Notice Regarding Substitution of Party
Upon Death of Claimant, which allows them to request to become a
substitute party for the deceased claimant. The judge and the hearing
office support staff use the information from the HA-539 to: (1)
Maintain a written record of request; (2) establish the relationship of
the requester to the deceased claimant; (3) determine the substituted
individual's wishes regarding an oral hearing or decision on the
record; and (4) admit the data into the claimant's official record as
an exhibit. The respondents are individuals requesting to be substitute
parties for a deceased claimant.
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) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-539............................................ 4,000 1 5 333 * $10.95 ** $3,646
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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.
5. Claimant Statement about Loan of Food or Shelter; Statement
about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. SSA bases an SSI claimant's or recipient's eligibility on
need, as measured by the amount of income an individual receives. Per
our calculations, income includes other people providing in-kind
support and maintenance in the form of food and shelter to SSI
applicants or recipients. SSA uses Forms SSA-5062, Claimant Statement
about Loan of Food or Shelter, and SSA-L5063, Statement about Food or
Shelter Provided to Another, to obtain statements about food or shelter
provided to SSI claimants or recipients. SSA uses this information to
determine whether the food or shelter are bona fide loans or income for
SSI purposes. This determination may affect claimants' or recipients'
eligibility for SSI as well as the amounts of their SSI payments. The
respondents are claimants and recipients for SSI payments, and
individuals who provide loans of food or shelter to them.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average Estimated theoretical Average wait Total annual
Modality of completion Number of Frequency of burden per total annual hourly cost time in field opportunity
respondents response response burden (hours) amount office cost (dollars)
(minutes) (dollars) * (minutes) ** ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-5062--Paper Version................. 29,026 1 10 4,838 * $19.01 ** 24 *** $312,676
SSA-L5063--Paper Version................ 29,026 1 10 4,838 * 19.01 ** 24 *** 312,676
[[Page 40223]]
SSA-5062--SSI Claims System............. 29,026 1 10 4,838 * 19.01 ** 24 *** 312,676
SSA-L5063--SSI Claims System............ 29,026 1 10 4,838 * 19.01 ** 24 *** 312,676
---------------------------------------------------------------------------------------------------------------
Totals.............................. 116,104 .............. .............. 19,352 .............. .............. *** 1,250,704
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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 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.
6. Application for Circuit Court Law--20 CFR 404.985 & 416.1485--
0960-0581. Individuals claiming that an acquiescence ruling (AR) would
change SSA's prior determination or decision must submit a written
readjudication request with specific information. SSA reviews the
information in the requests to determine if the issues stated in the AR
pertain to the claimant's case, and if the claimant is entitled to
readjudication. If readjudication is appropriate, SSA considers the
issues the AR covers. Any new determination or decision is subject to
administrative or judicial review as specified in the regulations, and
the claimants must provide information to request readjudication. The
respondents are claimants for Social Security benefits and SSI
payments, who request a readjudication of their claim based on an AR
notice.
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
respondents response (minutes) (hours) amount cost (dollars)
(dollars) * **
--------------------------------------------------------------------------------------------------------------------------------------------------------
AR-based Readjudication Requests.................. 10,000 1 17 2,833 * $10.95 ** $31,021
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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.
7. Social Security Administration Health IT Partner Program
Assessment--Participating Facilities and Available Content Form--20 CFR
404.1614 & 416.1014--0960-0798. The Health Information Technology for
Economic and Clinical Health (HITECH) Act promotes the adoption and
meaningful use of health information technology (IT), particularly in
the context of working with government agencies. Similarly, section
3004 of the Public Health Service Act requires health care providers or
health insurance issuers with government contracts to implement,
acquire, or upgrade their health IT systems and products to meet
adopted standards and implementation specifications. To support
expansion of SSA's health IT initiative as defined under HITECH, SSA
developed Form SSA-680, the Health IT Partner Program Assessment--
Participating Facilities and Available Content Form. The SSA-680 allows
healthcare providers to provide the information SSA needs to determine
their ability to exchange health information with the agency
electronically. We evaluate potential partners (i.e., healthcare
providers and organizations) on: (1) The accessibility of health
information they possess; and (2) the content value of their electronic
health records' systems for our disability adjudication processes. SSA
reviews the completeness of organizations' SSA-680 responses as one
part of our careful analysis of their readiness to enter into a health
IT partnership with us. The respondents are healthcare providers and
organizations exchanging information with the agency.
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-680........................................... 30 1 300 150 * $41.30 ** $6,195
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figures on average Healthcare Practitioners and Technical Occupations, 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.
[[Page 40224]]
8. Authorization for the Social Security Administration to Obtain
Personal Information--20 CFR 404.704, 404.820 404.823, 404.1926,
416.203, & 418.3001--0960-0801. SSA uses Form SSA-8510, Authorization
for the Social Security Administration to Obtain Personal Information,
to contact a public or private custodian of records on behalf of an
applicant or recipient of an SSA program to request evidence
information or proofs, which may support a benefit application or
payment continuation. SSA also uses this form to obtain evidence or
proofs to determine the claimant's payment amount. We ask for
information such as the following:
Age requirements (e.g., birth certificate, court
documents)
Insured status (e.g., earnings, employer verification)
Marriage or divorce
Pension offsets
Wages verification
Annuities
Dividends, royalties, or other similar payments
Property information
Benefit verification from a State agency or third party
Immigration status (rare instances)
Income verification from public agencies or private
individuals
Unemployment benefits
Insurance policies
Alimony or Child Support payments.
If the custodian of the records requires a signed authorization
from the individual(s) whose information SSA requests, SSA may provide
the custodian with a copy of the SSA-8510. Once the respondent
completes the SSA-8510, either using the paper form or using the
Personal Information Authorization Intranet version, SSA uses the form
as the authorization to obtain personal information regarding the
respondent from third parties until the authorizing person (respondent)
withdraws their claim or revokes the permission of its use. The
collection is voluntary; however, failure to verify the individuals'
eligibility can prevent SSA from making an accurate and timely decision
for their benefits. The respondents are individuals who may file for,
or currently receive, Social Security benefits, SSI payments, or
Medicare Part D subsidies.
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) ** ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
Paper SSA[dash]8510 for general evidence 8,226 1 5 686 * $19.01 ** 24 *** $75,584
purposes...............................
Personal Information Authorization 192,235 1 5 16,020 * 19.01 ** 24 *** 1,766,295
Intranet Screens for general evidence
purposes (SSI Claims System)...........
Totals.............................. 200,461 .............. .............. 16,706 .............. .............. *** 1,841,879
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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 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.
Dated: July 21, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-15898 Filed 7-26-21; 8:45 am]
BILLING CODE 4191-02-P
