[Federal Register Volume 81, Number 98 (Friday, May 20, 2016)]
[Notices]
[Pages 31999-32001]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-11851]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2016-0020]
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 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, Fax:
202-395-6974, Email address: [email protected]
(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 www.regulations.gov,
referencing Docket ID Number [SSA-2016-0020].
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 July
19, 2016. Individuals can obtain copies of the collection instruments
by writing to the above email address.
1. Application for Supplemental Security Income--20 CFR 416.207 and
416.305-416.335, Subpart C--0960-0229. The Supplemental Security Income
(SSI) program provides aged, blind, and disabled individuals who have
little or no income, with funds for food, clothing, and shelter.
Individuals complete Form SSA-8000-BK to apply for SSI. SSA uses the
information from Form SSA-8000-BK and its electronic Intranet
counterpart, the Modernized SSI Claims Systems (MSSICS), to determine:
(1) Whether SSI claimants
[[Page 32000]]
meet all statutory and regulatory eligibility requirements; and (2) SSI
payment amounts. The respondents are applicants for SSI or their
representative payees.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8000-BK (Paper Version)..................... 17,541 1 41 11,986
MSSICS/Signature Proxy.......................... 1,373,401 1 35 801,151
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Totals...................................... 1,390,942 .............. .............. 813,137
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2. Application for Supplemental Security Income--20 CFR 416.305-
416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to determine
an applicant's eligibility for SSI and SSI payment amounts. SSA
employees also collect this information during interviews with members
of the public who wish to file for SSI. SSA uses the information for
two purposes: (1) To deny SSI formally, for non-medical reasons when
information the applicant provides results in ineligibility; or (2) to
establish a disability claim, but defer the complete development of
non-medical issues until SSA approves the disability. The respondents
are applicants for SSI.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
MSSICS/Signature Proxy.......................... 937,207 1 20 312,402
SSA-8001-BK (Paper Version)..................... 1,033 1 20 344
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Totals...................................... 938,240 .............. .............. 312,746
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3. Function Report--Child (Birth to 1st Birthday, Age 1 to 3rd
Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th
Birthday)--20 CFR 416.912 and 416.924a(a)(2)--0960-0542. As part of
SSA's disability determination process, we use Forms SSA-3375-BK
through SSA-3379-BK to request information from a child's parent or
guardian for children applying for SSI. The five different versions of
the form contain questions about the child's day-to-day functioning
appropriate to a particular age group; thus, respondents use only one
version of the form for each child. The adjudicative team (disability
examiners and medical or psychological consultants) of State disability
determination services offices collect the information on the
appropriate version of this form (in conjunction with medical and other
evidence) to form a complete picture of the children's ability to
function and their impairment-related limitations. The adjudicative
team uses the completed profile to determine: (1) If each child's
impairment(s) results in marked and severe functional limitations; and
(2) whether each child is disabled. The respondents are parents and
guardians of child applicants for SSI.
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-3375; SSA-3376; SSA-3377; SSA-3378; SSA- 532,000 1 20 177,333
3379 *.....................................
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* Respondents complete only one form per child.
4. Government-to-Government Services Online Web site Registration;
Government-to-Government Services Online Web site Account Modification/
Deletion Form--20 CFR 401.45--0960-0757. The Government-to-Government
Services Online (GSO) Web site allows various external organizations to
submit files to a variety of SSA systems and, in some cases, receive
files in return. The SSA systems that process data transferred via GSO
include, but are not limited to, systems responsible for disability
processing and benefit determination or termination. SSA uses the
information on Form SSA-159, Government-to-Government Online Web site
Registration Form, to register the requestor to use the GSO Web site.
Once we receive the SSA-159, SSA provides the user with account
information and conducts a walkthrough of the GSO Web site as
necessary. Established organizations may submit Form SSA-159 to
register additional users as well. The established requesting
organizations can also complete Form SSA-160, Government-to-Government
Online Web site Account Modification/Deletion Form, to modify their
online accounts (e.g., address change). Respondents are State and local
government agencies, and some private sector business entities.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 32001]]
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Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
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SSA-159......................................... 1,543 1 15 386
SSA-160......................................... 130 1 15 33
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Totals...................................... 1,673 .............. .............. 419
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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 June 20, 2016. Individuals can obtain copies of the OMB
clearance packages by writing to [email protected].
1. Agency/Employer Government Pension Offset Questionnaire--20 CFR
404.408(a)--0960-0470. When an individual is concurrently receiving
Social Security spousal, or surviving spousal, benefits and a
government pension, the individual may have the amount of Social
Security benefits reduced by the government pension amount. This is the
Government Pension Offset (GPO). SSA uses Form SSA-L4163 to collect
accurate pension information from the Federal or State government
agency paying the pension for purposes of applying the pension offset
provision. SSA uses this form only when (1) the claimant does not have
the information; and (2) the pension-paying agency has not cooperated
with the claimant. Respondents are State government agencies which have
information SSA needs to determine if the GPO applies and the amount of
offset.
Type of Request: Extension 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-L4163................................... 1000 1 3 50
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2. Real Property Current Market Value Estimate--0960-0471. SSA
considers an individual's resources when evaluating eligibility for SSI
payments. The value of an individual's resources, including non-home
real property, is one of the eligibility requirements for SSI payments.
SSA obtains current market value estimates of the claimant's real
property through Form SSA-L2794. We allow respondents to use readily
available records to complete the form, or we can accept their best
estimates. We use this form as part of initial applications and in
post-entitlement situations. The respondents are small business
operators in real estate; state and local government employees tasked
with assessing real property values; and other individuals
knowledgeable about local real estate values.
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-L2794................................... 250 1 20 83
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Dated: May 16, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-11851 Filed 5-19-16; 8:45 am]
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