80 FR 53608 - 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 Extensions of OMB-Approved Information Collections.
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 80, Issue 172 (September 4, 2015)
Federal Register Volume 80, Issue 172 (September 4, 2015)
| Page Range | 53608-53611 | |
| FR Document | 2015-21967 |
[Federal Register Volume 80, Number 172 (Friday, September 4, 2015)] [Notices] [Pages 53608-53611] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-21967] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No: SSA-2015-0052] 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 Extensions 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- 0052]. 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 November 3, 2015. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. The Ticket to Work and Self-Sufficiency Program--20 CFR 411-- 0960-0644. SSA's Ticket to Work (TTW) Program transitions Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) recipients toward independence by allowing them to receive Social Security payments while maintaining employment under the auspices of the program. SSA uses service providers, called Employment Networks (ENs), to supervise participant progress through the stages of TTW Program participation, such as job searches and interviews, progress reviews, and changes in ticket status. ENs can be private for-profit and nonprofit organizations, as well as state vocational rehabilitation agencies (VRs). SSA and the ENs utilize the TTW program manager to operate the TTW Program and exchange information about participants. For example, the ENs use the program manager to provide updates on tasks such as selecting a payment system or requesting payments for helping the beneficiary achieve certain work goals. Since the ENs are not PRA-exempt, the multiple information collections within the TTW program manager require OMB approval, and we clear them under this information collection request (ICR). Most of the categories of information in this ICR are necessary for SSA to: (1) Comply with the Ticket to Work legislation; and (2) provide proper oversight of the program. SSA collects this information through several modalities, including forms, electronic exchanges, and written documentation. The respondents are the ENs or state VRs, as well as SSDI [[Page 53609]] beneficiaries, and blind or disabled SSI recipients working under the auspices of the TTW Program. Type of Collection: 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) ---------------------------------------------------------------------------------------------------------------- a) 20 CFR 411.140(d)(2)--Interactive 6,428 1 2.5 268 Voice Recognition Telephone........ a) 20 CFR 411.140(d)(2)--Portal..... 25,713 1 1.25 536 a) 20 CFR 411.140(d)(3)--Virtual Job 500 1 10 83 Fair Registration-Employment Networks........................... a) 20 CFR 411.140(d)(3); 411.325(a); 948 1 15 237 411.150(b)(3)--SSA-1365............ a) 20 CFR 411.140(d)(3); 411.325(a); 3,792 1 11 695 411.150(b)(3)--SSA-1365 Portal..... a) 20 CFR 411.140(d)(3); 411.325(a); 1,956 1 60 1,956 411.150(b)(3)--SSA-1370............ a) 20 CFR 411.140(d)(3); 411.325(a); 5,868 1 10 978 411.150(b)(3)--SSA-1370 Portal..... a) 20 CFR 411.166; 411.170(b)-- 40,324 1 5 3,360 Electronic File Submission......... b) 20 CFR 411.145; 411.325.......... 2,494 1 15 624 b) 20 CFR 411.145; 411.325--Portal.. 7,481 1 11 1,372 b) 20 CFR 411.535(a)(1)(iii)--Data 8,505 1 5 709 Sharing/Portal..................... c) 20 CFR 411.192(b) & (c).......... 6 1 30 3 c) 20 CFR 411.200(b)--SSA-1375...... 112,362 1 15 28,091 c) 20 CFR 411.200(b)--Portal........ 64,824 1 5 5,402 c) 20 CFR 411.210(b)................ 41 1 30 21 c) 20 CFR 411.200(b) Wise Webinar 24,000 1 3 1,200 Registration Page.................. c) 20 CFR 411.200(b) Virtual Job 9,000 1 10 1,500 Fair Registration.................. d) 20 CFR 411.365; 411.505; 411.515. 6 1 10 1 e) 20 CFR 411.325(d); 411.415....... 1* 1 480 8 f) 20 CFR 411.575--SSA-1389; SSA- 2,805 1 40 1,870 1391; SSA-1393; SSA-1396; SSA-1398; SSA-1399........................... f) 20 CFR 411.575--Portal........... 42,075 1 22 15,427 f) 20 CFR 411.575--Automatic 11,220 1 0 0 Payments........................... f) 20 CFR 411.560--SSA-1401......... 100 1 20 33 g) 20 CFR 411.325(f)................ 1,371 1 45 1,028 h) 20 CFR 411.435; 411.615; 411.625. 2 1 120 4 i) 20 CFR 411.320--SSA-1394......... 52 1 10 9 i) 20 CFR 411.320--SSA-1394 Portal.. 158 1 5 13 --------------------------------------------------------------------------- Totals.......................... 372,032 ................. ................. 65,428 ---------------------------------------------------------------------------------------------------------------- * (None received in 2012, 2013, 2014) 2. Representative Payment Policies and Administrative Procedures for Imposing Penalties for False or Misleading Statements or Withholding of Information--0960-0740. This information collection request comprises several regulation sections that provide additional safeguards for Social Security beneficiaries' whose representative payees receive their payment. SSA requires representative payees to notify them of any event or change in circumstances that would affect receipt of benefits or performance of payee duties. SSA uses the information to determine continued eligibility for benefits, the amount of benefits due and if the payee is suitable to continue servicing as payee. The respondents are representative payees who receive and use benefits on behalf of Social Security beneficiaries. Type of Request: Extension of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion (regulation Number of Frequency of per response annual burden citation) respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- 404.2035(d)--Paper/Mail............. 28,600 1 5 2,383 404.2035(d)--Office interview/ 543,400 1 5 45,283 Intranet........................... 404.2035(f)--Paper/Mail............. 286 1 5 24 404.2035(f)--Office interview/ 5,434 1 5 453 Intranet........................... 416.635(d)--Paper/Mail.............. 15,600 1 5 1,300 416.635(d)--Office interview/ 286,400 1 5 23,867 Intranet........................... 416.635(f)--Paper/Mail.............. 156 1 5 13 416.635(f)--Office interview/ 2,964 1 5 247 Intranet........................... --------------------------------------------------------------------------- Totals.......................... 882,840 ................. ................. 73,570 ---------------------------------------------------------------------------------------------------------------- [[Page 53610]] 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 October 5, 2015. Individuals can obtain copies of the OMB clearance packages by writing to [email protected]. 1. Statement of Employer--20 CFR 404.801-404.803--0960-0030. When workers report they were paid wages but cannot provide proof of those earnings, and the wages do not appear in SSA's records of earnings, SSA uses Form SSA-7011-F4 to document the alleged wages. Specifically, the agency uses the form to resolve discrepancies in the individual's Social Security earnings record and to process claims for Social Security benefits. We only send Form SSA-7011-F4 to employers if we are unable able to locate the earnings information within our own records. The respondents are employers who can verify wage allegations made by wage earners. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden per Estimated total Modality of completion Number of Frequency of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-7011-F4..................... 500 1 20 167 ---------------------------------------------------------------------------------------------------------------- 2. Substitution of Party Upon Death of Claimant--20 CFR 404.957(c)(4) and 416.1457(c)(4)--0960-0288. An administrative law judge (ALJ) may dismiss a request for a hearing on a pending claim of a deceased individual for Social Security benefits or SSI payments. Individuals who believe the dismissal may adversely affect them may complete Form HA-539, which allows them to request to become a substitute party for the deceased claimant. The ALJs and the hearing office support staff use this information from the HA-539 to: (1) Maintain a written record of request; (2) establish the relationship of the requester to the deceased claimant; (3) determine the substituted individual's wishes regarding an oral hearing or decision on the record; and (4) admit the data into the claimant's official record as an exhibit. The respondents are individuals requesting to be a substitute party for a deceased claimant. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden per Estimated total Modality of completion Number of Frequency of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- HA-539.......................... 4,000 1 5 333 ---------------------------------------------------------------------------------------------------------------- 3. Claimant Statement about Loan of Food or Shelter; Statement about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148-- 0960-0529. SSA bases an SSI claimant or recipient's eligibility on need, as measured by the amount of income an individual receives. Per our calculations, income includes other people providing in-kind support and maintenance in the form of food and shelter to SSI applicants or recipients. SSA uses Forms SSA-5062 and SSA-L5063 to obtain statements about food or shelter provided to SSI claimants or recipients. SSA uses this information to determine whether food or shelters are bona fide loans or income for SSI purposes. This determination may affect claimants' or recipients' eligibility for SSI as well as the amounts of their SSI payments. The respondents are claimants and recipients for SSI payments, and individuals who provide loans of food or shelter to them. 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-5062 Paper form................. 34,752 1 10 5,792 SSA-L5063 Paper form................ 34,752 1 10 5,792 SSA-5062 Modernized SSI Claims 34,752 1 10 5,792 System (MSSICS).................... SSA-L5063 MSSICS.................... 34,752 1 10 5,792 --------------------------------------------------------------------------- Total........................... 139,008 ................. ................. 3,168 ---------------------------------------------------------------------------------------------------------------- 4. Representative Payee Report of Benefits and Dedicated Account-- 20 CFR 416.546, 416.635, 416.640, 416.665--0960-0576. SSA requires representative payees (RPs) to submit a written report accounting for the use of money paid to Social Security or SSI recipients, and to establish and maintain a dedicated account for these payments. SSA uses Form SSA-6233 to: (1) Ensure the RPs use the payments for the recipient's current maintenance and personal needs; and (2) confirm the expenditures of funds from the dedicated account remain in compliance with the law. Respondents are RPs for SSI and Social Security recipients. Type of Request: Revision of an OMB-approved information collection. [[Page 53611]] ---------------------------------------------------------------------------------------------------------------- Average burden per Estimated total Modality of completion Number of Frequency of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-6233........................ 30,000 1 20 10,000 ---------------------------------------------------------------------------------------------------------------- 5. Application for Circuit Court Law--20 CFR 404.985 & 416.1458-- 0960-0581. Persons claiming an acquiescence ruling (AR) would change SSA's prior determination or decision must submit a written readjudication request with specific information. SSA reviews the information in the requests to determine if the issues stated in the AR pertain to the claimant's case, and if the claimant is entitled to readjudication. If readjudication is appropriate, SSA considers the issues the AR covers. Any new determination or decision is subject to administrative or judicial review as specified in the regulations. Respondents are claimants for Social Security benefits and SSI payments who request readjudication. This information collection request is for the information claimants must provide to request readjudication. Type of Request: Extension of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden per Estimated total Modality of completion Number of Frequency of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- AR-based Readjudication......... 10,000 1 17 2,833 Requests........................ ---------------------------------------------------------------------------------------------------------------- 6. Certification of Prisoner Identity Information--20 CFR 422.107-- 0960-0688. Inmates of Federal, State, or local prisons may need a Social Security card as verification of their Social Security number for school or work programs, or as proof of employment eligibility upon release from incarceration. Before SSA can issue a replacement Social Security card, applicants must show SSA proof of their identity. People who are in prison for an extended period typically do not have current identity documents. Therefore, under formal written agreement with the correctional institution, SSA allows prison officials to verify the identity of certain incarcerated U.S. citizens who need replacement Social Security cards. Information prison officials provide comes from the official prison files, sent on correctional facility letterhead. SSA uses this information to establish the applicant's identity in the replacement Social Security card process. The respondents are prison officials who certify the identity of prisoners applying for replacement Social Security cards. Type of Request: Extension of an OMB-approved Information Collection. -------------------------------------------------------------------------------------------------------------------------------------------------------- Average burden per Estimated total Modality of completion Number of Frequency of (Number of response annual burden respondents response responses) (minutes) (hours) -------------------------------------------------------------------------------------------------------------------------------------------------------- Verification of Prisoner Identity Statements........ 1,000 200 (200,000) 3 10,000 -------------------------------------------------------------------------------------------------------------------------------------------------------- Dated: September 1, 2015. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2015-21967 Filed 9-3-15; 8:45 am] BILLING CODE 4191-02-PDEPARTMENT OF STATE
![53608 Federal Register / Vol. 80, No. 172 / Friday, September 4, 2015 / Notices
Commission takes such action, the For the Commission, by the Division of collection(s) to the OMB Desk Officer
Commission shall institute proceedings Trading and Markets, pursuant to delegated and SSA Reports Clearance Officer at
to determine whether the proposed rule authority.17 the following addresses or fax numbers.
should be approved or disapproved. Robert W. Errett, (OMB), Office of Management and
Deputy Secretary. Budget, Attn: Desk Officer for SSA, Fax:
IV. Solicitation of Comments 202–395–6974, Email address: OIRA_
[FR Doc. 2015–21956 Filed 9–3–15; 8:45 am]
Interested persons are invited to BILLING CODE 8011–01–P Submission@omb.eop.gov.
submit written data, views, and (SSA), Social Security
arguments concerning the foregoing, Administration, OLCA, Attn: Reports
including whether the proposed rule Clearance Director, 3100 West High
SMALL BUSINESS ADMINISTRATION
change is consistent with the Act. Rise, 6401 Security Blvd., Baltimore,
Comments may be submitted by any of Surrender of License of Small MD 21235, Fax: 410–966–2830, Email
the following methods: Business Investment Company address: OR.Reports.Clearance@ssa.gov.
Or you may submit your comments
Electronic Comments Pursuant to the authority granted to online through www.regulations.gov,
the United States Small Business referencing Docket ID Number [SSA–
• Use the Commission’s Internet Administration under the Small 2015–0052].
comment form (http://www.sec.gov/ Business Investment Act of 1958, as I. The information collections below
rules/sro.shtml); or amended, under Section 309 of the Act are pending at SSA. SSA will submit
• Send an email to rule- and Section 107.1900 of the Small them to OMB within 60 days from the
comments@sec.gov. Please include File Business Administration Rules and date of this notice. To be sure we
Number SR–Phlx–2015–74 on the Regulations (13 CFR 107.1900) to consider your comments, we must
subject line. function as a small business investment receive them no later than November 3,
Paper Comments company under the Small Business 2015. Individuals can obtain copies of
Investment Company License No. 05/ the collection instruments by writing to
• Send paper comments in triplicate 05–0248 issued to Banc of America the above email address.
to Secretary, Securities and Exchange Capital Investors SBIC II, LP said license 1. The Ticket to Work and Self-
Commission, 100 F Street NE., is hereby declared null and void. Sufficiency Program—20 CFR 411—
Washington, DC 20549–1090. 0960–0644. SSA’s Ticket to Work (TTW)
United States Small Business
Administration.
Program transitions Social Security
All submissions should refer to File Disability Insurance (SSDI) and
Number SR–Phlx–2015–74. This file Dated: August 31, 2015.
Supplemental Security Income (SSI)
number should be included on the Javier Saade, recipients toward independence by
subject line if email is used. To help the Associate Administrator for Investment and allowing them to receive Social Security
Commission process and review your Innovation. payments while maintaining
comments more efficiently, please use [FR Doc. 2015–21948 Filed 9–3–15; 8:45 am] employment under the auspices of the
only one method. The Commission will BILLING CODE P program. SSA uses service providers,
post all comments on the Commission’s called Employment Networks (ENs), to
Internet Web site (http://www.sec.gov/ supervise participant progress through
rules/sro.shtml). Copies of the SOCIAL SECURITY ADMINISTRATION the stages of TTW Program
submission, all subsequent participation, such as job searches and
amendments, all written statements [Docket No: SSA–2015–0052]
interviews, progress reviews, and
with respect to the proposed rule changes in ticket status. ENs can be
change that are filed with the Agency Information Collection
Activities: Proposed Request and private for-profit and nonprofit
Commission, and all written organizations, as well as state vocational
communications relating to the Comment Request the Social Security
Administration (SSA) Publishes a List rehabilitation agencies (VRs). SSA and
proposed rule change between the the ENs utilize the TTW program
Commission and any person, other than of Information Collection Packages
Requiring Clearance by the Office of manager to operate the TTW Program
those that may be withheld from the and exchange information about
public in accordance with the Management and Budget (OMB) in
Compliance With Public Law 104–13, participants. For example, the ENs use
provisions of 5 U.S.C. 552, will be the program manager to provide updates
available for Web site viewing and the Paperwork Reduction Act of 1995,
effective October 1, 1995. This Notice on tasks such as selecting a payment
printing in the Commission’s Public system or requesting payments for
Reference Room, 100 F Street NE., Includes Revisions and Extensions of
helping the beneficiary achieve certain
Washington, DC 20549 on official OMB-Approved Information
work goals. Since the ENs are not PRA-
business days between the hours of Collections.
exempt, the multiple information
10:00 a.m. and 3:00 p.m. Copies of such SSA is soliciting comments on the collections within the TTW program
filing also will be available for accuracy of the agency’s burden manager require OMB approval, and we
inspection and copying at the principal estimate; the need for the information; clear them under this information
office of the Exchange. All comments its practical utility; ways to enhance its collection request (ICR). Most of the
received will be posted without change; quality, utility, and clarity; and ways to categories of information in this ICR are
the Commission does not edit personal
mstockstill on DSK4VPTVN1PROD with NOTICES
minimize burden on respondents, necessary for SSA to: (1) Comply with
identifying information from including the use of automated the Ticket to Work legislation; and (2)
submissions. You should submit only collection techniques or other forms of provide proper oversight of the program.
information that you wish to make information technology. Mail, email, or SSA collects this information through
available publicly. All submissions fax your comments and several modalities, including forms,
should refer to File Number SR–Phlx– recommendations on the information electronic exchanges, and written
2015–74, and should be submitted on or documentation. The respondents are the
before September 25, 2015. 17 17 CFR 200.30–3(a)(12). ENs or state VRs, as well as SSDI
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![Federal Register / Vol. 80, No. 172 / Friday, September 4, 2015 / Notices 53611
Average burden Estimated total
Number of Frequency of
Modality of completion per response annual burden
respondents response (minutes) (hours)
SSA–6233 ................................................................................ 30,000 1 20 10,000
5. Application for Circuit Court Law— if the issues stated in the AR pertain to Respondents are claimants for Social
20 CFR 404.985 & 416.1458—0960– the claimant’s case, and if the claimant Security benefits and SSI payments who
0581. Persons claiming an acquiescence is entitled to readjudication. If request readjudication. This information
ruling (AR) would change SSA’s prior readjudication is appropriate, SSA collection request is for the information
determination or decision must submit considers the issues the AR covers. Any claimants must provide to request
a written readjudication request with new determination or decision is subject readjudication.
specific information. SSA reviews the to administrative or judicial review as Type of Request: Extension of an
information in the requests to determine specified in the regulations. OMB-approved information collection.
Average burden Estimated total
Number of Frequency of
Modality of completion per response annual burden
respondents response (minutes) (hours)
AR-based Readjudication ........................................................
Requests .................................................................................. 10,000 1 17 2,833
6. Certification of Prisoner Identity of their identity. People who are in comes from the official prison files, sent
Information—20 CFR 422.107—0960– prison for an extended period typically on correctional facility letterhead. SSA
0688. Inmates of Federal, State, or local do not have current identity documents. uses this information to establish the
prisons may need a Social Security card Therefore, under formal written applicant’s identity in the replacement
as verification of their Social Security agreement with the correctional Social Security card process. The
number for school or work programs, or institution, SSA allows prison officials respondents are prison officials who
as proof of employment eligibility upon to verify the identity of certain certify the identity of prisoners applying
release from incarceration. Before SSA incarcerated U.S. citizens who need for replacement Social Security cards.
can issue a replacement Social Security replacement Social Security cards. Type of Request: Extension of an
card, applicants must show SSA proof Information prison officials provide OMB-approved Information Collection.
Average burden Estimated total
Number of Frequency of (Number of
Modality of completion per response annual burden
respondents response responses) (minutes) (hours)
Verification of Prisoner Identity State-
ments .................................................. 1,000 200 (200,000) 3 10,000
Dated: September 1, 2015. organizations. The purpose of this FOR FURTHER INFORMATION CONTACT:
Naomi R. Sipple, notice is to allow 60 days for public Direct requests for additional
Reports Clearance Officer, Social Security comment preceding submission of the information regarding the collection
Administration. collection to OMB. listed in this notice, including requests
[FR Doc. 2015–21967 Filed 9–3–15; 8:45 am] DATES: The Department will accept for copies of the proposed collection
BILLING CODE 4191–02–P comments from the public up to instrument and supporting documents,
November 3, 2015. to Heather Rudow, 2401 E Street NW.,
You may submit comments by any of Washington, DC 20520, who may be
the following methods: reached on 202–261–8953 or at
DEPARTMENT OF STATE • Web: Persons with access to the rudowh@state.gov.
[Public Notice: 9256] Internet may comment on this notice by SUPPLEMENTARY INFORMATION:
going to www.Regulations.gov. You can • Title of Information Collection:
60-Day Notice of Proposed Information search for the document by entering INTERNational Connections.
Collection: INTERNational ‘‘Docket Number: DOS–2015–0044’’ in • OMB Control Number: 1405–0190.
Connections the Search field. Then click the • Type of Request: Extension of an
‘‘Comment Now’’ button and complete Approved Collection.
Notice of request for public
ACTION: the comment form. • Originating Office: Bureau of
comment. • Email: rudowh@state.gov. Human Resources, Office of
• Regular Mail: Send written Recruitment, Examination and
mstockstill on DSK4VPTVN1PROD with NOTICES
SUMMARY: The U.S. Department of State comments to: U.S. Department of State, Employment (HR/REE).
is seeking Office of Management and 2401 E St. NW., SA1–518H, • Form Number: DS–5103.
Budget (OMB) approval for the Washington, DC 20520. Attn.: Heather • Respondents: Current and former
information collection described below. Rudow. interns of the U.S. Department of State’s
In accordance with the Paperwork You must include the DS form student programs, including
Reduction Act of 1995, we are number (if applicable), information internships, Pickerings, Rangels,
requesting comments on this collection collection title, and the OMB control Pathways, etc., and Department
from all interested individuals and number in any correspondence. employees.
VerDate Sep<11>2014 16:57 Sep 03, 2015 Jkt 235001 PO 00000 Frm 00127 Fmt 4703 Sfmt 4703 E:\FR\FM\04SEN1.SGM 04SEN1](https://thefederalregister.org/doc/80_FR_53780/page/4.svg)
Document Created: 2015-12-15 09:57:51
Document Modified: 2015-12-15 09:57:51
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| 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 53608 |
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