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