[Federal Register Volume 76, Number 185 (Friday, September 23, 2011)]
[Notices]
[Pages 59180-59182]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-24437]
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SOCIAL SECURITY ADMINISTRATION
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 (Pub. L.)
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995.
This notice includes extensions and revisions of OMB-approved
information collections, and an information collection in use without
an OMB number.
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, Fax:
202-395-6974, E-mail address: [email protected].
(SSA)
Social Security Administration, DCBFM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235,
E-mail address: [email protected].
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
November 22, 2011. Individuals can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
8783 or by writing to the above email address.
1. Incoming and Outgoing Intergovernmental Personnel Act Assignment
Agreement--5 CFR 334--0960-NEW. The Intergovernmental Personnel Act
(IPA) mobility program provides for the temporary assignment of
civilian personnel between the Federal Government and state and local
governments, colleges and universities, Indian tribal governments,
federally funded research and development centers, and other eligible
organizations. The Office of Personnel Management (OPM) created a
generic form, the OF-69, for agencies to use as a template when
collecting information for the IPA assignment. The OF-69 collects
specific information about the agreement including the name, social
security number, job title, salary, classification, and address of the
employee enrolled in the program, as well as the type of assignment,
reimbursement arrangement, and explanation as to how the assignment
will benefit both SSA and the non-federal organization involved in the
exchange.
OPM directs agencies to use their own forms for recording these
agreements. Therefore, SSA modified the OF-69 to meet our needs,
creating the SSA-187 for incoming employees, and the SSA-188 for
outgoing employees. Respondents are the individuals we describe above
who participate in the IPA exchange with SSA.
Type of Request: Existing collection in use without an OMB number.
[[Page 59181]]
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Average burden Estimated total
Respondent type Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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Non-federal employee, SSA-187........... 10 1 30 5
Non-federal employer signers, both SSA- 20 1 5 2
187 & SSA-188..........................
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Totals.............................. 30 ................ ................ 7
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2. Coverage of Employees of State and Local Governments--20 CFR
404, Subpart M--0960-0425. The Code of Federal Regulations at 20 CFR
part 404, Subpart M, prescribes the rules for states submitting reports
of deposits and recordkeeping to SSA. States (and interstate
instrumentalities) are required to provide wage and deposit
contribution information for pre-1987 periods. Not all the states have
completely satisfied their pending wage report and contribution
liability with SSA for pre-1987 tax years. These regulations are needed
until all pending items with all states are closed out, and to provide
for collection of this information in the future, if necessary. The
respondents are state and local governments or interstate
instrumentalities.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Regulation section Number of Frequency of per response annual burden
respondents response (hours) (hours)
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404. 1204 (a) & (b)..................... 52 1 0.5 26
404.1215................................ 52 1 1 52
404. 1216 (a) & (b)..................... 52 1 1 52
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Total............................... 156 ................ ................ 130
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3. Medical Report on Adult with Allegation of Human
Immunodeficiency Virus Infection; Medical Report on Child with
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.993-
416.994--0960-0500. SSA or state agencies (Disability Determination
Services) use Forms SSA-4814-F5 and SSA-4815-F6 to collect information
necessary to determine if an individual with the human immunodeficiency
virus infection, who is applying for Supplemental Security Income
(SSI), meets the requirements for presumptive disability payments. The
respondents are the medical sources of the applicants for SSI
disability payments.
Type of Request: Revision of an OMB-approved information
collection.
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Estimated total
Form Number of Frequency of Response time annual burden
respondents response (minutes) (hours)
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SSA-4814-F5............................. 46,200 1 10 7,700
SSA-4815-F6............................. 12,900 1 10 2,150
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Totals.............................. 59,100 ................ ................ 9,850
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4. Public Information Campaign--0960-0544. Periodically, SSA sends
various public information materials, including public service
announcements, news releases, and educational tapes, to public
broadcasting systems so they can inform the public about the various
programs and activities SSA conducts. SSA frequently sends follow-up
business reply cards for these public information materials to obtain
suggestions for improving them. The respondents are broadcast
television sources.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 1,000.
Frequency of Response: 2.
Average Burden per Response: 1 minute.
Estimated Total Annual Burden: 33 hours.
5. Redetermination of Eligibility for Help with Medicare
Prescription Drug Plan Costs--0960-0723. As per the requirements of the
Medicare Modernization Act of 2003 (Pub. L. 108-173), SSA conducts low-
income subsidy eligibility redeterminations for Medicare beneficiaries
who currently receive the Medicare Part D subsidy and who meet certain
criteria. Respondents complete Form SSA-1026-REDE under the following
circumstances: (1) When individuals became entitled to the Medicare
Part D subsidy during the past 12 months; (2) if they were eligible for
the Part D subsidy for more than 12 months; or (3) if they reported a
change in income, resources, or household size. Part D beneficiaries
complete the SSA-1026-SCE when they need to report a potentially
subsidy-changing event, including the following: (1) Marriage, (2)
spousal separation, (3) divorce, (4) annulment of a marriage, (5)
spousal death, or (6) moving back in with one's spouse following a
separation. The respondents are current recipients of the Medicare Part
D low-income subsidy who will undergo an eligibility redetermination
for one of the reasons mentioned above.
Type of Request: Extension of an OMB-approved information
collection.
[[Page 59182]]
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Average burden Estimated total
Form Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-1026-OCR-MS-SCE..................... 11,400 1 18 3,420
SSA-1026-OCR-SM-REDE.................... 225,000 1 18 67,500
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Total............................... 236,400 ................ ................ 70,920
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II. SSA submitted the information collection below to OMB for
clearance. Your comments regarding the information collection would be
most useful if OMB and SSA receive them within 30 days from the date of
this publication. To be sure we consider your comments, we must receive
them no later than October 24, 2011. Individuals can obtain copies of
the OMB clearance package by calling the SSA Reports Clearance Officer
at 410-965-8783 or by writing to the above e-mail address.
Statement of Claimant or Other Person--Medical Resident FICA Refund
Claims--20 CFR 404.702 and 416.570--0960-0786. The Internal Revenue
Service (IRS) is contacting medical residents (and their employers) who
filed Federal Insurance Contributions Act (FICA) refund claims from
1993 through 2005. Those medical residents who claimed their
residencies were actually training, not employment, should not have
been subject to FICA tax. The IRS made a decision to honor these claims
and issue a full refund of FICA tax, plus statutory interest, to those
who wish to participate in the refund resolution. SSA will remove wages
from the participating residents' earnings records for the period of
the refund requests, which will cause the residents' recorded earnings
to decrease. This not only affects earnings for future retirement
benefits, but also could adversely affect those residents (or their
beneficiaries) who are currently receiving Social Security benefits.
To ensure they understand the potential impact on their benefits,
SSA will call those residents who will be adversely affected and
explain the effect on their Social Security benefits if they accept the
IRS FICA refund. If SSA cannot reach the resident by phone, we will
send a contact letter and the SSA-795-OP2 to the resident to complete
and return to SSA to document the decision. Once we have the
information, we will forward the signed forms to the IRS for the
residents who no longer want the FICA refund.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 496.
Frequency of Response: 1.
Average Burden per Response: 4 minutes.
Estimated Total Annual Burden: 33 hours.
Dated: September 20, 2011.
Faye Lipsky,
Reports Clearance Officer, Center for Reports Clearance, Social
Security Administration.
[FR Doc. 2011-24437 Filed 9-22-11; 8:45 am]
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