80 FR 43828 - Agency Information Collection Activities: Proposed Request and Comment Request
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 80, Issue 141 (July 23, 2015)
Federal Register Volume 80, Issue 141 (July 23, 2015)
| Page Range | 43828-43830 | |
| FR Document | 2015-18040 |
[Federal Register Volume 80, Number 141 (Thursday, July 23, 2015)] [Notices] [Pages 43828-43830] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-18040] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No: SSA-2015-0046] 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 reinstatements 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, 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-2015-0046]. 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 21, 2015. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Authorization for the Social Security Administration to Obtain Account Records from a Financial Institution--20 CFR 416.200 and 416.203--0960-0293. SSA collects and verifies financial information from individuals applying for Supplemental Security Income (SSI) payments to determine if the applicant meets the SSI resource eligibility requirements. If the SSI claimants provide incomplete, unavailable, or seemingly altered records, SSA contacts their financial institutions to verify the existence, ownership, and value of accounts owned. Financial institutions require individuals to sign Form SSA- 4641-F4, or complete the e4641 electronic application, to authorize them to disclose records to SSA. The respondents are SSI applicants, recipients, and their deemors. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-4641 (paper)................................ 252,500 1 6 25,250 e4641 (electronic).............................. 15,747,500 1 2 524,917 --------------------------------------------------------------- Totals...................................... 16,000,000 .............. .............. 550,167 ---------------------------------------------------------------------------------------------------------------- 2. Site Review Questionnaire for Volume and Fee-for-Service Payees and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665, 416.701, and 416.708--0960-0633. SSA asks organizational representative payees to complete Form SSA-637, the Site Review Questionnaire for Volume and Fee-for-Service Payees, to provide information on how they carry out their responsibilities, including how they manage beneficiary funds. SSA then obtains information from the beneficiaries these organizations represent via Form SSA-639, Beneficiary Interview Form, to corroborate the payees' statements. Due to the sensitivity of the information, SSA employees always complete the forms based on the answers respondents give during the interview. The respondents are individuals, State and local governments, non-profit and for-profit organizations serving as representative payees, and the beneficiaries they serve. Type of Request: Revision of an OMB-approved information collection. [[Page 43829]] ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-637......................................... 1,999 1 120 3,998 SSA-639......................................... 8,293 1 10 1,382 --------------------------------------------------------------- Totals...................................... 10,292 .............. .............. 5,380 ---------------------------------------------------------------------------------------------------------------- 3. Notification of a Social Security Number (SSN) To An Employer for Wage Reporting--20 CFR 422.103(a)--0960-0778. Individuals applying for employment must provide a Social Security number (SSN), or indicate they have applied for one. However, when an individual applies for an initial SSN, there is a delay between the assignment of the number and the delivery of the SSN card. At an individual's request, SSA uses Form SSA-132 to send the individual's SSN to an employer. Mailing this information to the employer: (1) ensures the employer has the correct SSN for the individual; (2) allows SSA to receive correct earnings information for wage reporting purposes; and (3) reduces the delay in the initial SSN assignment and delivery of the SSN information directly to the employer. It also enables SSA to verify the employer as a safeguard for the applicant's personally identifiable information. The majority of individuals who take advantage of this option are in the United States with exchange visitor and student visas; however, we allow any applicant for an SSN to use the SSA-132. The respondents are individuals applying for an initial SSN who ask SSA to mail confirmation of their application or the SSN to their employers. 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) ---------------------------------------------------------------------------------------------------------------- SSA-132..................................... 298,953 1 2 9,965 ---------------------------------------------------------------------------------------------------------------- 4. Important Information About Your Appeal, Waiver Rights, and Repayment Options--20 CFR 404.502-521--0960-0779. When SSA accidentally overpays beneficiaries, the agency informs them of the following rights: (1) The right to reconsideration of the overpayment determination; (2) the right to request a waiver of recovery and the automatic scheduling of a personal conference if SSA cannot approve a request for waiver; and (3) the availability of a different rate of withholding when SSA proposes the full withholding rate. SSA uses Form SSA-3105, Important Information About Your Appeal, Waiver Rights, and Repayment Options, to explain these rights to overpaid individuals and allow them to notify SSA of their decision(s) regarding these rights. The respondents are overpaid claimants requesting a waiver of recovery for the overpayment; reconsideration of the fact of the overpayment; or a lesser rate of withholding of the overpayment. 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-3105.................................... 80,000 1 15 20,000 ---------------------------------------------------------------------------------------------------------------- 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 August 24, 2015. Individuals can obtain copies of the OMB clearance packages by writing to [email protected]. 1. Statement of Funds You Provided to Another and Statement of Funds You Received--20 CFR 404.1520(b), 404.1571-404.1576, 404.1584- 404.1593 and 416.971-416.976--0960-0059. SSA uses Form SSA-821-BK to collect recipient employment information to determine whether recipients worked after becoming disabled and, if so, whether the work is substantial gainful activity. SSA's field offices use Form SSA-821- BK to obtain work information during the initial claims process, the continuing disability review process, and for SSI claims involving work issues. SSA's processing centers and the Office of Disability and International Operations use the form to obtain post-adjudicative work issue from recipients. SSA reviews and evaluates the data to determine if the applicant or recipient meets the disability requirements of the law. The respondents are applicants and recipients of Title II Social Security and Title XVI SSI disability payments. Type of Request: Reinstatement with change of a previous OMB- approved information collection. [[Page 43830]] ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-821-BK.................................. 300,000 1 30 150,000 ---------------------------------------------------------------------------------------------------------------- 2. 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: Reinstatement without change of a previous OMB- approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-1414........................................ 6,000 1 2 200 ---------------------------------------------------------------------------------------------------------------- Date: July 19, 2015. Faye I. Lipsky, Reports Clearance Officer, Social Security Administration. [FR Doc. 2015-18040 Filed 7-22-15; 8:45 am] BILLING CODE 4191-02-P
![43828 Federal Register / Vol. 80, No. 141 / Thursday, July 23, 2015 / Notices
• Send an email to rule-comments@ should refer to File Number SR– Fax: 202–395–6974, Email address:
sec.gov. Please include File Number SR– ISEGemini-2015–13, and should be OIRA_Submission@omb.eop.gov.
ISEGemini-2015–13 on the subject line. submitted on or before August 13, 2015. (SSA) Social Security Administration,
Paper Comments For the Commission, by the Division of OLCA, Attn: Reports Clearance
Trading and Markets, pursuant to delegated Director, 3100 West High Rise, 6401
• Send paper comments in triplicate authority.9 Security Blvd., Baltimore, MD 21235,
to Brent J. Fields, Secretary, Securities Robert W. Errett, Fax: 410–966–2830, Email address:
and Exchange Commission, 100 F Street Deputy Secretary. OR.Reports.Clearance@ssa.gov.
NE., Washington, DC 20549–1090. [FR Doc. 2015–18032 Filed 7–22–15; 8:45 am] Or you may submit your comments
All submissions should refer to File BILLING CODE 8011–01–P
online through www.regulations.gov,
Number SR–ISEGemini-2015–13. This referencing Docket ID Number [SSA–
file number should be included on the 2015–0046].
subject line if email is used. To help the SOCIAL SECURITY ADMINISTRATION I. The information collections below
Commission process and review your are pending at SSA. SSA will submit
comments more efficiently, please use [Docket No: SSA–2015–0046] them to OMB within 60 days from the
only one method. The Commission will date of this notice. To be sure we
post all comments on the Commission’s Agency Information Collection consider your comments, we must
Internet Web site (http://www.sec.gov/ Activities: Proposed Request and receive them no later than September
rules/sro.shtml). Copies of the Comment Request 21, 2015. Individuals can obtain copies
submission, all subsequent The Social Security Administration of the collection instruments by writing
amendments, all written statements (SSA) publishes a list of information to the above email address.
with respect to the proposed rule collection packages requiring clearance 1. Authorization for the Social
change that are filed with the by the Office of Management and Security Administration to Obtain
Commission, and all written Budget (OMB) in compliance with Account Records from a Financial
communications relating to the Public Law 104–13, the Paperwork Institution—20 CFR 416.200 and
proposed rule change between the Reduction Act of 1995, effective October 416.203—0960–0293. SSA collects and
Commission and any person, other than 1, 1995. This notice includes revisions verifies financial information from
those that may be withheld from the and reinstatements of OMB-approved individuals applying for Supplemental
public in accordance with the information collections. Security Income (SSI) payments to
provisions of 5 U.S.C. 552, will be SSA is soliciting comments on the determine if the applicant meets the SSI
available for Web site viewing and accuracy of the agency’s burden resource eligibility requirements. If the
printing in the Commission’s Public estimate; the need for the information; SSI claimants provide incomplete,
Reference Room, 100 F Street NE., its practical utility; ways to enhance its unavailable, or seemingly altered
Washington, DC 20549 on official quality, utility, and clarity; and ways to records, SSA contacts their financial
business days between the hours of minimize burden on respondents, institutions to verify the existence,
10:00 a.m. and 3:00 p.m. Copies of such including the use of automated ownership, and value of accounts
filing also will be available for collection techniques or other forms of owned. Financial institutions require
inspection and copying at the principal information technology. Mail, email, or individuals to sign Form SSA–4641–F4,
office of the Exchange. All comments fax your comments and or complete the e4641 electronic
received will be posted without change; recommendations on the information application, to authorize them to
the Commission does not edit personal collection(s) to the OMB Desk Officer disclose records to SSA. The
identifying information from and SSA Reports Clearance Officer at respondents are SSI applicants,
submissions. You should submit only the following addresses or fax numbers. recipients, and their deemors.
information that you wish to make (OMB) Office of Management and Type of Request: Revision of an OMB-
available publicly. All submissions Budget, Attn: Desk Officer for SSA, approved information collection.
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
SSA–4641 (paper) ........................................................................................... 252,500 1 6 25,250
e4641 (electronic) ............................................................................................ 15,747,500 1 2 524,917
Totals ........................................................................................................ 16,000,000 ........................ ........................ 550,167
2. Site Review Questionnaire for responsibilities, including how they give during the interview. The
Volume and Fee-for-Service Payees and manage beneficiary funds. SSA then respondents are individuals, State and
Beneficiary Interview Form—20 CFR obtains information from the local governments, non-profit and for-
404.2035, 404.2065, 416.665, 416.701, beneficiaries these organizations profit organizations serving as
mstockstill on DSK4VPTVN1PROD with NOTICES
and 416.708—0960–0633. SSA asks represent via Form SSA–639, representative payees, and the
organizational representative payees to Beneficiary Interview Form, to beneficiaries they serve.
complete Form SSA–637, the Site corroborate the payees’ statements. Due
Review Questionnaire for Volume and to the sensitivity of the information, Type of Request: Revision of an OMB-
Fee-for-Service Payees, to provide SSA employees always complete the approved information collection.
information on how they carry out their forms based on the answers respondents
9 17 CFR 200.30–3(a)(12).
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![43830 Federal Register / Vol. 80, No. 141 / Thursday, July 23, 2015 / Notices
Average Estimated total
Number of Frequency of burden per
Modality of completion annual burden
respondents response response (hours)
(minutes)
SSA–821–BK ................................................................................................... 300,000 1 30 150,000
2. Credit Card Payment Form—0960– agreements; and (3) credit card reimbursable agreements with SSA, and
0648. SSA uses Form SSA–1414 to payments for all Freedom of Information individuals who request information
process: (1) Credit card payments from Act (FOIA) requests requiring payment. through FOIA.
former employees and vendors with The respondents are former employees Type of Request: Reinstatement
outstanding debts to the agency; (2) and vendors who have outstanding without change of a previous OMB-
advance payments for reimbursable debts to the agency, entities who have approved information collection.
Average Estimated total
Number of Frequency of burden per
Modality of completion annual burden
respondents response response (hours)
(minutes)
SSA–1414 ........................................................................................................ 6,000 1 2 200
Date: July 19, 2015. • Regular Mail: Send written We are soliciting public comments to
Faye I. Lipsky, comments to: Sophie Yan Gao, PRM/ permit the Department to:
Reports Clearance Officer, Social Security Admissions, 2025 E Street NW., SA–9, • Evaluate whether the proposed
Administration. 8th Floor, Washington, DC 20522–0908. information collection is necessary for
[FR Doc. 2015–18040 Filed 7–22–15; 8:45 am] • Fax: (202) 453–9393. the proper functions of the Department.
BILLING CODE 4191–02–P You must include the DS form • Evaluate the accuracy of our
number (if applicable), information estimate of the time and cost burden for
collection title, and the OMB control this proposed collection, including the
number in any correspondence. validity of the methodology and
DEPARTMENT OF STATE FOR FURTHER INFORMATION CONTACT: assumptions used.
Direct requests for additional • Enhance the quality, utility, and
[Public Notice 9199] clarity of the information to be
information regarding the collection
listed in this notice, including requests collected.
60-Day Notice of Proposed Information • Minimize the reporting burden on
Collection: Iraqi Citizens and Nationals for copies of the proposed collection
instrument and supporting documents, those who are to respond, including the
Employed by Federal Contractors and use of automated collection techniques
Grantees to Sophie Yan Gao, PRM/Admissions,
2025 E Street NW., SA–9, 8th Floor, or other forms of information
Washington, DC 20522–0908, who may technology.
Notice of request for public
ACTION:
Please note that comments submitted
comment. be reached on (202) 453–9255 or at
in response to this Notice are public
GaoY1@state.gov.
SUMMARY: The Department of State is record. Before including any detailed
seeking Office of Management and SUPPLEMENTARY INFORMATION: personal information, you should be
Budget (OMB) approval for the • Title of Information Collection: Iraqi aware that your comments as submitted,
information collection described below. Citizens and Nationals Employed by including your personal information,
In accordance with the Paperwork Federal Contractors and Grantees. will be available for public review.
Reduction Act of 1995, we are • OMB Control Number: 1405–0184.
• Type of Request: Revision of a Abstract of Proposed Collection
requesting comments on this collection
from all interested individuals and Currently Approved Collection. The information requested will be
organizations. The purpose of this • Originating Office: Bureau of used to verify the employment of Iraqi
notice is to allow 60 days for public Population, Refugees, and Migration, citizens and nationals for the processing
comment preceding submission of the Office of Admissions, PRM/A. and adjudication of other refugee,
• Form Number: N/A. asylum, special immigrant visa, and
collection to OMB.
• Respondents: Refugee applicants for other immigration claims and
DATES: The Department will accept the U.S. Refugee Admissions Program. applications.
comments from the public up to • Estimated Number of Respondents:
September 21, 2015. 50 Department of State contractors, Methodology
ADDRESSES: You may submit comments grantees, and cooperative agreement The method for the collection of
by any of the following methods: partners. information will be via electronic
• Web: Persons with access to the • Estimated Number of Responses: submission. The format for compiling
mstockstill on DSK4VPTVN1PROD with NOTICES
Internet may comment on this notice by 200. the information will be the Department
going to www.Regulations.gov. You can • Average Time per Response: 30 of State’s eForms application which is
search for the document by entering minutes. currently used by over 36,000
‘‘Docket Number: DOS–2015–0031’’ in • Total Estimated Burden Time: 100 Department users worldwide.
the Search field. Then click the hours. Contracting Officers and Grants Officers
‘‘Comment Now’’ button and complete • Frequency: On occasion. will distribute by email to the
the comment form. • Obligation to Respond: Required to contractors, grantees and cooperative
• Email: GaoY1@State.gov. Obtain a Benefit. agreement partners under their
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Document Created: 2015-12-15 12:53:37
Document Modified: 2015-12-15 12:53:37
| 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 | |
| Dates | July 19, 2015. Faye I. Lipsky, Reports Clearance Officer, Social Security Administration. [FR Doc. 2015-18040 Filed 7-22-15; 8:45 am] | |
| FR Citation | 80 FR 43828 |
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