[Federal Register Volume 77, Number 247 (Wednesday, December 26, 2012)]
[Notices]
[Pages 76160-76163]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-30949]
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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 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions to and an extension of OMB-approved information
collections.
SSA is soliciting comments on the accuracy of the agency's burden
[[Page 76161]]
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
Director, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD
21235, Fax: 410-966-2830, Email 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
February 22, 2013. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application for Benefits Under the Italy-U.S. International
Social Security Agreement--20 CFR 404.1925--0960-0445. As per the
November 1, 1978 agreement between the United States and Italian Social
Security agencies, residents of Italy filing an application for U.S.
Social Security benefits directly with one of the Italian Social
Security agencies must complete Form SSA-2528. SSA uses the SSA-2528 to
establish age, relationship, citizenship, marriage, death, military
service, or to evaluate a family bible or other family record when
determining eligibility for benefits. The Italian Social Security
agencies assist applicants in completing Form SSA-2528, and then
forward the application to SSA for processing. The respondents are
individuals living in Italy who wish to file for U.S. Social Security
benefits.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
responses response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2528.................................... 300 1 20 100
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2. Internet Direct Deposit Application--31 CFR 210--0960-0634. SSA
requires all applicants and recipients of Social Security Old Age,
Survivors, and Disability Insurance (OASDI) benefits, or Supplemental
Security Income (SSI) payments to receive these benefits and payments
via direct deposit at a financial institution. SSA receives Direct
Deposit/Electronic Funds Transfer (DD/EFT) enrollment information from
OASDI beneficiaries and SSI recipients to facilitate DD/EFT of their
funds with their chosen financial institution. We also use this
information when an enrolled individual wishes to change their DD/EFT
information. For the convenience of the respondents, we collect this
information through several modalities, including an Internet
application, in-office or telephone interviews, and our automated
telephone system. In addition to using the direct deposit information
to enable DD/EFT of funds to the recipients' chosen financial
institution, we also use the information through our Direct Deposit
Fraud Indicator to ensure the correct recipient receives the funds.
Respondents are OASDI beneficiaries and SSI recipients requesting that
we enroll them in the Direct Deposit program or change their direct
deposit banking information.
Type of Request: Extension of an OMB-approved information
collection.
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Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Internet DD..................................... 188,129 1 10 31,355
Non-Electronic Services (FO, 800-ePath, 6,455,815 1 12 1,291,163
MSSICS,SPS,MACADE,POS,RP)......................
Automated 800 Response System.......... 237,065 1 8 31,609
Direct Deposit Fraud Indicator.................. 10,000 1 2 333
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Totals...................................... 6,891,009 .............. .............. 1,354,460
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3. Certification of Contents of Document(s) or Record(s)--20 CFR
404.715--0960-0689. SSA established procedures for individuals to
provide the evidence necessary to establish their rights to Social
Security benefits. Examples of such evidence categories include age,
relationship, citizenship, marriage, death, and military service. Form
SSA-704 allows SSA employees, State record custodians, and other
custodians of evidentiary documents to certify and record information
from original documents and records under their custodial ownership to
establish these types of evidence. SSA uses Form SSA-704 in situations
where individuals cannot produce the original evidentiary documentation
required to establish benefits eligibility. The respondents are State
record custodians and other custodians of evidentiary documents.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 76162]]
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
responses response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-704..................................... 4,800 1 10 800
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II. 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 30 days from the date of this
publication. To be sure we consider your comments, we must receive them
no later than January 23, 2013. Individuals can obtain copies of the
OMB clearance packages by writing to [email protected].
1. Certificate of Support--20 CFR 404.370, 404.750, 404.408a--0960-
0001. A parent of a deceased, fully insured worker may be entitled to
Social Security OASDI benefits based on the earnings record of the
deceased worker under certain conditions. One of the conditions is the
parent must have received at least one-half support from the deceased
worker. The one-half support requirement also applies to a spousal
applicant in determining whether OASDI benefits are subject to
Government Pension Offset (GPO). SSA uses the information from Form
SSA-760-F4 to determine if the parent of a deceased worker or a spouse
applicant meets the one-half support requirement. Respondents are (1)
parents of deceased workers and (2) spouses who may meet the GPO
exception.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-760-F4.................................. 18,000 1 15 4,500
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2. Physician's/Medical Officer's Statement of Patient's Capability
to Manage Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA
appoints a representative payee in cases where we determine
beneficiaries are not capable of managing their own benefits. In those
instances, we require medical evidence to determine the beneficiaries'
capability of managing or directing their benefit payments. SSA
collects medical evidence on Form SSA-787 to (1) determine
beneficiaries' capability or inability to handle their own benefits,
and (2) assist in determining the beneficiaries' need for a
representative payee. The respondents are the beneficiaries'
physicians, or medical officers of the institution in which the
beneficiaries reside.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-787..................................... 120,000 1 10 20,000
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3. Pre-1957 Military Service Federal Benefit Questionnaire--20 CFR
404.1301-404.1371--0960-0120. SSA may grant gratuitous military wage
credits for active military or naval service (under certain conditions)
during the period September 16, 1940 through December 31, 1956, if no
other Federal agency (other than the Veterans Administration) credited
the service for benefit eligibility or computation purposes. We use
Form SSA-2512 to collect specific information about other Federal,
military, or civilian benefits the wage earner may receive when the
applicant indicates both pre-1957 military service and the receipt of a
Federal benefit. SSA uses the data in the claims adjudication process
to grant gratuitous military wage credits when applicable, and to
solicit sufficient information to determine eligibility. Respondents
are applicants for Social Security benefits on a record where the wage
earner claims pre-1957 military service.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2512.................................... 5,000 1 10 833
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4. Authorization for the Social Security Administration to Obtain
Account Records from a Financial Institution and Request for Records--
20 CFR 416.200, 416.203--0960-0293. SSA collects and verifies financial
information from individuals applying for SSI to determine if the
applicant meets the SSI resource eligibility requirements. SSA contacts
claimants' financial institutions to verify the existence, ownership,
and value of the account owned when the claimants provide incomplete,
unavailable, or seemingly altered records. Financial
[[Page 76163]]
institutions require individuals to sign Form SSA-461-U2 to authorize
them to disclose records to SSA. The respondents are SSI applicants,
recipients, and their deemors.
Type of Request: Revision of an OMB-approved information
collection.
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Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
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SSA-4641 (paper)................................ 44,100 1 6 4,410
e4641 (electronic).............................. 6,955,900 1 2 231,863
Totals...................................... 7,000,000 .............. .............. 236,273
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5. Statement of Household Expenses and Contributions--20 CFR
416.1130-416.1148--0960-0456. SSA bases eligibility for SSI on the
needs of the recipient. In part, we assess need by determining the
amount of income a recipient receives. This income includes in-kind
support and maintenance in the form of food and shelter provided by
others. SSA uses Form SSA-8011-F3 to determine whether the claimant or
recipient receives in-kind support and maintenance. This is necessary
to determine (1) the claimant or recipient's eligibility for SSI and
(2) the SSI payment amount. SSA only uses this form in cases where SSA
needs the householder's (head of household) corroboration of in-kind
support and maintenance. Respondents are householders of homes in which
an SSI applicant or recipient resides.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8011-F3................................. 428,100 1 15 107,025
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6. Notification of a Social Security Number (SSN) to An Employer
for Wage Reporting--20 CFR 422.103(a)--0960-0778. Individuals applying
for employment must provide an SSN or indicate they have applied for
one.
However, when an individual applies for an initial SSN, there is a
delay between the assignment of the number and the delivery of the SSN
card. At an individual's request, SSA uses Form SSA-132 to send the
individual's SSN to an employer. Mailing this information to the
employer (1) ensures the employer has the correct SSN for the
individual; (2) allows SSA to receive correct earnings information for
wage reporting purposes; and (3) reduces the delay in the initial SSN
assignment and delivery of the SSN information directly to the
employer. It also enables SSA to verify the employer as a safeguard for
the applicant's personally identifiable information. The majority of
individuals who take advantage of this option are in the United States
with exchange visitor and student visas; however, we allow any
applicant for an SSN to use the SSA-132. The respondents are
individuals applying for an initial SSN who ask SSA to mail
confirmation of their application or the SSN to their employers.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-132..................................... 249,000 1 2 8,300
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Dated: December 19, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2012-30949 Filed 12-21-12; 8:45 am]
BILLING CODE 4191-02-P