Agency Information Collection Activities: Comment Request, 59262-59265 [2021-23273]
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Federal Register / Vol. 86, No. 204 / Tuesday, October 26, 2021 / Notices
dated 09/05/2021, is hereby amended to
include the following areas as adversely
affected by the disaster:
Primary Counties (Physical Damage and
Economic Injury Loans): Dutchess.
Contiguous Counties (Economic Injury
Loans Only):
New York: Columbia, Ulster.
Connecticut: Litchfield.
Massachusetts: Berkshire.
All other information in the original
declaration remains unchanged.
(Catalog of Federal Domestic Assistance
Number 59008)
James Rivera,
Associate Administrator for Disaster
Assistance.
[FR Doc. 2021–23305 Filed 10–25–21; 8:45 am]
BILLING CODE 8026–03–P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2021–0044]
Agency Information Collection
Activities: 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 one extension of OMB-approved
information collections.
SSA is soliciting comments on the
accuracy of the agency’s burden
estimate; the need for the information;
its practical utility; ways to enhance its
quality, utility, and clarity; and ways to
minimize burden on respondents,
including the use of automated
collection techniques or other forms of
information technology. Mail, email, or
fax your comments and
recommendations on the information
collection(s) to the OMB Desk Officer
and SSA Reports Clearance Officer at
the following addresses or fax numbers.
(OMB) Office of Management and
Budget, Attn: Desk Officer for SSA.
Comments: https://www.reginfo.gov/
public/do/PRAMain. Submit your
comments online referencing Docket
ID Number [SSA–2021–0044].
(SSA) Social Security Administration,
OLCA, Attn: Reports Clearance
Director, 3100 West High Rise, 6401
Security Blvd., Baltimore, MD 21235,
Fax: 410–966–2830, Email address:
OR.Reports.Clearance@ssa.gov. Or
you may submit your comments
online through https://
www.reginfo.gov/public/do/PRAMain,
referencing Docket ID Number [SSA–
2021–0044].
SSA submitted the information
collections below to OMB for clearance.
Your comments regarding these
information collections would be most
useful if OMB and SSA receive them 30
days from the date of this publication.
Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
Estimated total
annual burden
(hours)
To be sure we consider your comments,
we must receive them no later than
November 26, 2021. Individuals can
obtain copies of these OMB clearance
packages by writing to
OR.Reports.Clearance@ssa.gov.
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, 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
theoretical
hourly cost
amount
(dollars) *
Average
wait time in
field office
or for
teleservice
centers
(minutes) **
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
* 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 & 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
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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 a myriad of other
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program-related matters. The most
common respondents are applicants for
Social Security, SSI, or recipients of
these programs. However, 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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Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
Estimated total
annual burden
(hours)
Average
theoretical
hourly cost
amount
(dollars) *
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 time 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 Medication—20 CFR
404.1512, 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.
Estimated total
annual burden
(hours)
Average
theoretical
hourly cost
amount
(dollars) *
Average
wait time in
field office
(minutes) **
Total annual
opportunity
cost
(dollars) ***
HA–4632 (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 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.
4. Disability Report—Adult—20 CFR
404.1512 and 416.912—0960–0579.
State Disability Determination Services
(DDS) use the SSA–3368, Disability
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 dictates 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.
Estimated total
annual burden
(hours)
Average
theoretical
hourly cost
amount
(dollars) *
Average
wait time in
field office or
for teleservice
centers
(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
* 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
VerDate Sep<11>2014
22:39 Oct 25, 2021
Jkt 256001
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
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Sfmt 4703
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
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measure of protection, SSA asks
requestors who use the Internet and
Automated Telephone Services to
provide additional 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
Number of
respondents
Modality of completion
individuals and third parties who are
registering for SSA’s online business
services.
Type of Request: Revision of an OMBapproved information collection.
Average
burden
per
response
(minutes)
Frequency of
response
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
........................
........................
198,930
........................
** 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#000000).
** 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. Regulations at 20
CFR 403.100–403.155 of the Code of
Federal Regulations establish SSA’s
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 to SSA, 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
Number of
respondents
Modality of completion
20 CFR 403.100–403.155 .........................................................
I
100
Average
burden per
response
(minutes)
Frequency of
response
I
I
1
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.
I
60
Average
theoretical
hourly cost
amount
(dollars) *
Estimated total
annual burden
(hours)
I
100
* $27.07
Total annual
opportunity
cost
(dollars) **
I
** $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#000000).
** 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. Function Report—Adult-Third
Party—20 CFR 404.1512 & 416.912—
0960–0635. Individuals receiving or
applying for Social Security Disability
Insurance (SSDI) or SSI provide SSA
with medical evidence and other proof
SSA requires to prove their disability.
SSA, and DDS on our behalf, collect this
information using Form SSA–3380–BK,
Function Report—Adult-Third Party.
We use the information to document
how claimant’s disabilities affect their
ability to function, and to determine
eligibility for SSI and SSDI claims. The
Number of
respondents
Modality of completion
SSA–3380–BK ..............................................................
I
709,700
Average
burden per
response
(minutes)
Frequency
of response
I
1
I
61
respondents are third parties familiar
with the functional limitations (or lack
thereof) of claimants who apply for SSI
and SSDI benefits.
Type of Request: Revision of an OMB
approved information collection.
Estimated
annual burden
(hours)
I
721,528
Average
theoretical
hourly cost
amount
(dollar) *
Total annual
opportunity
cost
(dollars) **
* $27.07
** $19,531,763
I
* 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#000000).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the
application.
8. 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
VerDate Sep<11>2014
22:39 Oct 25, 2021
Jkt 256001
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
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Fmt 4703
Sfmt 4703
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
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prisoners applying for replacement
Social Security cards.
Type of Request: Extension of an
OMB-approved Information Collection.
Number of
respondents
Modality of completion
Verification of Prisoner Identity Statements ..
I
1,000
Frequency of
response
I
200
Average
burden per
response
(minutes)
Number of
responses
I
200,000
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.
Dated: October 21, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security
Administration.
—Pollution prevention and response
—Reports of other sub-committees
—Work programme of the Committee
and subsidiary bodies
—Application of the Committee’s
method of work
—Any other business
—Consideration of the report of the
Committee
[FR Doc. 2021–23273 Filed 10–25–21; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice: 11570]
Notice of Shipping Coordinating
Committee Meeting in Preparation for
International Maritime Organization
MEPC 77 Meeting
The Department of State will conduct
a public meeting of the Shipping
Coordinating Committee at 10:00 a.m.
on Wednesday, November 17, 2021, by
way of teleconference. Members of the
public may participate up to the
capacity of the teleconference phone
line, which can handle 500 participants.
To RSVP, participants should contact
the meeting coordinator, LCDR Jessica
Anderson, by email at
jessica.p.anderson@uscg.mil. To access
the teleconference line participants
should call (202) 475–4000 and use
Participant Code: 138 541 34#.
The primary purpose of the meeting is
to prepare for the seventy seventh
session of the International Maritime
Organization’s (IMO) Marine
Environment Protection Committee to
be held virtually from Monday,
November 22, 2021 to Friday, November
26, 2021. The agenda items to be
considered at the advisory committee
meeting mirror those to be considered at
MEPC 77, and include:
—Adoption of the agenda
—Decisions of other bodies
—Identification and protection of
Special Areas, ECAs and PSSAs
—Harmful aquatic organisms in ballast
water
—Air pollution prevention
—Energy efficiency of ships
—Reduction of GHG emissions from
ships
—Follow-up work emanating from the
Action Plan to address marine plastic
litter from ships
VerDate Sep<11>2014
22:39 Oct 25, 2021
Jkt 256001
Please note: the IMO may, on short
notice, adjust the MEPC 77 agenda to
accommodate the constraints associated
with the virtual meeting format. Any
changes to the agenda will be reported
to those who RSVP and those in
attendance at the meeting.
Those who plan to participate may
contact the meeting coordinator, LCDR
Jessica Anderson, by email at
Jessica.P.Anderson@uscg.mil, or in
writing at 2703 Martin Luther King Jr.
Ave. SE, Stop 7509, Washington, DC
20593–7509. Members of the public
needing reasonable accommodation
should advise LCDR Jessica Anderson
not later than November 15, 2021.
Requests made after that date will be
considered, but might not be possible to
fulfill.
Additional information regarding this
and other IMO public meetings may be
found at: https://www.dco.uscg.mil/
IMO.
(Authority: 22 U.S.C. 2656 and 5 U.S.C. 552)
Emily A. Rose,
Executive Secretary, Shipping Coordinating
Committee, Office of Ocean and Polar Affairs,
Department of State.
[FR Doc. 2021–23290 Filed 10–25–21; 8:45 am]
BILLING CODE 4710–09–P
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DEPARTMENT OF TRANSPORTATION
Federal Aviation Administration
[Docket No. FAA–2021–0984]
Agency Information Collection
Activities: Requests for Comments;
Clearance of Renewed Approval of
Information Collection: Application for
Pilot School Certification
Federal Aviation
Administration (FAA), DOT.
ACTION: Notice and request for
comments.
AGENCY:
In accordance with the
Paperwork Reduction Act of 1995, FAA
invites public comments about our
intention to request Office of
Management and Budget (OMB)
approval to renew an information
collection. The collection involves
filling out the Application for a Pilot
School Certification form and
submitting this form to the Federal
Aviation Administration (FAA). The
information to be collected is necessary
because an applicant for a pilot school
must receive the FAA Administrator’s
approval for the issuance of a pilot
school certificate. We have revised the
name of this information collection for
consistency with FAA form 8420–8,
Application for Pilot School
Certification. We have also updated the
number of pilot schools
DATES: Written comments should be
submitted by December 27, 2021.
ADDRESSES: Please send written
comments to:
By Electronic Docket:
www.regulations.gov (Enter docket
number into search field).
By Mail: Jean M. Hardy, General
Aviation and Commercial Division,
Training and Certification Group, AFS
810, Portland Flight Standards District
Office, 82 Running Hill Road, Suite 300,
South Portland, Maine 04106.
FOR FURTHER INFORMATION CONTACT: Jean
M. Hardy, by email at Jean.Hardy@
faa.gov; phone: 207–289–7287.
SUPPLEMENTARY INFORMATION:
SUMMARY:
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]]>Agencies
[Federal Register Volume 86, Number 204 (Tuesday, October 26, 2021)]
[Notices]
[Pages 59262-59265]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-23273]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2021-0044]
Agency Information Collection Activities: 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 one extension of OMB-approved information
collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and ways to minimize burden
on respondents, including the use of automated collection techniques or
other forms of information technology. Mail, email, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer at the following
addresses or fax numbers.
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA.
Comments: https://www.reginfo.gov/public/do/PRAMain. Submit your
comments online referencing Docket ID Number [SSA-2021-0044].
(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-2021-0044].
SSA submitted the information collections below to OMB for
clearance. Your comments regarding these information collections would
be most useful if OMB and SSA receive them 30 days from the date of
this publication. To be sure we consider your comments, we must receive
them no later than November 26, 2021. Individuals can obtain copies of
these OMB clearance packages by writing to
[email protected].
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, 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 &
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 a myriad of other
program-related matters. The most common respondents are applicants for
Social Security, SSI, or recipients of these programs. However,
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 59263]]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated theoretical Average wait Total annual
Modality of completion Number of Frequency of per response total annual hourly cost time in field opportunity
respondents response (minutes) burden (hours) amount office cost (dollars)
(dollars) * (minutes) ** ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
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 time 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 Medication--20 CFR 404.1512, 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)
(dollars) * (minutes) ** ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-4632 (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 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.
4. Disability Report--Adult--20 CFR 404.1512 and 416.912--0960-
0579. State Disability Determination Services (DDS) use the SSA-3368,
Disability 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
dictates 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 wait
Average Average time in field Total annual
Number of Frequency of burden per Estimated theoretical office or for opportunity
Modality of completion respondents response response total annual hourly cost teleservice cost
(minutes) burden (hours) amount centers (dollars) ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
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
[[Page 59264]]
measure of protection, SSA asks requestors who use the Internet and
Automated Telephone Services to provide additional 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 Estimated theoretical Total annual
Modality of completion Number of Frequency of burden per total annual hourly cost opportunity
respondents response response burden (hours) amount cost (dollars)
(minutes) (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 .............. .............. 198,930 .............. ** 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.
Regulations at 20 CFR 403.100-403.155 of the Code of Federal
Regulations establish SSA's 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 to SSA, 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. Function Report--Adult-Third Party--20 CFR 404.1512 & 416.912--
0960-0635. Individuals receiving or applying for Social Security
Disability Insurance (SSDI) or SSI provide SSA with medical evidence
and other proof SSA requires to prove their disability. SSA, and DDS on
our behalf, collect this information using Form SSA-3380-BK, Function
Report--Adult-Third Party. We use the information to document how
claimant's disabilities affect their ability to function, and to
determine eligibility for SSI and SSDI claims. The respondents are
third parties familiar with the functional limitations (or lack
thereof) of claimants who apply for SSI and SSDI benefits.
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 annual burden hourly cost opportunity cost
respondents response (minutes) (hours) amount (dollar) (dollars) **
*
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3380-BK................................. 709,700 1 61 721,528 * $27.07 ** $19,531,763
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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.
8. 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
[[Page 59265]]
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.
Dated: October 21, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-23273 Filed 10-25-21; 8:45 am]
BILLING CODE 4191-02-P
