[Federal Register Volume 78, Number 5 (Tuesday, January 8, 2013)]
[Notices]
[Pages 1296-1298]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-00162]
=======================================================================
-----------------------------------------------------------------------
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 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, 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
March 11, 2013. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Supplemental Statement Regarding Farming Activities of Person
Living Outside the U.S.A.--0960-0103. When a beneficiary or claimant
reports farm work from outside the United States, SSA documents this
work on Form SSA-7163A-F4. Specifically, SSA uses the form to determine
if we should apply foreign work deductions to the recipient's title II
benefits. We collect the information either annually or every other
year, depending on the respondent's country of residence. Respondents
are Social Security recipients engaged in farming activities outside
the United States.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7163A-F4................................ 1,000 1 60 1,000
----------------------------------------------------------------------------------------------------------------
2. International Direct Deposit--31 CFR 210--0960-0686. SSA's
International Direct Deposit (IDD) Program allows beneficiaries living
abroad to receive their payments via direct deposit to an account at a
financial institution outside the United States. SSA uses Form SSA-
1199-(Country) to enroll title II beneficiaries residing abroad in IDD,
and to obtain the direct deposit information for foreign accounts.
Routing account number information varies slightly for each foreign
country, so we use a variation of the Treasury Department's Form SF-
1199A per country. The respondents are Social Security beneficiaries
residing abroad who want SSA to deposit their benefits payments
directly to a foreign financial institution.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 1297]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1199-(Country).......................... 5,000 1 5 417
----------------------------------------------------------------------------------------------------------------
3. Certificate of Incapacity--5 CFR 890.302(d)--0960-0739. Rules
governing the Federal Employee Health Benefits (FEHB) plan require a
physician to verify the disability of Federal employees' children ages
26 and over for such children to retain health benefits under their
employed parents' plans. The physician must verify that the adult
child's disability: (1) Pre-dates the child's 26th birthday; (2) is
very serious; and (3) will continue for at least one year. Physicians
use Form SSA-604, Certificate of Incapacity, to document this
information. The respondents are physicians of SSA employees' children
ages 26 or over who are seeking to retain health benefits under their
parent's FEHB plan coverage.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-604..................................... 50 1 45 38
----------------------------------------------------------------------------------------------------------------
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 February 7, 2013. Individuals can obtain copies of the
OMB clearance packages by writing to [email protected].
1. Child Relationship Statement--20 CFR 404.355 & 404.731--0960-
0116. To help determine a child's entitlement to Social Security
benefits, SSA uses criteria under section 216(h)(3) of the Social
Security Act (Act), deemed child provision. SSA may deem a child to an
insured individual if: (1) The insured individual presents SSA with
satisfactory evidence of parenthood and was living with or contributing
to the child's support at certain specified times; or (2) the insured
individual (a) acknowledged the child in writing; (b) was court decreed
as the child's parent; or (c) was court ordered to support the child.
To obtain this information, SSA uses Form SSA-2519, Child Relationship
Statement. Respondents are people with knowledge of the relationship
between certain individuals filing for Social Security benefits and
their alleged biological children.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of collection Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2519.................................... 50,000 1 15 12,500
----------------------------------------------------------------------------------------------------------------
2. Pain Report Child--20 CFR 404.1512 and 416.912--0960-0540.
Before SSA can make a disability determination for a child, we require
evidence from Supplemental Security Income (SSI) applicants or
claimants to prove their disability. Form SSA-3371-BK provides
disability interviewers, and SSI applicants or claimants in self-help
situations, with a convenient way to record information on claimants'
pain or other symptoms. The State disability determination services
adjudicators and administrative law judges then use the information
from Form SSA-3371-BK to assess the effects of symptoms on function for
purposes of determining disability under the Act. The respondents are
applicants for, or claimants of, SSI payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of collection Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3371.................................... 250,000 1 15 62,500
----------------------------------------------------------------------------------------------------------------
3. Internet Request for Replacement of Forms SSA-1099/SSA--1042S--
20 CFR 401.--0960-0583. Title II beneficiaries use Forms SSA-1099 and
SSA-1042S, Social Security Benefit Statement, to determine if their
Social Security benefits are taxable, and the amount they need to
report to the Internal Revenue Service. In cases where the original
forms are unavailable (e.g., lost, stolen, mutilated), an individual
may use SSA's Internet request form or automated telephone application
to request a replacement SSA-1099 and SSA-1042S. SSA uses the
information from the Internet and automated telephone requests to
verify the identity of the requestor and to provide
[[Page 1298]]
replacement copies of the forms. The Internet and automated telephone
options reduce requests to the National 800 Number Network (N8NN) and
visits to local Social Security field offices (FO). The respondents are
title II beneficiaries who wish to request a replacement SSA-1099 or
SSA-1042S via the Internet or telephone.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Internet Requestors......................... 145,390 1 10 24,232
Automated Telephone Requestors.............. 190,413 1 2 6,347
Live calls to the N8NN...................... 566,667 1 3 28,333
Live calls to local FOs..................... 783,333 1 3 39,167
Other (program service centers)............. 90,000 1 3 4,500
-------------------------------------------------------------------
Totals.................................. 1,775,803 ............... ............... 102,579
----------------------------------------------------------------------------------------------------------------
4. Important Information About Your Appeal, Waiver Rights, and
Repayment Options--20 CFR 404.502-521--0960-0779. When SSA accidentally
overpays beneficiaries, the agency informs them of the following
rights: (1) The right to reconsideration of the overpayment
determination; (2) the right to request a waiver of recovery and the
automatic scheduling of a personal conference if SSA cannot approve a
request for waiver; and (3) the availability of a different rate of
withholding when SSA proposes the full withholding rate. SSA uses Form
SSA-3105, Important Information About Your Appeal, Waiver Rights, and
Repayment Options, to explain these rights to overpaid individuals and
allow them to notify SSA of their decision(s) regarding these rights.
The respondents are overpaid claimants requesting a waiver of recovery
for the overpayment, reconsideration of the fact of the overpayment, or
a lesser rate of withholding of the overpayment.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of collection Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3105.................................... 80,000 1 15 20,000
----------------------------------------------------------------------------------------------------------------
Dated: January 3, 2013.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2013-00162 Filed 1-7-13; 8:45 am]
BILLING CODE 4191-02-P