[Federal Register Volume 83, Number 144 (Thursday, July 26, 2018)]
[Notices]
[Pages 35526-35533]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-15939]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2018-0040]


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 extensions and revisions 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,

[[Page 35527]]

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-2018-0040].
    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 
September 24, 2018. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Credit Card Payment Form--0960-0648. SSA uses Form SSA-1414 to 
process: (1) Credit card payments from former employees and vendors 
with outstanding debts to the agency; (2) advance payments for 
reimbursable agreements; and (3) credit card payments for all Freedom 
of Information Act (FOIA) requests requiring payment. The respondents 
are former employees and vendors who have outstanding debts to the 
agency; entities who have reimbursable agreements with SSA; and 
individuals who request information through FOIA.
    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-1414....................................           6,000                1                2              200
----------------------------------------------------------------------------------------------------------------

    2. Promoting Readiness of Minors in SSI (PROMISE) Evaluation--0960-
0799.

Background

    The Promoting Readiness of Minors in SSI (PROMISE) demonstration 
pursues positive outcomes for children with disabilities who receive 
Supplemental Security Income (SSI) and their families by reducing 
dependency on SSI. The Department of Education (ED) awarded six 
cooperative agreements to states to improve the provision and 
coordination of services and support for children with disabilities who 
receive SSI and their families to achieve improved education and 
employment outcomes. ED awarded PROMISE funds to five single-state 
projects, and to one six-state consortium.\1\ With support from ED, the 
Department of Labor (DOL), and the Department of Health and Human 
Services (HHS), SSA is evaluating the six PROMISE projects. SSA 
contracted with Mathematica Policy Research to conduct the evaluation.
---------------------------------------------------------------------------

    \1\ The six-state consortium project goes by the name Achieving 
Success by Promoting Readiness for Education and Employment (ASPIRE) 
rather than by PROMISE.
---------------------------------------------------------------------------

    Under PROMISE, targeted outcomes for youth include an enhanced 
sense of self-determination; achievement of secondary and post-
secondary educational credentials; an attainment of early work 
experiences culminating with competitive employment in an integrated 
setting; and long-term reduction in reliance on SSI. Outcomes of 
interest for families include heightened expectations for and support 
of the long-term self-sufficiency of their youth; parent or guardian 
attainment of education and training credentials; and increases in 
earnings and total income. To achieve these outcomes, we expect the 
PROMISE projects to make better use of existing resources by improving 
service coordination among multiple state and local agencies and 
programs.
    ED, SSA, DOL, and HHS intend the PROMISE projects to address key 
limitations in the existing service system for youth with disabilities. 
By intervening early in the lives of these young people, at ages 14-16, 
the projects engage the youth and their families well before critical 
decisions regarding the age 18 redetermination are upon them. We expect 
the required partnerships among the various state and Federal agencies 
that serve youth with disabilities to result in improved integration of 
services and fewer dropped handoffs as youth move from one agency to 
another. By requiring the programs to engage and serve families and 
provide youth with paid work experiences, the initiative is mandating 
the adoption of critical best practices in promoting the independence 
of youth with disabilities.

Project Description

    SSA is requesting clearance for the collection of data needed to 
implement and evaluate PROMISE. The evaluation provides empirical 
evidence on the impact of the intervention for youth and their families 
in several critical areas, including: (1) Improved educational 
attainment; (2) increased employment skills, experience, and earnings; 
and (3) long-term reduction in use of public benefits. We base the 
PROMISE evaluation on a rigorous design that entails the random 
assignment of approximately 2,000 youth in each of the six projects to 
treatment or control groups (12,000 total). The PROMISE projects 
provide enhanced services for youth in the treatment groups; whereas 
youth in the control groups are eligible only for those services 
already available in their communities independent of the 
interventions.
    The evaluation assesses the effect of PROMISE services on 
educational attainment, employment, earnings, and reduced receipt of 
disability payments. The three components of this evaluation include:
     The process analysis, which documents program models, 
assesses the relationships among the partner organizations, documents 
whether the grantees implemented the programs as planned, identifies 
features of the programs that may account for their impacts on youth 
and families, and identifies lessons for future programs with similar 
objectives.
     The impact analysis, which determines whether youth and 
families in the treatment groups receive more services than their 
counterparts in the control groups. It also determines whether 
treatment group members have better results than control group members 
with respect to the targeted outcomes noted above.
     The cost-benefit analysis, which assesses whether the 
benefits of PROMISE, including increases in employment and reductions 
in benefit receipt, are large enough to justify its costs. We conduct 
this assessment from a range of perspectives, including those of the 
participants, state and Federal governments, SSA, and society as a 
whole.
    SSA planned several data collection efforts for the evaluation. 
These include: (1) Follow-up interviews with youth and their parent or 
guardian 18 months and 5 years (60 months) after enrollment; (2) phone 
and in-person interviews with local program administrators, program 
supervisors, and service delivery staff at two points in time over the 
course of the

[[Page 35528]]

demonstration; (3) two rounds of focus groups with participating youth 
in the treatment group; (4) two rounds of focus groups with parents or 
guardians of participating youth; (5) staff activity logs which provide 
data on aspects of service delivery; and (6) collection of 
administrative data.
    At this time, SSA requests clearance for the 5-year (60-month) 
survey interviews. The respondents are the youth and their parents 
participating in the PROMISE demonstration.
    Type of Request: Revision to an OMB-approved information 
collection.

Time Burden on Respondents

                                        2019--60-Month Survey Interviews
----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Parent Interview--telephone (using electronic              1,095               1              32             584
 assisted capturing)............................
Youth Interview--telephone (using electronic               1,110               1              38             703
 assisted capturing)............................
Parent Interview--Self-Administered                           22               1              18               7
 Questionnaire..................................
Youth Interview--Self-Administered Questionnaire              23               1              18               7
                                                 ---------------------------------------------------------------
    Totals......................................           2,250  ..............  ..............           1,301
----------------------------------------------------------------------------------------------------------------


                                        2020--60-Month Survey Interviews
----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Parent Interview--telephone (using electronic              5,127               1              32           2,734
 assisted capturing)............................
Youth Interview--telephone (using electronic               5,169               1              38           3,274
 assisted capturing)............................
Parent Interview--Self-Administered                          105               1              18              32
 Questionnaire..................................
Youth Interview--Self-Administered Questionnaire             105               1              18              32
                                                 ---------------------------------------------------------------
    Totals......................................          10,506  ..............  ..............           6,072
----------------------------------------------------------------------------------------------------------------


                                        2021--60-Month Survey Interviews
----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Parent Interview--telephone (using electronic              2,656               1              32           1,417
 assisted capturing)............................
Youth Interview--telephone (using electronic               2,671               1              38           1,692
 assisted capturing)............................
Parent Interview--Self-Administered                           54               1              18              16
 Questionnaire..................................
Youth Interview--Self-Administered Questionnaire              55               1              18              17
                                                 ---------------------------------------------------------------
    Totals......................................           5,436  ..............  ..............           3,142
----------------------------------------------------------------------------------------------------------------


                                                  Grand Totals
----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Parent Interview--telephone (using electronic              8,878               1              32           4,735
 assisted capturing)............................
Youth Interview--telephone (using electronic               8,950               1              38           5,669
 assisted capturing)............................
Parent Interview--Self-Administered                          181               1              18              55
 Questionnaire..................................
Youth Interview--Self-Administered Questionnaire             183               1              18              56
                                                 ---------------------------------------------------------------
    Totals......................................          18,192  ..............  ..............          10,515
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding these 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 August 27, 2018. Individuals can obtain copies of 
the OMB clearance packages by writing to [email protected].
    1. Statement of Employer--20 CFR 404.801-404.803--0960-0030. When 
workers report they were paid wages but cannot provide proof of those 
earnings, and the wages do not appear in SSA's records of earnings, SSA 
uses Form SSA-7011-F4 to document the alleged wages. Specifically, the 
agency uses the form to resolve discrepancies in the individual's 
Social Security earnings record and to process claims for Social 
Security benefits. We only send Form

[[Page 35529]]

SSA-7011-F4 to employers if we are unable able to locate the earnings 
information within our own records. The respondents are employers who 
can verify wage allegations made by wage earners.
    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-7011-F4.................................             500                1               20              167
----------------------------------------------------------------------------------------------------------------

    2. Statement of Claimant or Other Person--20 CFR 404.702 & 16.570--
0960-0045. SSA uses Form SSA-795 in special situations where there is 
no authorized form or questionnaire, yet we require a signed statement 
from the applicant, claimant, or other individuals who have knowledge 
of facts, in connection with claims for Social Security benefits or 
SSI. The information we request on the SSA-795 is of sufficient 
importance that we need both a signed statement and a penalty clause. 
SSA uses this information to process, in addition to claims for 
benefits, issues about continuing eligibility; ongoing benefit amounts; 
use of funds by a representative payee; fraud investigation; and a 
myriad of other program-related matters. The most common respondents 
are applicants for Social Security, SSI, or recipients of these 
programs. However, respondents also include friends and relatives of 
the involved parties; coworkers; neighbors; or anyone else in a 
position to provide information pertinent to the issue(s).
    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-795.....................................         305,500                1               15           76,375
----------------------------------------------------------------------------------------------------------------

    3. Application for a Social Security Number Card, the Social 
Security Number Application Process (SSNAP), and internet SSN 
Replacement Card (iSSNRC) Application--20 CFR 422.103-422.110--0960-
0066. SSA collects information on the SS-5 (used in the United States) 
and SS-5-FS (used outside the United States) to issue original or 
replacement Social Security cards. SSA also enters the application data 
into the SSNAP application when issuing a card via telephone or in 
person. In addition, hospitals collect the same information on SSA's 
behalf for newborn children through the Enumeration-at-Birth process. 
In this process, parents of newborns provide hospital birth 
registration clerks with information required to register these 
newborns. Hospitals send this information to State Bureaus of Vital 
Statistics (BVS), and they send the information to SSA's National 
Computer Center. SSA then uploads the data to the SSA mainframe along 
with all other enumeration data, and we assign the newborn a Social 
Security number (SSN) and issue a Social Security card. Respondents can 
also use these modalities to request a change in their SSN records. 
Finally, the iSSNRC internet application collects information similar 
to the paper SS-5 for no-change replacement SSN cards for adult U.S. 
citizens. The iSSNRC modality allows certain applicants for an SSN 
replacement cards to complete the internet application and submit the 
required evidence online rather than completing a paper Form SS-5. The 
respondents for this collection are applicants for original and 
replacement Social Security cards, or individuals who wish to change 
information in their SSN records, who use any of the modalities 
described above.

    Note:  This is a correction notice: SSA published the incorrect 
burden information for this collection at 83 FR 21328, on 5/09/18. 
We are correcting this error here.

    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
              Application scenario                  respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Respondents who do not have to provide parents'       10,500,000               1             8.5       1,487,500
 SSNs...........................................
Adult U.S. Citizens requesting a replacement             480,000               1               5          40,000
 card with no changes through the iSSNRC
 modality *.....................................
Respondents whom we ask to provide parents' SSNs         250,000               1               9          37,500
 (when applying for original SSN cards for
 children under age 12).........................
Applicants age 12 or older who need to answer          1,470,000               1             9.5         232,750
 additional questions so SSA can determine
 whether we previously assigned an SSN..........
Applicants asking for a replacement SSN card                4000               1              60            4000
 beyond the new allowable limits (i.e., who must
 provide additional documentation to accompany
 the application)...............................
Authorization to SSA to obtain personal                      500               1              15             125
 information cover letter.......................
Authorization to SSA to obtain personal                      500               1              15             125
 information follow-up cover letter.............
                                                 ---------------------------------------------------------------
    Totals......................................      12,705,000  ..............  ..............       1,802,000
----------------------------------------------------------------------------------------------------------------


[[Page 35530]]

    4. Statement of Care and Responsibility for Beneficiary--20 CFR 
404.2020, 404.2025, 408.620, 408.625, 416.620, & 416.625--0960-0109. 
SSA uses the information from Form SSA-788 to verify payee applicants' 
statements of concern, and to identify other potential payees. SSA is 
concerned with selecting the most qualified representative payee who 
will use Social Security benefits in the beneficiary's best interest. 
SSA considers factors such as the payee applicant's capacity to perform 
payee duties; awareness of the beneficiary's situation and needs; 
demonstration of past, and current concern for the beneficiary's well-
being; etc. in making that determination. If the payee applicant does 
not have custody of the beneficiary, SSA obtains information from the 
custodian for evaluation against the information the applicant 
provides. Respondents are individuals who have custody of the 
beneficiary in cases where someone else filed to be the beneficiary's 
representative payee.
    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-788.....................................         130,000                1               10           21,667
----------------------------------------------------------------------------------------------------------------

    5. Certificate of Election for Reduced Spouse's Benefits--20 CFR 
404.421--0960-0398. SSA cannot pay reduced Social Security benefits to 
an already entitled spouse unless the spouse elects to receive reduced 
benefits and is (1) at least age 62, but under full retirement age; and 
(2) no longer is caring for a child. In this situation, spouses who 
decide to elect reduced benefits must file Form SSA-25, Certificate of 
Election for Reduced Spouse's Benefits. SSA uses the information to pay 
qualified spouses who elect to receive reduced benefits. Respondents 
are entitled spouses seeking reduced Social Security benefits.
    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-25......................................          30,000                1                2            1,000
----------------------------------------------------------------------------------------------------------------

    6. Coverage of Employees of State and Local Governments--20 CFR 
404, Subpart M--0960-0425. The Code of Federal Regulations (CFR) at 20 
CFR 404, Subpart M, prescribes the rules for States submitting reports 
of deposits and recordkeeping to SSA. SSA requires States (and 
interstate instrumentalities) to provide wage and deposit contribution 
information for pre-1987 periods. Not all states have completely 
satisfied their pending wage report and contribution liability with SSA 
for pre-1987 tax years. SSA needs these regulations 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: Extension of an OMB approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
                  CFR citation                       Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
404.1204(a) & (b)...............................              52               1              30              26
404.1215........................................              52               1              60              52
404.1216(a) & (b)...............................              52               1              60              52
                                                 ---------------------------------------------------------------
    Total.......................................             156  ..............  ..............             130
----------------------------------------------------------------------------------------------------------------

    7. Continuation of Supplemental Security Income Payments for the 
Temporarily Institutionalized--Certification of Period and Need to 
Maintain Home--20 CFR 416.212(b)(1)--0960-0516. When SSI recipients (1) 
enter a public institution, or (2) enter a private medical treatment 
facility with Medicaid paying more than 50 percent of expenses, SSA 
reduces recipients' SSI payments to a nominal sum. However, if this 
institutionalization is temporary (defined as a maximum of three 
months), SSA may waive the reduction. Before SSA can waive the SSI 
payment reduction, the agency must receive the following documentation: 
(1) A physician's certification stating the SSI recipient will only be 
institutionalized for a maximum of three months, and (2) certification 
from the recipient, the recipient's family, or friends, confirming the 
recipient needs SSI payments to maintain the living arrangements to 
which the individual will return post-institutionalization. To obtain 
this information, SSA employees contact the recipient (or a 
knowledgeable source) to collect the required physician's certification 
and the statement of need. SSA does not require any specific format for 
these items, so long as we obtain the necessary attestations. The 
respondents are SSI recipients, their family or friends, as well as 
physicians or hospital staff members who treat the SSI recipient.
    Type of Request: Extension of an OMB-approved information 
collection.

[[Page 35531]]



----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
Physician's Certifications and Statements             60,000                1                5            5,000
 from Other Respondents.....................
----------------------------------------------------------------------------------------------------------------

    8. Disability Report-Adult--20 CFR 404.1512 and 416.912--0960-0579. 
State Disability Determination Services (DDS) use the SSA-3368 and its 
electronic versions to determine if adult disability applicants' 
impairments are severe and, if so, how the impairments affect the 
applicants' ability to work. This determination dictates whether the 
DDSs and SSA will find the applicant to be disabled and entitled to SSI 
payments. The respondents are applicants for Title II disability 
benefits or Title XVI SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3368 (Paper form)...........................           7,571               1              90          11,357
Electronic Disability Collection System (EDCS)..       2,484,231               1              90       3,726,347
i3368 (internet)................................       1,060,360               1              90       1,590,540
                                                 ---------------------------------------------------------------
    Totals......................................       3,552,162  ..............  ..............       5,328,244
----------------------------------------------------------------------------------------------------------------

    9. Request for Internet Services and 800# Automated Telephone 
Services Knowledge-Based Authentication (RISA-KBA)--20 CFR 401.45--
0960-0596. The Request for Internet Services and 800# Automated 
Telephone Services (RISA) Knowledge-Based Authentication (KBA) is one 
of the authentication methods SSA uses to allow individuals access to 
their personal information through our internet and Automated Telephone 
Services. SSA asks individuals and third parties who seek personal 
information from SSA records, or who register to participate in SSA's 
online business services, to provide certain identifying information. 
As an extra measure of protection, SSA asks requestors who use the 
internet and telephone services to provide additional identifying 
information unique to those individuals so SSA can authenticate their 
identities before releasing personal information. The respondents are 
current beneficiaries who are requesting personal information from SSA, 
and individuals and third parties who are registering for SSA's online 
business services.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Internet Requestors.............................       2,903,902               1             2.5         120,996
Telephone Requestors............................       9,795,655               1               4         653,044
* Change of Address (on hold)...................               1  ..............  ..............               1
* Screen Splash (on hold).......................               1  ..............  ..............               1
                                                 ---------------------------------------------------------------
    Totals......................................      12,699,559  ..............  ..............         774,042
----------------------------------------------------------------------------------------------------------------
* One-hour placeholder burdens; Screen Splash and Change of Address applications are on hold.

    10. Representative Payment Policies Regulation--20 CFR 404.2011, 
404.2025, 416.611, and 416.625--0960-0679. Per 20 CFR 404.2011 and 20 
CFR 416.611, if SSA determines it may cause substantial harm for Title 
II or Title XVI recipients to receive their payments directly, 
recipients may dispute that decision. To do so, recipients provide SSA 
with information the agency uses to reevaluate its determination. In 
addition, our regulations state that after SSA selects a representative 
payee to receive benefits on a recipient's behalf, the payees provide 
SSA with information on their continuing relationship and 
responsibility for the recipients, and explain how they use the 
recipients' payments. Sections 20 CFR 404.2025 and 20 CFR 416.625 
provide a process to follow up with the representative payee to verify 
payee performance. The respondents are Title II and Title XVI 
recipients, and their representative payees.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden  per    total  annual
                  CFR citation                      respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
404.2011(a)(1); 416.611(a)(1)...................             250               1              15              63
404.2025; 416.625...............................           3,000               1               6             300
                                                 ---------------------------------------------------------------

[[Page 35532]]

 
    Totals......................................           3,250  ..............  ..............             363
----------------------------------------------------------------------------------------------------------------

    11. Function Report Adult--20 CFR 404.1512 & 416.912--0960-0681. 
Individuals receiving or applying for Social Security disability 
insurance (SSDI) or SSI must provide medical evidence and other proof 
SSA requires to prove their disability. SSA staff, and, on our behalf, 
DDS employees, collect the information via paper Form SSA-3373-BK, or 
through an in-person or telephone interview for cases where we need 
information about a claimant's activities and abilities to evaluate the 
claimant's disability. We use the information to document how 
claimants' disabilities affect their ability to function, and to 
determine eligibility, or continued eligibility, for SSI and SSDI 
claims. The respondents are Title II and Title XVI applicants (or 
current recipients undergoing redeterminations) for disability 
payments.
    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-3373-BK.................................       1,734,635                1               61        1,763,546
----------------------------------------------------------------------------------------------------------------

    12. Request for Business Entity Taxpayer Information--0960-0731. 
SSA requires Law firms or other business entities to complete Form SSA-
1694, Request for Business Entity Taxpayer Information, if they wish to 
serve as appointed representatives and receive direct payment of fees 
from SSA. SSA uses the information to issue a Form 1099-MISC. SSA also 
uses the information to allow business entities to designate 
individuals to serve as entity administrators authorized to perform 
certain administrative duties on their behalf, such as providing bank 
account information, maintaining entity information, and updating 
individual affiliations. Respondents are law firms or other business 
entities with attorneys or other qualified individuals as partners or 
employees who represent claimants before SSA.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total  annual
             Modality of completion                 respondents      response       per response      burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1694--Paper Version.........................             750               1              10             125
SSA-1694--Business Services Online Submission...             150               1              10              25
                                                 ---------------------------------------------------------------
    Totals......................................             900  ..............  ..............             150
----------------------------------------------------------------------------------------------------------------

    13. Authorization for the Social Security Administration to Obtain 
Personal Information--20 CFR 404.704; 404.820-404.823; 404.1926; 
416.203; and 418.3001--0960-0801. SSA uses Form SSA-8510 to contact a 
public or private custodian of records on behalf of an applicant or 
recipient of an SSA program to request evidence information, which may 
support a benefit application or payment continuation. We ask for 
evidence information such as the following:

 Age requirements (e.g., birth certificate, court documents)
 Insured status (e.g., earnings, employer verification)
 Marriage or divorce information
 Pension offsets
 Wages verification
 Annuities
 Property information
 Benefit verification from a State agency or third party
 Immigration status (rare instances)
 Income verification from public agencies or private 
individuals
 Unemployment benefits
 Insurance policies

    If the custodian requires a signed authorization from the 
individual(s) whose information SSA requests, SSA may provide the 
custodian with a copy of the SSA-8510. Once the respondent completes 
the SSA-8510, either using the paper form, or using the Personal 
Information Authorization web page version, SSA uses the form as the 
authorization to obtain personal information regarding the respondent 
from third parties until the authorizing person (respondent) revokes 
the permission of its usage. The collection is voluntary; however, 
failure to verify the individuals' eligibility can prevent SSA from 
making an accurate and timely decision for their benefits. The 
respondents are individuals who may file for, or currently receive, 
Social Security benefits, SSI payments, or Medicare Part D subsidies.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 Respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Paper SSA-8510..................................           3,500               1               5             292
for Medicare Subsidy Quality Review.............

[[Page 35533]]

 
Paper SSA-8510 for general evidence purposes....          19,800               1               5           1,650
Personal Information Authorization web page.....         140,145               1               5         11, 679
                                                 ---------------------------------------------------------------
    Totals......................................         163,445  ..............  ..............          13,621
----------------------------------------------------------------------------------------------------------------


    Dated: July 20, 2018.
Naomi Sipple,
Reports Clearance Officer,
    Social Security Administration.
[FR Doc. 2018-15939 Filed 7-25-18; 8:45 am]
 BILLING CODE 4191-02-P