[Federal Register Volume 60, Number 33 (Friday, February 17, 1995)]
[Notices]
[Pages 9341-9342]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-3672]
=======================================================================
-----------------------------------------------------------------------
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 January 13, 1995.
(Call Reports Clearance Officer on (410) 965-4142 for copies of
package.)
1. Drug Addiction and Alcoholism Referral and Monitoring Agency
Treatment Requirements Acknowledgement; Drug Addiction and Alcoholism
Referral and Monitoring Agency Assessment/Referral and Tracking
Summary--0960-NEW. The information is needed to implement the
requirements of Public Law 103-296, section 201. The form SSA-386 is
used by the Social Security Administration to obtain acknowledgement of
the individual's understanding of his rights and responsibilities as a
beneficiary receiving drug addiction and alcoholism (DA&A) benefits.
The form SSA-387 is used to monitor compliance with treatment
requirements of DA&A beneficiaries and to determine eligibility for and
retention of DA&A benefits. The respondents are referral and monitoring
agencies, treatment facilities and [[Page 9342]] beneficiaries who are
disabled based on DA&A.
Number of Respondents: 184,000
Frequency of Response: One (SSA-386) One per month (SSA-387)
Average Burden Per Response: 5 minutes (SSA-386) 10 minutes (SSA-387)
Estimated Annual Burden: 395,600 hours
2. Employer Verification of Earnings for Children Under Age 7--
0960-0505. The information on form SSA-L3231-C1 is used by the Social
Security Administration to ensure that the proper person is credited
with earnings reported for a minor under age 7. The respondents are
businesses reporting earnings for children under age 7.
Number of Respondents: 20,000
Frequency of Response: 1
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 3,333 hours
3. Application for Child's Insurance Benefits--0960-0010. The
information on form SSA-4-BK is used by the Social Security
Administration to elicit information needed to determine eligibility of
benefits to the child of an insured individual retired because of old
age or disability, and to a surviving child of a deceased worker. The
respondents are children of fully insured wage earners.
Number of Respondents: 1,740,000
Frequency of Response: 1
Average Burden Per Response: Varies--10.5 or 15.5 minutes, depending on
type of claim
Estimated Annual Burden: 372,417 hours
4. Certificate of Responsibility for Welfare and Care of Child Not
in Applicant's Custody--0960-0019. The information on form SSA-781 is
used by the Social Security Administration to determine whether the
``In Care'' entitlement factor is met. The respondents are applicants
for benefits whose entitlement depends upon having an entitled child of
the wage earner in their care.
Number of Respondents: 14,000
Frequency of Response: 1
Average Burden Per Response: 10 minutes
Estimated Annual Burden: 2,333 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: Office of Management and
Budget, OIRA New Executive Office Building, Room 10230 Washington, DC
20503.
Date: February 8, 1995.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 95-3672 Filed 2-16-95; 8:45 am]
BILLING CODE 4190-29-P