80 FR 24307 - Agency Information Collection Activities: Proposed Request and Comment Request
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 80, Issue 83 (April 30, 2015)
Federal Register Volume 80, Issue 83 (April 30, 2015)
| Page Range | 24307-24310 | |
| FR Document | 2015-10057 |
[Federal Register Volume 80, Number 83 (Thursday, April 30, 2015)] [Notices] [Pages 24307-24310] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-10057] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No: SSA-2015-0027] 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 an extension of OMB-approved information collections, and one new information collection. 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-2015-0015]. 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 June 29, 2015. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. 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 Social Security Number Application Process (SSNAP) when [[Page 24308]] applicants request a new or replacement 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. Additionally, the iSSNRC application will collect information similar to the paper SS-5 for no-change replacement SSN cards for adult U.S. citizens. A new iSSNRC modality included in the current clearance will allow certain applicants for an SSN replacement card to apply by completing an internet application and submitting the required evidence online rather than completing a paper Form SS-5, Application for a Social Security Card. 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. 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 1,500,000 1 5 125,000 card with no changes through new iSSNRC modality....................................... Respondents whom we ask to provide parents' SSNs 400,000 1 9 60,000 (when applying for original SSN cards for children under age 18)......................... Applicants age 12 or older who need to answer 1,500,000 1 9.5 237,500 additional questions so SSA can determine whether we previously assigned an SSN.......... Applicants asking for a replacement SSN card 900 1 60 900 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...................................... 13,901,900 .............. .............. 1,911,150 ---------------------------------------------------------------------------------------------------------------- * The total timeline for complete national coverage of the iSSNRC application is two years from the date of initial implementation and is dependent on the contractor enrolling each State into the network. By FY 2018, we would expect to issue about 1.5 million replacement cards annually via the iSSNRC application. However, the estimated volume could vary based on the date of implementation, when the contractor acquires States, and our marketing efforts to the public. Cost Burden: The state BVSs incur costs of approximately $11 million for transmitting data to SSA's mainframe. However, SSA reimburses the states for these costs. 2. Third Party Liability Information Statement--42 CFR 433.136- 433.139--0960-0323. To reduce Medicaid costs, Medicaid state agencies must identify third party insurers liable for medical care or services for Medicaid beneficiaries. Regulations at 42 CFR 433.136-433.139 require Medicaid state agencies to obtain this information on Medicaid applications and redeterminations as a condition of Medicaid eligibility. States may enter into agreements with the Commissioner of Social Security to make Medicaid eligibility determinations for aged, blind, and disabled beneficiaries in those states. Applications for and redeterminations of Supplemental Security Income (SSI) eligibility in jurisdictions with such agreements are applications and redeterminations of Medicaid eligibility. Under these agreements, SSA obtains third party liability information using Form SSA-8019, and provides that information to the Medicaid state agencies. The Medicaid state agencies use the information to bill third parties liable for medical care, support, or services for a beneficiary to guarantee that Medicaid remains the payer of last resort. The respondents are SSI claimants and recipients. 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-8012 Paper form............................. 200 1 5 17 Modernized SSI Claims System (MSSICS)........... 51,381 1 5 4,282 --------------------------------------------------------------- Totals...................................... 51,581 .............. .............. 4,299 ---------------------------------------------------------------------------------------------------------------- 3. Request for Deceased Individual's Social Security Record--20 CFR 402.130--0960-0665. When a member of the public requests an individual's Social Security record, SSA needs the name and address of the requestor as well as a description of the requested record to process the request. SSA uses the information the respondent provides on Form SSA-711, or via an Internet request through SSA's electronic Freedom of Information Act (eFOIA) Web site, to (1) verify the wage earner is deceased and (2) access the correct Social Security record. Respondents are members of the public requesting deceased individuals' Social Security records. [[Page 24309]] 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) ---------------------------------------------------------------------------------------------------------------- Internet Request through eFOIA.................. 49,800 1 7 5,810 SSA-711 (paper)................................. 200 1 7 23 --------------------------------------------------------------- Total....................................... 50,000 .............. .............. 5,833 ---------------------------------------------------------------------------------------------------------------- Cost Burden *: In addition, SSA charges fees to the respondent for this information. The following chart shows the fees per transaction based on the information the respondent provides on the SSA-711 (or in eFOIA): ------------------------------------------------------------------------ Information provided Cost per Modality of completion (or not provided) transaction ------------------------------------------------------------------------ SSA-711 (paper)................... SSN of decedent is $29 not provided. SSA-711 (paper)................... SSN of decedent is $27 provided. eFOIA (Internet).................. SSN of decedent is $18 not provided. ------------------------------------------------------------------------ * As these costs are dependent on the respondent's provided information, we charge them on an as needed basis, and cannot provide a total annual estimate of the cost burden. We do not know whether the respondent provided the decedent's SSN until we manually review and process each SSA-711. 4. 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, and State disability determinations services on our behalf, collect the information using Form SSA-3373. We use the information to document how claimants' disabilities affect their ability to function, and to determine 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 Number of Frequency of burden per Estimated Modality of completion respondents response response total annual (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-3373........................................ 2,085,721 1 61 2,120,483 ---------------------------------------------------------------------------------------------------------------- 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 1, 2015. Individuals can obtain copies of the OMB clearance packages by writing to [email protected]. 1. Data Exchange Request Form--20 CFR 401.100--0960-NEW. SSA maintains approximately 3,000 data exchange agreements and regularly receives new requests from Federal, State, local, and foreign governments, as well as private organizations, to share data electronically. SSA engages in various forms of data exchanges from Social Security number verifications to computer matches for benefit eligibility, depending on the requestor's business needs. Section 1106 of the Social Security Act requires we consider the requestor's legal authority to receive the data, our disclosure policies, systems' feasibility, systems' security, and costs before entering into a data exchange agreement. We will use Form SSA-157, Data Exchange Request Form, for this purpose. Requesting agencies, governments, or private organizations will use the form when voluntarily initiating a request for data exchange from SSA. Respondents are Federal, State, local, and foreign governments, as well as private organizations seeking to share data electronically with SSA. This is a correction notice: SSA published the incorrect burden information for this collection at 80 FR 9499, on February 23, 2015. We are correcting this error here. Type of Request: This is a new information collection request. ---------------------------------------------------------------------------------------------------------------- Average Number of Frequency of burden per Estimated Modality of completion respondents response response total annual (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-157......................................... 121 1 30 61 ---------------------------------------------------------------------------------------------------------------- 2. Statement of Self-Employment Income--20 CFR 404.101, 404.110, 404.1096(a)-(d)--0960-0046. To qualify for insured status and thus collect Social Security benefits, self-employed individuals must demonstrate they have [[Page 24310]] earned the minimum amount of self-employment income (SEI) in a current year. SSA uses Form SSA-766, Statement of Self-Employment Income, to collect the information we need to determine if the individual will have at least the minimum amount of SEI needed for one or more quarters of coverage in the current year. Based on the information we obtain, we may credit additional quarters of coverage to give the individual insured status thus expediting benefit payments. Respondents are self-employed individuals who may be eligible for Social Security benefits. 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-766......................................... 2,500 1 5 208 ---------------------------------------------------------------------------------------------------------------- 3. Request for Workers' Compensation/Public Disability Benefit Information--20 CFR 404.408(e)--0960-0098. Claimants for Social Security disability payments who are also receiving Worker's Compensation/Public Disability Benefits (WC/PDB) must notify SSA about their WC/PDB, so the agency can reduce claimants' Social Security disability payments accordingly. If claimants provide necessary evidence, such as a copy of their award notice, benefit check, etc., that is sufficient verification. In cases where claimants cannot provide such evidence, SSA uses Form SSA-1709. The entity paying the WC/PDB benefits, its agent (such as an insurance carrier), or an administering public agency complete this form. The respondents are Federal, State, and local agencies, insurance carriers, and public or private self-insured companies administering WC/PDB benefits to disability claimants. This is a correction notice. SSA published this information collection as a revision on February 23, 2015 at 80 FR 9500. Since we are not revising the Privacy Act Statement, this is now an extension of an OMB-approved information collection. Type of Request: Extension 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-1709........................................ 120,000 1 15 30,000 ---------------------------------------------------------------------------------------------------------------- Dated: April 27, 2015. Faye I. Lipsky, Reports Clearance Officer, Social Security Administration. [FR Doc. 2015-10057 Filed 4-29-15; 8:45 am] BILLING CODE 4191-02-P
![Federal Register / Vol. 80, No. 83 / Thursday, April 30, 2015 / Notices 24307
Putnam Capital Appreciation Fund Putnam Tax-Free Health Care Fund SOCIAL SECURITY ADMINISTRATION
[File No. 811–7061] [File No. 811–6659]
[Docket No: SSA–2015–0027]
Summary: Applicant seeks an order Summary: Applicant, a closed-end
declaring that it has ceased to be an investment company, seeks an order Agency Information Collection
investment company. Applicant declaring that it has ceased to be an Activities: Proposed Request and
transferred its assets to Putnam investment company. Applicant Comment Request
Investors Fund, and on December 29, transferred its assets to Putnam Tax
2008, made a distribution to its The Social Security Administration
Exempt Income Fund, and on (SSA) publishes a list of information
shareholders based on net asset value. September 17, 2007, made a distribution
Expenses of approximately $66,568 collection packages requiring clearance
to its shareholders based on net asset by the Office of Management and
incurred in connection with the value. Expenses of approximately
reorganization were paid by applicant. Budget (OMB) in compliance with
$335,299 incurred in connection with Public Law 104–13, the Paperwork
Filing Date: The application was filed
the reorganization were paid by Reduction Act of 1995, effective October
on April 15, 2015.
Applicant’s Address: One Post Office applicant. 1, 1995. This notice includes revisions
Sq., Boston, MA 02109. Filing Date: The application was filed and an extension of OMB-approved
on April 13, 2015. information collections, and one new
Putnam Classic Equity Fund [File No. information collection.
811–7223] Applicant’s Address: One Post Office
SSA is soliciting comments on the
Sq., Boston, MA 02109.
Summary: Applicant seeks an order accuracy of the agency’s burden
declaring that it has ceased to be an Martin Currie Business Trust [File No. estimate; the need for the information;
investment company. Applicant 811–8612] its practical utility; ways to enhance its
transferred its assets to The Putnam quality, utility, and clarity; and ways to
Fund for Growth and Income, and on Summary: Applicant seeks an order minimize burden on respondents,
December 29, 2008, made distributions declaring that it has ceased to be an including the use of automated
to its shareholders based on net asset investment company. On January 30, collection techniques or other forms of
value. Expenses of approximately 2015, applicant made a liquidating information technology. Mail, email, or
$66,568 incurred in connection with the distribution to its shareholders, based fax your comments and
reorganization were paid by applicant. on net asset value. Expenses of $87,460 recommendations on the information
Filing Date: The application was filed incurred in connection with the collection(s) to the OMB Desk Officer
on April 15, 2015. liquidation were paid by Martin Currie, and SSA Reports Clearance Officer at
Applicant’s Address: One Post Office Inc., applicant’s investment adviser. the following addresses or fax numbers.
Sq., Boston, MA 02109. Filing Dates: The application was (OMB), Office of Management and
Putnam Discovery Growth Fund [File filed on March 24, 2015, and amended Budget, Attn: Desk Officer for SSA,
No. 811–6203] on April 23, 2015. Fax: 202–395–6974, Email address:
Applicant’s Address: Saltire Court, 20 OIRA_Submission@omb.eop.gov.
Summary: Applicant seeks an order (SSA), Social Security Administration,
declaring that it has ceased to be an Castle Terrace, Edinburgh, Scotland
EH1 2ES. OLCA, Attn: Reports Clearance
investment company. Applicant Director, 3100 West High Rise, 6401
transferred its assets to Putnam New Security Equity Fund [File No. 811– Security Blvd., Baltimore, MD 21235,
Opportunities Fund (now known as 22932] Fax: 410–966–2830, Email address:
Putnam Multi-Cap Growth Fund), and OR.Reports.Clearance@ssa.gov.
on December 29, 2008, made a Summary: Applicant seeks an order
distribution to its shareholders based on declaring that i0t has ceased to be an Or you may submit your comments
net asset value. Expenses of investment company. Applicant online through www.regulations.gov,
approximately $66,568 incurred in transferred its assets to a corresponding referencing Docket ID Number [SSA–
connection with the reorganization were shell series of Guggenheim Funds Trust, 2015–0015].
paid by applicant. and on January 27, 2014 and September I. The information collections below
Filing Date: The application was filed 23, 2014, made distributions to its are pending at SSA. SSA will submit
on April 15, 2015. shareholders based on net asset value. them to OMB within 60 days from the
Applicant’s Address: One Post Office Expenses of $523,662 incurred in date of this notice. To be sure we
Sq., Boston, MA 02109. connection with the reorganization were consider your comments, we must
paid by applicant and Security receive them no later than June 29,
Putnam OTC & Emerging Growth Fund 2015. Individuals can obtain copies of
[File No. 811–3512] Investors, LLC, applicant’s investment
adviser. the collection instruments by writing to
Summary: Applicant seeks an order the above email address.
declaring that it has ceased to be an Filing Dates: The application was 1. Application for a Social Security
investment company. Applicant filed on February 19, 2015, and Number Card, the Social Security
transferred its assets to Putnam Vista amended on April 23, 2015. Number Application Process (SSNAP),
Fund, and on December 29, 2008, made Applicant’s Address: 805 King Farm and Internet SSN Replacement Card
distributions to its shareholders based Blvd., Ste. 600, Rockville, MD 20850. (iSSNRC) Application—20 CFR
mstockstill on DSK4VPTVN1PROD with NOTICES
on net asset value. Expenses of For the Commission, by the Division of
422.103–422.110—0960–0066. SSA
approximately $66,568 incurred in Investment Management, pursuant to
collects information on the SS–5 (used
connection with the reorganization were delegated authority. in the United States) and SS–5–FS (used
paid by applicant. outside the United States) to issue
Brent J. Fields,
Filing Date: The application was filed original or replacement Social Security
on April 15, 2015. Secretary. cards. SSA also enters the application
Applicant’s Address: One Post Office [FR Doc. 2015–10094 Filed 4–29–15; 8:45 am] data into the Social Security Number
Sq., Boston, MA 02109. BILLING CODE 8011–01–P Application Process (SSNAP) when
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![24310 Federal Register / Vol. 80, No. 83 / Thursday, April 30, 2015 / Notices
earned the minimum amount of self- needed for one or more quarters of Respondents are self-employed
employment income (SEI) in a current coverage in the current year. Based on individuals who may be eligible for
year. SSA uses Form SSA–766, the information we obtain, we may Social Security benefits.
Statement of Self-Employment Income, credit additional quarters of coverage to Type of Request: Revision of an OMB-
to collect the information we need to give the individual insured status thus approved information collection.
determine if the individual will have at expediting benefit payments.
least the minimum amount of SEI
Average Estimated total
Number of Frequency of burden per
Modality of completion annual burden
respondents response response (hours)
(minutes)
SSA–766 .......................................................................................................... 2,500 1 5 208
3. Request for Workers’ their award notice, benefit check, etc., WC/PDB benefits to disability
Compensation/Public Disability Benefit that is sufficient verification. In cases claimants.
Information—20 CFR 404.408(e)—0960– where claimants cannot provide such This is a correction notice. SSA
0098. Claimants for Social Security evidence, SSA uses Form SSA–1709. published this information collection as
disability payments who are also The entity paying the WC/PDB benefits, a revision on February 23, 2015 at 80 FR
receiving Worker’s Compensation/ its agent (such as an insurance carrier), 9500. Since we are not revising the
Public Disability Benefits (WC/PDB) or an administering public agency
must notify SSA about their WC/PDB, Privacy Act Statement, this is now an
complete this form. The respondents are extension of an OMB-approved
so the agency can reduce claimants’ Federal, State, and local agencies,
Social Security disability payments information collection.
insurance carriers, and public or private
accordingly. If claimants provide Type of Request: Extension of an
self-insured companies administering
necessary evidence, such as a copy of OMB-approved information collection.
Average Estimated total
Number of Frequency of burden per
Modality of completion annual burden
respondents response response (hours)
(minutes)
SSA–1709 ........................................................................................................ 120,000 1 15 30,000
Dated: April 27, 2015. Still Life,’’ imported from abroad for Dated: April 20, 2015.
Faye I. Lipsky, temporary exhibition within the United Kelly Keiderling,
Reports Clearance Officer, Social Security States, are of cultural significance. The Principal Deputy Assistant Secretary, Bureau
Administration. objects are imported pursuant to loan of Educational and Cultural Affairs,
[FR Doc. 2015–10057 Filed 4–29–15; 8:45 am] agreements with the foreign owners or Department of State.
BILLING CODE 4191–02–P custodians. I also determine that the [FR Doc. 2015–10147 Filed 4–29–15; 8:45 am]
exhibition or display of the exhibit BILLING CODE 4710–05–P
objects at the Crystal Bridges Museum of
DEPARTMENT OF STATE American Art, Bentonville, Arkansas,
from on or about May 16, 2015, until on DEPARTMENT OF STATE
[Public Notice 9119] or about September 14, 2015, the High [Public Notice: 9116]
Museum of Art, Atlanta, Georgia, from
Culturally Significant Objects Imported on or about September 26, 2015, until Culturally Significant Objects Imported
for Exhibition Determinations: on or about January 31, 2016, and at for Exhibition Determinations: ‘‘FRIDA
‘‘American Encounters: The Simple KAHLO: Art, Garden, Life’’ Exhibition
possible additional exhibitions or
Pleasures of Still Life’’
venues yet to be determined, is in the SUMMARY: Notice is hereby given of the
SUMMARY: Notice is hereby given of the national interest. I have ordered that following Determinations: Pursuant to
following determinations: Pursuant to Public Notice of these Determinations the authority vested in me by the Act of
the authority vested in me by the Act of be published in the Federal Register. October 19, 1965 (79 Stat. 985; 22 U.S.C.
October 19, 1965 (79 Stat. 985; 22 U.S.C. 2459), Executive Order 12047 of March
FOR FURTHER INFORMATION CONTACT: For
2459), Executive Order 12047 of March 27, 1978, the Foreign Affairs Reform and
27, 1978, the Foreign Affairs Reform and further information, including a list of Restructuring Act of 1998 (112 Stat.
Restructuring Act of 1998 (112 Stat. the imported objects, contact the Office 2681, et seq.; 22 U.S.C. 6501 note, et
2681, et seq.; 22 U.S.C. 6501 note, et of the Legal Adviser, U.S. Department of seq.), Delegation of Authority No. 234 of
State, SA–5, L/PD, Fifth Floor (Suite
mstockstill on DSK4VPTVN1PROD with NOTICES
seq.), Delegation of Authority No. 234 of October 1, 1999, Delegation of Authority
October 1, 1999, and Delegation of 5H03), Washington, DC 20522–0505, No. 236–3 of August 28, 2000 (and, as
Authority No. 236–3 of August 28, 2000 telephone (202–632–6471), or email at appropriate, Delegation of Authority No.
(and, as appropriate, Delegation of section2459@state.gov. 257 of April 15, 2003), I hereby
Authority No. 257 of April 15, 2003), I determine that the objects to be
hereby determine that the objects to be included in the exhibition ‘‘FRIDA
included in the exhibition ‘‘American KAHLO: Art, Garden, Life,’’ imported
Encounters: The Simple Pleasures of from abroad for temporary exhibition
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Document Created: 2018-02-21 10:15:11
Document Modified: 2018-02-21 10:15:11
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| FR Citation | 80 FR 24307 |
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