[Federal Register Volume 77, Number 53 (Monday, March 19, 2012)]
[Notices]
[Pages 16113-16115]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-6499]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
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 information collections 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, Email address: [email protected].
(SSA), Social Security Administration, DCRDP, Attn: Reports Clearance
Officer, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD
21235, Fax: 410-965-6400, Email address: [email protected].
SSA submitted the information collections below to OMB for
clearance. Your comments regarding the information collections 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 April 18, 2012. Individuals can obtain copies of the
OMB clearance packages by calling the SSA Reports Clearance Officer at
410-965-8783 or by writing to the above email address.
1. Notice to Show Cause for Failure to Appear--20 CFR 404.938,
416.1438, 404.957(a)(ii)-0960-NEW. When claimants who requested a
hearing before an administrative law judge (ALJ) fail to appear at
their scheduled hearing, the ALJ may reschedule the hearing if the
claimants establish good cause for missing the hearings. The claimants
can provide a reason for not appearing at their scheduled hearings
using Form HA-L90. If the ALJ determines the claimants established good
cause for failure to appear at the hearing, the ALJ will schedule a
supplemental hearing; if not, the ALJ makes a claims eligibility
determination based on the claimants' evidence of record. Respondents
are claimants seeking to show cause for failure to appear at a
scheduled hearing before an ALJ.
Type of Request: Existing collection in use without an OMB number.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Collection instrument responses response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
HA-L90 PDF/Paper................................ 7,000 1 10 1,167
Electronic Records Express...................... 28,000 1 10 4,667
---------------------------------------------------------------
Total....................................... 35,000 .............. .............. 5,834
----------------------------------------------------------------------------------------------------------------
2. Request for Documents or Information--20 CFR 404.703-0960-NEW.
SSA asks individuals applying for Social Security benefits for
additional information when the information they provided is incomplete
or insufficient for us to determine their eligibility for benefits. SSA
uses the SSA-2118-U2, Request for Documents or Information, to request
the additional documents or information we need to process individuals'
claims for benefits. Respondents are claimants for title II Social
Security Old Age, Survivors, and Disability Insurance benefits.
Type of Request: Existing collection in use without an OMB number.
[[Page 16114]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Collection instrument Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2118-U2................................. 7,500 1 5 625
----------------------------------------------------------------------------------------------------------------
3. Statement of Living Arrangements, In-Kind Support and
Maintenance--20 CFR 416.1130-416.1148--0960-0174. SSA determines
Supplemental Security Income (SSI) payment amounts based on applicants'
and recipients' needs. We measure individuals' needs, in part, by the
amount of income they receive, including in-kind support and
maintenance in the form of food and shelter provided by other persons.
SSA uses information from Form SSA-8006-F4 to determine if in-kind
support and maintenance exists for SSI applicants and recipients. This
information also assists SSA in determining the income value of in-kind
support and maintenance SSI applicants and recipients receive. The
respondents are individuals who apply for SSI payments, or who complete
an SSI eligibility redeterminination.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Collection instrument Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8006-F4................................. 173,380 1 7 20,228
----------------------------------------------------------------------------------------------------------------
4. Statement of Funds You Provided to Another and Statement of
Funds You Received--20 CFR 416.1103(f)--0960-0481. SSA uses Forms SSA-
2854 and SSA-2855 to gather information to verify if a loan is bona
fide for SSI recipients. The SSA-2854 asks the lender for details on
the transaction, and Form SSA-2855 asks the borrower the same basic
questions independently. Agency personnel then compare the two
statements, gather evidence if needed, and make a decision on the
validity of the bona fide status of the loan.
For SSI purposes, we consider a loan bona fide if it meets these
requirements:
Must be between a borrower and lender with the
understanding that the borrower has an obligation to repay the money;
Must be in effect at the time the cash goes to the
borrower, that is, the agreement cannot come after the cash is paid;
and
Must be enforceable under State law; often there are
additional requirements from the State.
SSA collects this information at the time of initial application
for SSI or at any point when an individual alleges being party to an
informal loan while receiving SSI. SSA collects information on the
informal loan through both interviews and mailed forms. The agency's
field personnel conduct the interviews and mail the form(s) for
completion, as needed. The respondents are SSI recipients and
applicants, and individuals who lend money to them.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Form respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2854........................................ 20,000 1 10 3,333
SSA-2855........................................ 20,000 1 10 3,333
---------------------------------------------------------------
Totals...................................... 40,000 .............. .............. 6,666
----------------------------------------------------------------------------------------------------------------
5. Certification of Low Birth Weight for SSI Eligibility of Funds
You Provided to Another and Statement of Funds You Received--20 CFR
416.931, 416.926a(m), and 416.924--0960-0720. Hospitals and claimants
use Form SSA-3380 to provide medical information to local field offices
(FO) and the Disability Determination Services (DDS) on behalf of
infants with low birth weight. FOs use the form as a protective filing
statement and the medical information to make presumptive disability
findings, which allow expedited payment to eligible claimants. DDSs use
the medical information to determine disability and continuing
disability. The respondents are hospitals and claimants who have
information identifying low birth weight babies and their medical
conditions.
This is a correction notice. SSA published this information
collection as an extension on January 3, 2012 at 77 FR 147. Since we
are revising the Privacy Act Statement, this is actually a revision of
an OMB-approved information collection.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Collection instrument Number of Frequency of of response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3380.................................... 24,000 1 15 6,000
----------------------------------------------------------------------------------------------------------------
[[Page 16115]]
Dated: March 14, 2012.
Faye Lipsky,
Reports Clearance Director, Office of Regulations and Reports
Clearance, Social Security Administration.
[FR Doc. 2012-6499 Filed 3-16-12; 8:45 am]
BILLING CODE 4191-02-P