Agency Information Collection Activities: Proposed Request and Comment Request, 46897-46900 [2021-17857]

Download as PDF 46897 Federal Register / Vol. 86, No. 159 / Friday, August 20, 2021 / Notices SSA is soliciting comments on the accuracy of the agency’s burden Non-Profit Organizations withestimate; the need for the information; out Credit Available Elseits practical utility; ways to enhance its where ..................................... 2.000 quality, utility, and clarity; and ways to minimize burden on respondents, The number assigned to this disaster including the use of automated for physical damage is 17087 B and for collection techniques or other forms of economic injury is 17088 0. information technology. Mail, email, or (Catalog of Federal Domestic Assistance fax your comments and Number 59008) recommendations on the information collection(s) to the OMB Desk Officer James Rivera, and SSA Reports Clearance Officer at Associate Administrator for Disaster the following addresses or fax numbers. Assistance. (OMB) Office of Management and [FR Doc. 2021–17871 Filed 8–19–21; 8:45 am] Budget, Attn: Desk Officer for SSA BILLING CODE 8026–03–P Comments: https://www.reginfo.gov/ public/do/PRAMain. Submit your comments online referencing Docket ID SOCIAL SECURITY ADMINISTRATION Number [SSA–2021–0024]. [Docket No: SSA–2021–0024] (SSA) Social Security Administration, OLCA, Attn: Reports Clearance Agency Information Collection Director, 3100 West High Rise, 6401 Activities: Proposed Request and Security Blvd., Baltimore, MD 21235, Comment Request Fax: 410–966–2830, Email address: OR.Reports.Clearance@ssa.gov The Social Security Administration (SSA) publishes a list of information Or you may submit your comments collection packages requiring clearance online through https://www.reginfo.gov/ by the Office of Management and public/do/PRAMain, referencing Docket Budget (OMB) in compliance with ID Number [SSA–2021–0024]. Public Law 104–13, the Paperwork I. The information collections below Reduction Act of 1995, effective October are pending at SSA. SSA will submit 1, 1995. This notice includes revisions them to OMB within 60 days from the and extensions of OMB-approved date of this notice. To be sure we information collections. consider your comments, we must Percent Number of respondents Modality of completion Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) receive them no later than October 19, 2021. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Request for Waiver of Overpayment Recovery and Request for Change in Overpayment Recovery Rate—20 CFR 404.502, 404.506–404.512, 416.550– 416.558, 416.570–416.571—0960–0037. When Social Security beneficiaries and Supplemental Security Income (SSI) recipients receive an overpayment, they must return the extra money. These beneficiaries and recipients can use Form SSA–632–BK, Request for Waiver of Overpayment Recovery, to request a waiver from repaying their overpayment. Beneficiaries and recipients can also use Form SSA–634, Request for Change in Overpayment Recovery Rate, to request a change to the monthly recovery rate of their overpayment. The respondents must provide financial information to help the agency determine how much the overpaid person can afford to repay each month. The respondents are individuals who are overpaid Social Security or SSI payments who are requesting: (1) A waiver of recovery of an overpayment, or (2) a lesser rate of withholding. Type of Request: Revision of an OMBapproved information collection. Average wait time in field office or for teleservice centers (minutes)** Average theoretical hourly cost amount (dollars)* Total annual opportunity cost (dollars)*** SSA–632—Request for Waiver of Overpayment Recovery (If completing entire paper form, including the AFI authorization) ........................ SSA–634—Request for Change in Overpayment Recovery Rate (Completing paper form) ............................ 400,000 1 120 800,000 * $10.95 ** 21 *** $10,293,000 100,000 1 45 75,000 * 10.95 ** 21 *** 1,204,500 Totals ............................................. 500,000 ........................ ........................ 875,000 ........................ ........................ *** 11,497,500 khammond on DSKJM1Z7X2PROD with NOTICES * We based this figure on the average DI payments based on SSA’s current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf). ** 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. Statement of Claimant or Other Person—20 CFR 404.702 and 416.570— 0960–0045. SSA uses Form SSA–795, Statement of Claimant or Other Person, in special situations where there is no authorized form or questionnaire, yet we require a signed statement from the applicant, claimant, or other individuals who have knowledge of facts, in connection with claims for Social Security benefits or SSI. The VerDate Sep<11>2014 17:27 Aug 19, 2021 Jkt 253001 information we request on the SSA–795 is of sufficient importance that we need both a signed statement and a penalty clause. SSA uses this information to process, in addition to claims for benefits, issues about continuing eligibility; ongoing benefit amounts; use of funds by a representative payee; fraud investigation; and other program-related matters. The most common respondents are applicants for, or recipients of, PO 00000 Frm 00077 Fmt 4703 Sfmt 4703 Social Security or SSI. Respondents also include friends and relatives of the involved parties, coworkers, neighbors, or anyone else in a position to provide information pertinent to the issue(s). Type of Request: Revision of an OMBapproved information collection. E:\FR\FM\20AUN1.SGM 20AUN1 46898 Federal Register / Vol. 86, No. 159 / Friday, August 20, 2021 / Notices Number of respondents Modality of completion Average burden per response (minutes) Frequency of response Average theoretical hourly cost amount (dollars)* Estimated total annual burden (hours) Average wait time in field office (minutes)** Total Annual Opportunity Cost (dollars)*** SSA–795 (paper version) .............................. SSA–795 (Person Statement) electronic version ....................................................... 207,239 1 15 51,810 * $10.95 ** 24 *** $1,475,031 24,583 1 15 6,146 * 27.07 ........................ *** 166,372 Totals ..................................................... 231,822 ........................ ........................ 57,956 ........................ ........................ *** 1,641,403 * We based these figures on the average DI payments based on SSA’s current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf) and 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 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. 3. Claimant’s Medications—20 CFR 404.1512 and 416.912—0960–0289. In cases where claimants request a hearing after denial of their disability claim for Social Security, SSA uses Form HA– 4632, Claimant’s Medications, to request information from the claimant regarding the medications they use. This information helps the judge overseeing the case to fully investigate: (1) The claimant’s medical treatment and (2) the effects of the medications on the claimant’s medical impairments and functional capacity. The judge makes the completed form a part of the documentary evidence of record, placing it in the official record of the proceedings as an exhibit. The Number of respondents Modality of completion Average burden per response (minutes) Frequency of response respondents are applicants (or their representatives) for Old Age Survivors and Disability Insurance (OASDI) benefits or SSI payments who request a hearing to contest an agency denial of their claim. 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 (minutes)** Total Annual Opportunity Cost (dollars)*** HA–46321—PDF/paper version .................... Electronic Records Express Submissions .... 53,200 136,800 1 1 15 15 13,300 34,200 * $10.95 * 27.07 ** 24 ........................ *** $378,651 *** 925,794 Totals ..................................................... 190,000 ........................ ........................ 47,500 ........................ ........................ *** 1,304,445 * We based this figure on the average DI payments based on SSA’s current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf) and 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 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. 4. Disability Report-Adult—20 CFR 404.1512 and 416.912—0960–0579. State Disability Determination Services (DDS) use Form SSA–3368, Disabilty Report—Adult, and its electronic versions, to determine if adult disability applicants’ impairments are severe and, if so, how the impairments affect the applicants’ ability to work. This determination informs whether the DDSs and SSA will find the applicant to be disabled and entitled to SSI Number of respondents Modality of completion Average burden per response (minutes) Frequency of response payments. The respondents are applicants for Title II disability benefits or Title XVI SSI payments. 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 (minutes)** Total Annual Opportunity Cost (dollars)*** SSA–3368 (Paper) ........................................ EDCS 3368 (Intranet) ................................... i3368 (Internet) .............................................. 6,045 1,263,104 989,361 1 1 1 90 90 90 9,068 1,894,656 1,484,042 * $10.95 * 10.95 * 10.95 ** 21 ** 21 ........................ *** $122,465 *** 25,587,325 *** 16,250,260 Totals ..................................................... 2,258,510 ........................ ........................ 3,387,766 ........................ ........................ *** 41,960,050 khammond on DSKJM1Z7X2PROD with NOTICES * We based this figure on the average DI payments based on SSA’s current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf). ** 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. Request for internet Services and 800# Automated Telephone Services Knowledge-Based Authentication (RISA–KBA)—20 CFR 401.45—0960– 0596. The Request for internet Services and 800# Automated Telephone Services (RISA) Knowledge-Based VerDate Sep<11>2014 17:27 Aug 19, 2021 Jkt 253001 Authentication (KBA) is one of the authentication methods SSA uses to allow individuals access to their personal information through our internet and Automated Telephone Services. SSA asks individuals and third parties who seek personal PO 00000 Frm 00078 Fmt 4703 Sfmt 4703 information from SSA records, or who register to participate in SSA’s online business services, to provide certain identifying information. As an extra measure of protection, SSA asks requestors who use the internet and telephone services to provide additional E:\FR\FM\20AUN1.SGM 20AUN1 46899 Federal Register / Vol. 86, No. 159 / Friday, August 20, 2021 / Notices identifying information unique to those individuals so SSA can authenticate their identities before releasing personal information. The respondents are current beneficiaries who are requesting personal information from SSA, and individuals and third parties who are Number of respondents Modality of completion Frequency of response Average burden per response (minutes) registering for SSA’s online business services. Type of Request: Revision of an OMBapproved information collection. Average theoretical hourly cost amount (dollars) * Estimated total annual burden (hours) Total annual opportunity cost (dollars) ** Internet Requestors ................................. Telephone Requestors ............................. 2,921,795 1,157,833 1 1 3 4 146,090 77,189 * $27.07 * 27.07 ** $3,954,656 ** 2,089,506 Totals ................................................ 4,079,628 ........................ ........................ 223,279 ........................ ** 6,044,162 * 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). ** 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. Testimony by Employees and the Production of Records and Information in Legal Proceedings—20 CFR 403.100– 403.155—0960–0619. SSA’s regulations establish policies and procedures for an individual, organization, or government entity to request official agency information, records, or testimony of an interest to provide the testimony; and (4) provide the date, time, and place for the testimony. Respondents are individuals or entities who request testimony from SSA employees in connection with a legal proceeding. Type of Request: Extension of an OMB-approved information collection. agency employee in a legal proceeding when the agency is not a party. The request, which respondents submit in writing, must: (1) Fully set out the nature and relevance of the sought testimony; (2) explain why the information is not available by other means; (3) explain why it is in SSA’s 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) ** 20 CFR 403.100–403.155 ....................... 100 1 60 100 * $27.07 ** $2,707 * 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). ** 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. Certification of Prisoner Identity Information—20 CFR 422.107—0960– 0688. Inmates of Federal, State, or local prisons may need a Social Security card as verification of their Social Security number for school or work programs, or as proof of employment eligibility upon release from incarceration. Before SSA can issue a replacement Social Security card, applicants must show SSA proof Number of respondents Modality of completion Verification of Prisoner Identity Statements .. khammond on DSKJM1Z7X2PROD with NOTICES of their identity. People who are in prison for an extended period typically do not have current identity documents. Therefore, under written agreement with the correctional institution, SSA allows prison officials to verify the identity of certain incarcerated U.S. citizens who need replacement Social Security cards. Prison officials provide SSA information from the official prison I 1,000 Frequency of response I 200 Average burden per response (minutes) Number of responses I 200,000 files, sent on correctional facility letterhead. SSA uses this information to establish the applicant’s identity in the replacement Social Security card process. The respondents are prison officials who certify the identity of prisoners applying for replacement Social Security cards. Type of Request: Extension of an OMB-approved Information Collection I 3 Average theoretical hourly cost amount (dollars) * Estimated total annual burden (hours) I 10,000 I * $28.80 Total annual opportunity cost (dollars) ** I ** $288,000 * We based this figure on average Probation Officers and Correctional Treatment Specialists hourly salary, as reported by Bureau of Labor Statistics data (https:// www.bls.gov/oes/current/oes211092.htm). ** 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. II. SSA submitted the information collection below to OMB for clearance. Your comments regarding this information collection would be most useful if OMB and SSA receive them 30 VerDate Sep<11>2014 17:27 Aug 19, 2021 Jkt 253001 days from the date of this publication. To be sure we consider your comments, we must receive them no later than September 20, 2021. Individuals can obtain copies of this OMB clearance PO 00000 Frm 00079 Fmt 4703 Sfmt 4703 package by writing to OR.Reports.Clearance@ssa.gov. Authorization for the Social Security Administration to Obtain Account Records from a Financial Institution E:\FR\FM\20AUN1.SGM 20AUN1 46900 Federal Register / Vol. 86, No. 159 / Friday, August 20, 2021 / Notices and Request for Records (Medicare)—20 CFR 418.3420—0960–0729. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established the Medicare Part D program for voluntary prescription drug coverage of premium, deductible, and copayment costs for individuals with limited income and resources. The MMA mandates that the Government provide subsidies for those individuals who qualify for the program, and who meet eligibility criteria for help with premium, deductible, or co-payment costs. SSA uses the SSA–4640, Authorization for the Social Security Administration to Obtain Account Records from a Financial Institution and Request for Records (Medicare), to determine if subsidy applicants or recipients qualify, or continue to qualify, for the subsidy. Number of respondents Modality of completion Frequency of response Average burden per response (minutes) SSA uses Form SSA–4640 to: (1) Obtain the individual’s consent to verify balances of financial institution (FI) accounts; and (2) obtain verification of such balances from the FI. Respondents are Medicare Part D program subsidy applicants or claimants, and their financial institutions. 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) ** Medicare Part D Subsidy Applicants ....... Financial Institutions ................................ 5,000 5,000 1 1 1 4 83 333 * $10.95 * 37.56 ** $909 ** 12,507 Totals ................................................ 10,000 ........................ ........................ 416 ........................ ** 13,416 * We based these figures on the average DI payments based on SSA’s current FY 2021 data https://www.ssa.gov/legislation/ 2021FactSheet.pdf), and the average Business and Financial operations occupations, as reported by Bureau of Labor Statistics data (https:// www.bls.gov/oes/current/oes130000.htm). ** 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: August 17, 2021. Naomi Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2021–17857 Filed 8–19–21; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice: 11505] khammond on DSKJM1Z7X2PROD with NOTICES Ninth Summit of the Americas Leaders Meeting We are delighted to inform that U.S. cities are invited to present proposals to host the concluding week of high-level events and meetings of the Ninth Summit of the Americas (Summit) process to occur during summer 2022. Over the course of approximately two to five days, the United States Government will organize official and informal events, bilateral meetings, and media events that Chiefs of State and Heads of Government and senior officials of participating governments from the Western Hemisphere will attend. As many as 10,000 participants, including support staff, security, media, and businesspersons may attend. Global media attention will focus on the leaders’ meeting at the Summit. The President of the United States and up to 50 Chiefs of State, Heads of Government, and high-level participants from the governments of the Americas, regional and global international organizations, and other special guests are expected to attend. Each Summit VerDate Sep<11>2014 17:27 Aug 19, 2021 Jkt 253001 delegation will likely be comprised of Cabinet Ministers, Senior Advisors, Security Officers, and members of the Foreign Media. The Summit’s associated high-level stakeholder forums and events, which may include but are not limited to the CEO Summit of the Americas, Civil Society Forum, Young Americas Forum, and commercial exhibitions, will attract prominent business executives, local government and civil society leaders, and youth entrepreneurs from around the world. With this many high-profile visitors, security will be a major consideration for the selection of the city and conference venues. The following meetings could be held during the Summit week: (1) Concluding Summit Implementation Review Group (SIRG) National Summit Coordinators Plenipotentiaries Meeting—2–3 days, approximately 200 delegates; (2) SIRG Ministerial Meeting—1 day, approximately 300 delegates; (3) CEO Summit—3 days, approximately 1,000 to 5,000 attendees; (4) Civil Society Forum—2 days, approximately 1,000 to 1,200 attendees; (5) Young Americas Forum—2 days, approximately 500 to 700 attendees; (6) Summit inaugural ceremony and dinner—half day, restricted attendance 1,000 to 3,000 delegates at the ceremony, and approximately two groups of 100 to 300 attendees each at separate receptions/ dinners; (7) Summit Leaders Meeting— 1 to 2 days, restricted in-room attendance up to 300 delegates; approximately 10,000 delegates in other PO 00000 Frm 00080 Fmt 4703 Sfmt 4703 venues. Additional stakeholder forums, events and meetings may take place throughout the week as well. The minimum requirements are as follows: An international airport with frequent and consistent connections to and from countries in the Western Hemisphere (further information about the Summit of the Americas can be found at the website for the Ninth Summit of the Americas: www.IXSummitAmericas.org, or the Summits of the Americas Secretariat’s website: www.summitamericas.org); an identified Fixed Based Operator (FBO) for private aircraft arrivals/departures and adequate parking space for 30 private aircraft; approximately 20,000 hotel room nights of international standard including 100 suites for Heads of Government and cabinet-level Ministers; Conference facilities for multiple meetings; Political, business, and civic support; Local security capable of supporting delegates and VIPs. Preparation of Proposals Deadline is September 3, 2021. Proposals must be submitted by email as a single PDF from a verified state/ territory or municipal government email address to IX-SummitAmericas@ state.gov. Items supporting proposals, including additional attachments, videos, or professional video presentations of the city and/or convention space, should identify complete URLs in the PDF. Questions about the proposal and submission process can be directed to IXSummitAmericas@state.gov. Questions E:\FR\FM\20AUN1.SGM 20AUN1

Agencies

[Federal Register Volume 86, Number 159 (Friday, August 20, 2021)]
[Notices]
[Pages 46897-46900]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-17857]


=======================================================================
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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2021-0024]


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions and extensions 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-2021-0024].

(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-
2021-0024].
    I. The information collections below are pending at SSA. SSA will 
submit them to OMB within 60 days from the date of this notice. To be 
sure we consider your comments, we must receive them no later than 
October 19, 2021. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Request for Waiver of Overpayment Recovery and Request for 
Change in Overpayment Recovery Rate--20 CFR 404.502, 404.506-404.512, 
416.550-416.558, 416.570-416.571--0960-0037. When Social Security 
beneficiaries and Supplemental Security Income (SSI) recipients receive 
an overpayment, they must return the extra money. These beneficiaries 
and recipients can use Form SSA-632-BK, Request for Waiver of 
Overpayment Recovery, to request a waiver from repaying their 
overpayment. Beneficiaries and recipients can also use Form SSA-634, 
Request for Change in Overpayment Recovery Rate, to request a change to 
the monthly recovery rate of their overpayment. The respondents must 
provide financial information to help the agency determine how much the 
overpaid person can afford to repay each month. The respondents are 
individuals who are overpaid Social Security or SSI payments who are 
requesting: (1) A waiver of recovery of an overpayment, or (2) a lesser 
rate of withholding.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                       Average wait
                                                                                                          Average      time in field
                                         Number of     Frequency of   Average burden     Estimated      theoretical    office or for     Total annual
       Modality of completion           respondents      response      per response    total annual     hourly cost     teleservice    opportunity cost
                                                                         (minutes)    burden (hours)      amount          centers        (dollars)***
                                                                                                        (dollars)*      (minutes)**
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-632--Request for Waiver of               400,000               1             120         800,000        * $10.95           ** 21     *** $10,293,000
 Overpayment Recovery (If completing
 entire paper form, including the
 AFI authorization).................
SSA-634--Request for Change in               100,000               1              45          75,000         * 10.95           ** 21       *** 1,204,500
 Overpayment Recovery Rate
 (Completing paper form)............
                                     -------------------------------------------------------------------------------------------------------------------
    Totals..........................         500,000  ..............  ..............         875,000  ..............  ..............      *** 11,497,500
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf).
** 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. Statement of Claimant or Other Person--20 CFR 404.702 and 
416.570--0960-0045. SSA uses Form SSA-795, Statement of Claimant or 
Other Person, in special situations where there is no authorized form 
or questionnaire, yet we require a signed statement from the applicant, 
claimant, or other individuals who have knowledge of facts, in 
connection with claims for Social Security benefits or SSI. The 
information we request on the SSA-795 is of sufficient importance that 
we need both a signed statement and a penalty clause. SSA uses this 
information to process, in addition to claims for benefits, issues 
about continuing eligibility; ongoing benefit amounts; use of funds by 
a representative payee; fraud investigation; and other program-related 
matters. The most common respondents are applicants for, or recipients 
of, Social Security or SSI. Respondents also include friends and 
relatives of the involved parties, coworkers, neighbors, or anyone else 
in a position to provide information pertinent to the issue(s).
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 46898]]



--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                              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)*      (minutes)**    (dollars)***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-795 (paper version).................         207,239               1              15          51,810        * $10.95           ** 24  *** $1,475,031
SSA-795 (Person Statement) electronic             24,583               1              15           6,146         * 27.07  ..............     *** 166,372
 version................................
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         231,822  ..............  ..............          57,956  ..............  ..............   *** 1,641,403
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf) and 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 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.

    3. Claimant's Medications--20 CFR 404.1512 and 416.912--0960-0289. 
In cases where claimants request a hearing after denial of their 
disability claim for Social Security, SSA uses Form HA-4632, Claimant's 
Medications, to request information from the claimant regarding the 
medications they use. This information helps the judge overseeing the 
case to fully investigate: (1) The claimant's medical treatment and (2) 
the effects of the medications on the claimant's medical impairments 
and functional capacity. The judge makes the completed form a part of 
the documentary evidence of record, placing it in the official record 
of the proceedings as an exhibit. The respondents are applicants (or 
their representatives) for Old Age Survivors and Disability Insurance 
(OASDI) benefits or SSI payments who request a hearing to contest an 
agency denial of their claim.
    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)*      (minutes)**    (dollars)***
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-46321--PDF/paper version.............          53,200               1              15          13,300        * $10.95           ** 24    *** $378,651
Electronic Records Express Submissions..         136,800               1              15          34,200         * 27.07  ..............     *** 925,794
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         190,000  ..............  ..............          47,500  ..............  ..............   *** 1,304,445
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf) and 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 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.

    4. Disability Report-Adult--20 CFR 404.1512 and 416.912--0960-0579. 
State Disability Determination Services (DDS) use Form SSA-3368, 
Disabilty Report--Adult, and its electronic versions, to determine if 
adult disability applicants' impairments are severe and, if so, how the 
impairments affect the applicants' ability to work. This determination 
informs whether the DDSs and SSA will find the applicant to be disabled 
and entitled to SSI payments. The respondents are applicants for Title 
II disability benefits or Title XVI SSI payments.
    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)*      (minutes)**    (dollars)***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3368 (Paper)........................           6,045               1              90           9,068        * $10.95           ** 21    *** $122,465
EDCS 3368 (Intranet)....................       1,263,104               1              90       1,894,656         * 10.95           ** 21  *** 25,587,325
i3368 (Internet)........................         989,361               1              90       1,484,042         * 10.95  ..............  *** 16,250,260
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................       2,258,510  ..............  ..............       3,387,766  ..............  ..............  *** 41,960,050
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf).
** 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. Request for internet Services and 800# Automated Telephone 
Services Knowledge-Based Authentication (RISA-KBA)--20 CFR 401.45--
0960-0596. The Request for internet Services and 800# Automated 
Telephone Services (RISA) Knowledge-Based Authentication (KBA) is one 
of the authentication methods SSA uses to allow individuals access to 
their personal information through our internet and Automated Telephone 
Services. SSA asks individuals and third parties who seek personal 
information from SSA records, or who register to participate in SSA's 
online business services, to provide certain identifying information. 
As an extra measure of protection, SSA asks requestors who use the 
internet and telephone services to provide additional

[[Page 46899]]

identifying information unique to those individuals so SSA can 
authenticate their identities before releasing personal information. 
The respondents are current beneficiaries who are requesting personal 
information from SSA, and individuals and third parties who are 
registering for SSA's online business services.
    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) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Internet Requestors.....................................       2,921,795               1               3         146,090        * $27.07   ** $3,954,656
Telephone Requestors....................................       1,157,833               1               4          77,189         * 27.07    ** 2,089,506
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................       4,079,628  ..............  ..............         223,279  ..............    ** 6,044,162
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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).
** 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. Testimony by Employees and the Production of Records and 
Information in Legal Proceedings--20 CFR 403.100-403.155--0960-0619. 
SSA's regulations establish policies and procedures for an individual, 
organization, or government entity to request official agency 
information, records, or testimony of an agency employee in a legal 
proceeding when the agency is not a party. The request, which 
respondents submit in writing, must: (1) Fully set out the nature and 
relevance of the sought testimony; (2) explain why the information is 
not available by other means; (3) explain why it is in SSA's interest 
to provide the testimony; and (4) provide the date, time, and place for 
the testimony. Respondents are individuals or entities who request 
testimony from SSA employees in connection with a legal proceeding.
    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) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
20 CFR 403.100-403.155............................             100                1               60              100         * $27.07        ** $2,707
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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).
** 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. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. Inmates of Federal, State, or local prisons may need a 
Social Security card as verification of their Social Security number 
for school or work programs, or as proof of employment eligibility upon 
release from incarceration. Before SSA can issue a replacement Social 
Security card, applicants must show SSA proof of their identity. People 
who are in prison for an extended period typically do not have current 
identity documents. Therefore, under written agreement with the 
correctional institution, SSA allows prison officials to verify the 
identity of certain incarcerated U.S. citizens who need replacement 
Social Security cards. Prison officials provide SSA information from 
the official prison files, sent on correctional facility letterhead. 
SSA uses this information to establish the applicant's identity in the 
replacement Social Security card process. The respondents are prison 
officials who certify the identity of prisoners applying for 
replacement Social Security cards.
    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      Number of       per response    annual burden     hourly cost      opportunity
                                     respondents        response        responses        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Verification of Prisoner Identity           1,000              200          200,000                3           10,000         * $28.80      ** $288,000
 Statements......................
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average Probation Officers and Correctional Treatment Specialists hourly salary, as reported by Bureau of Labor Statistics
  data (https://www.bls.gov/oes/current/oes211092.htm).
** 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.

    II. SSA submitted the information collection below to OMB for 
clearance. Your comments regarding this information collection would be 
most useful if OMB and SSA receive them 30 days from the date of this 
publication. To be sure we consider your comments, we must receive them 
no later than September 20, 2021. Individuals can obtain copies of this 
OMB clearance package by writing to [email protected].
    Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution

[[Page 46900]]

and Request for Records (Medicare)--20 CFR 418.3420--0960-0729. The 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(MMA) established the Medicare Part D program for voluntary 
prescription drug coverage of premium, deductible, and copayment costs 
for individuals with limited income and resources. The MMA mandates 
that the Government provide subsidies for those individuals who qualify 
for the program, and who meet eligibility criteria for help with 
premium, deductible, or co-payment costs. SSA uses the SSA-4640, 
Authorization for the Social Security Administration to Obtain Account 
Records from a Financial Institution and Request for Records 
(Medicare), to determine if subsidy applicants or recipients qualify, 
or continue to qualify, for the subsidy. SSA uses Form SSA-4640 to: (1) 
Obtain the individual's consent to verify balances of financial 
institution (FI) accounts; and (2) obtain verification of such balances 
from the FI. Respondents are Medicare Part D program subsidy applicants 
or claimants, and their financial institutions.
    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) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Medicare Part D Subsidy Applicants......................           5,000               1               1              83        * $10.95         ** $909
Financial Institutions..................................           5,000               1               4             333         * 37.56       ** 12,507
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................          10,000  ..............  ..............             416  ..............       ** 13,416
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on the average DI payments based on SSA's current FY 2021 data https://www.ssa.gov/legislation/2021FactSheet.pdf), and the
  average Business and Financial operations occupations, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes130000.htm).
** 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: August 17, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-17857 Filed 8-19-21; 8:45 am]
BILLING CODE 4191-02-P


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