[Federal Register Volume 59, Number 145 (Friday, July 29, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-18322]
[[Page Unknown]]
[Federal Register: July 29, 1994]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Social Security Administration
Agency Forms Submitted to the Office of Management and Budget for
Clearance
Normally on Fridays, the Social Security Administration publishes a
list of information collection packages that have been submitted to the
Office of Management and Budget (OMB) for clearance in compliance with
P.L. 96-511, The Paperwork Reduction Act. The following clearance
packages have been submitted to OMB since the last list was published
in the Federal Register on Friday, July 1, 1994.
(Call Reports Clearance Officer on (410) 965-4142 for copies of
package)
1. Application for Lump-Sum Death Payment--0960-0013. The
information on form SSA-8 is used by the Social Security Administration
to determine the eligibility of an applicant for the lump-sum death
payment. The respondents are widows, widowers, or children of the
deceased or their representatives.
Number of Respondents: 735,000
Frequency of Response: 1
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 122,500 hours
2. Statement of Self-Employment Income--0960-0046. The information
on form SSA-766 is used by the Social Security Administration to
determine if an individual will have at least the minimum amount of
self-employment income needed for one or more quarters of coverage in
the current year. The affected public consists of applicants who lack
1-4 quarters of coverage in order to be eligible to benefits.
Number of Respondents: 5,000
Frequency of Response: 1
Average Burden Per Response: 5 minutes
Estimated Annual Burden: 417 hours
3. State Agency Report of Obligations for SSA Disability Programs--
0960-0421. The information on form SSA-4513 is used by the Social
Security Administration (SSA) to budget and account for expenditures by
the State Disability Determination Service (DDS) agencies which are
incurred while making determinations for SSA. The respondents are DDSs
under contract to SSA.
Number of Respondents: 54
Frequency of Response: 4
Average Burden Per Response: 60 minutes
Estimated Annual Burden: 216 hours
4. Statement Regarding Contributions--0960-0020. The information on
form SSA-783 is used by the Social Security Administration to determine
one-half support, which is an eligibility factor for certain claimants.
The respondents are claimants who need to prove one-half support by the
wage earner or other persons having knowledge of the situation.
Number of Respondents: 30,000
Frequency of Response: 1
Average Burden Per Response: 15 minutes
Estimated Annual Burden: 7,500 hours
5. Statement for Determining Continuing Eligibility for
Supplemental Security Income--0960-0416. The information on form SSA-
8203 is used by the Social Security Administration to conduct a
redetermination of a recipient's continuing eligibility to Supplemental
Security Income Benefits (SSI). It has been revised to include a lead
question concerning potential entitlement to Social Security benefits
and to delete the question concerning earned income credits. The
respondents are SSI recipients who are scheduled for a redetermination.
Number of Respondents: 580,000
Frequency of Response: 1
Average Burden Per Response: 17 minutes
Estimated Annual Burden: 164,333 hours
6. Application for Search of Census Records for Proof of Age--
0960-0097. The information on form SSA-1535 is used by the Social
Security Administration to provide the Census Bureau with sufficient
information to accurately search its records for proof of age for an
individual claiming benefits. The respondents are claimants who need to
obtain a census record in order to prove their age.
Number of Respondents: 18,000
Frequency of Response: 1
Average Burden Per Response: 12 minutes
Estimated Annual Burden: 3,600 hours OMB Desk Officer: Laura Oliven
Written comments and recommendations regarding these information
collections should be sent directly to the appropriate OMB Desk Officer
designated above at the following address: OMB Reports Management
Branch, New Executive Office Building, Room 3208, Washington, D.C.
20503.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 94-18322 Filed 7-28-94; 8:45 am]
BILLING CODE 4190-29-P