[Federal Register Volume 71, Number 152 (Tuesday, August 8, 2006)]
[Notices]
[Pages 45090-45091]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-12803]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages that will require clearance by the
Office of Management and Budget (OMB) in compliance with Pub. L. 104-
13, the Paperwork Reduction Act of 1995, effective October 1, 1995. The
information collection packages that may be included in this notice are
for new information collections and 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 on ways to minimize
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed and/or faxed to the individuals
at the addresses and fax numbers listed below: (OMB) Office of
Management and Budget, Attn: Desk Officer for SSA, Fax: 202-395-6974;
(SSA) Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235,
Fax: 410-965-6400.
I. The information collection listed below is pending at SSA and
will be submitted to OMB within 60 days from the date of this notice.
Therefore, your comments should be submitted to SSA within 60 days from
the date of this publication. You can obtain copies of the collection
instrument by calling the SSA Reports Clearance Officer at 410-965-0454
or by writing to the address listed above.
1. Vendor List Registration Form--0960-NEW. The Social Security
Administration (SSA) maintains an Employer Wage Reporting and
Instructions Vendor Web site. On this site, relevant vendors are
allowed to list their products and services free of charge. Vendors
wishing to list their information on the site can submit these requests
via a written registration form, and will soon be able to use a new
electronic means of submitting the information through the Web site
itself. The respondents are vendors dealing with vendors who offer
employer wage reporting services and want SSA to list their information
on its Web site.
Type of Request: New information collection.
Number of Respondents: 500.
Frequency of Response: 1.
Average Burden Per Response: 8 minutes.
Estimated Annual Burden: 67 hours.
II. The information collections listed below have been submitted to
OMB for clearance. Your comments on the information collections would
be most
[[Page 45091]]
useful if received by OMB and SSA within 30 days from the date of this
publication. You can obtain a copy of the OMB clearance packages by
calling the SSA Reports Clearance Officer at 410-965-0454 or by writing
to the address listed above.
1. Function Report--Adult--20 CFR 404.1512 and 419.912--0960-0681.
Form SSA-3373 is used to collect information about a disability
applicant's impairment-related limitations and ability to function. It
documents the types of information specified in SSA regulations and
provides disability interviewers with a convenient means to record
information about how the claimant's condition affects his or her
ability to function. This information, together with medical evidence,
forms the evidentiary basis upon which the initial disability process
is founded. The respondents are Title II and Title XVI benefits
applicants.
Type of Request: Revision to an OMB-approved information
collection.
Number of Respondents: 4,005,367.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 4,005,367 hours.
2. Certificate of Incapacity--5 CFR 890.302(d)--0960-NEW. Rules
governing the Federal Employee Health Benefits (FEHB) plan state that
for federal employees' children ages 22 or over to retain health
benefits, they must be incapable of self-support due to a disability
that (1) pre-dated the child's 22nd birthday, (2) is very serious, and
(3) can be expected to last at least one year. Form SSA-604, the
Certificate of Incapacity, is used by physicians to document and
certify such a disability for their patients who are children of
federal employees.
The respondents are physicians of federal employees' children ages
22 or over who are seeking to retain health benefits under their
parent's FEHB coverage.
Type of Request: New information collection.
Number of Respondents: 38.
Frequency of Response: 1.
Average Burden Per Response: 45 minutes.
Estimated Annual Burden: 29 hours.
3. SSA Survey of Ticket to Work Beneficiaries--0960-NEW. The Social
Security Administration (SSA) plans to survey two groups of Social
Security beneficiaries who qualified for the Ticket to Work program.
The first group consists of those beneficiaries who did choose to enter
the program, while those in the second group did not. The information
gathered by the survey will be used to assess and contrast the social
and media interaction preferences of these beneficiaries, both on a
general level and specifically in relation to media preferences for the
Ticket to Work program. SSA will use this information to determine what
role, if any, the type of media outlet SSA used played in a
beneficiary's decision to join the Ticket to Work program and to
improve interactions with potential Ticket to Work program
participants. The respondents are Social Security beneficiaries who
qualified for the Ticket to Work program.
Type of Request: New information collection.
Number of Respondents: 800.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 200 hours.
Dated: August 2, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-12803 Filed 8-7-06; 8:45 am]
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