83 FR 26732 - Agency Information Collection Activities: Proposed Request and Comment Request
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 83, Issue 111 (June 8, 2018)
Federal Register Volume 83, Issue 111 (June 8, 2018)
| Page Range | 26732-26736 | |
| FR Document | 2018-12391 |
[Federal Register Volume 83, Number 111 (Friday, June 8, 2018)] [Notices] [Pages 26732-26736] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-12391] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2018-0025] 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] [[Page 26733]] (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-2018-0025]. 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 August 7, 2018. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Fee Agreement for Representation before the Social Security Administration--0960--NEW. Under the Social Security Act (Act), SSA requires individuals who represent a claimant before the agency and want to receive a fee for their services to obtain SSA's authorization of the fee. One way to obtain the authorization is to submit the fee agreement. To facilitate this process, individuals can use Form SSA- 1693. SSA uses the information from the SSA-1693 to review the request and authorize any fee to representatives who seek to charge and collect a fee from a claimant. The respondents are the representatives who help claimants through the application process. Note: SSA originally published this Notice on November 22, 2017, at 82 FR 55707, and received several public comments. In response to those public comments, SSA revised the SSA-1693, and is republishing this Notice. Type of Request: Request for a new information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-1693.................................... 600,000 1 12 120,000 ---------------------------------------------------------------------------------------------------------------- 2. State Supplementation Provisions: Agreement; Payments--20 CFR 416.2095-416.2098, and 20 CFR 416.2099--0960-0240. Section 1618 of the Act requires those states administering their own supplementary income payment program(s) to demonstrate compliance with the Act by passing Federal cost-of-living increases on to individuals who are eligible for state supplementary payments, and informing SSA of their compliance. In general, states report their supplementary payment information annually by the maintenance-of-payment levels method. However, SSA may ask them to report up to four times in a year by the total-expenditures method. Regardless of the method, the states confirm their compliance with the requirements, and provide any changes to their optional supplementary payment rates. SSA uses the information to determine each state's compliance or noncompliance with the pass-along requirements of the Act to determine eligibility for Medicaid reimbursement. If a state fails to keep payments at the required level, it becomes ineligible for Medicaid reimbursement under Title XIX of the Act. Respondents are state agencies administering supplemental programs. Type of Request: Extension of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average Number of Frequency of Number of burden per Estimated Modality of completion respondents Response responses response total annual (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- Total Expenditures.............. 7 4 28 60 28 Maintenance of Payment Levels... 26 1 26 60 26 ------------------------------------------------------------------------------- Total....................... 33 .............. .............. .............. 54 ---------------------------------------------------------------------------------------------------------------- 3. 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 Supplemental Security Income (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 the 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 substitute parties for a deceased claimant. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- HA-539...................................... 4,000 1 5 333 ---------------------------------------------------------------------------------------------------------------- 4. 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 [[Page 26734]] 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 Estimated Number of Frequency of burden of total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-5062........................................ 30,632 1 10 5,105 Paper form...................................... SSA-L5063....................................... 30,632 1 10 5,105 Paper form...................................... SSA-5062........................................ 30,632 1 10 5,105 SSI Claim System................................ SSA-L5063....................................... 30,632 1 10 5,105 SSI Claim System................................ --------------------------------------------------------------- Total....................................... 122,528 .............. .............. 20,420 ---------------------------------------------------------------------------------------------------------------- 5. Testimony by Employees and the Production of Records and Information in Legal Proceedings--20 CFR 403.100-403.155-0960-0619. Regulations at 20 CFR 403.100-403.155 of the Code of Federal Regulations establish SSA's policies and procedures for an individual; organization; or government entity to request official agency information, records, or testimony of an agency employee in a legal proceeding when the agency is not a party. The request, which respondents submit in writing to SSA, must: (1) Fully set out the nature and relevance of the sought testimony; (2) explain why the information is not available by other means; (3) explain why it is in SSA's interest to provide the testimony; and (4) provide the date, time, and place for the testimony. Respondents are individuals or entities who request testimony from SSA employees in connection with a legal proceeding. Type of Request: Extension of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- 20 CFR 403.100-403.155...................... 100 1 60 100 ---------------------------------------------------------------------------------------------------------------- 6. Function Report Adult-Third Party--20 CFR 404.1512 & 416.912- 0960-0635. Individuals receiving or applying for Social Security Disability Insurance (SSDI) or SSI provide SSA with medical evidence and other proof SSA requires to prove their disability. SSA, and Disability Determination Services (DDS) on our behalf, collect this information using Form SSA-3380-BK. We use the information to document how claimant's disabilities affect their ability to function, and to determine eligibility for SSI and SSDI claims. The respondents are third parties familiar with the functional limitations (or lack thereof) of claimants who apply for SSI and SSDI benefits. Type of Request: Revision of an OMB approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-3380-BK................................. 709,700 1 61 721,528 ---------------------------------------------------------------------------------------------------------------- 7. 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) website 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. Type of Request: Revision of an OMB-approved information collection. [[Page 26735]] ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden of total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- Internet Request through eFOIA.................. 49,800 1 7 5,810 SSA-711 (paper)................................. 200 1 7 23 --------------------------------------------------------------- Total....................................... 50,000 .............. .............. 5,833 ---------------------------------------------------------------------------------------------------------------- 8. 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 Estimated Modality of completion Number of Frequency of Number of of response total annual respondents response responses (minutes) burden (hours) -------------------------------------------------------------------------------------------------------------------------------------------------------- Verification of Prisoner Identity Statements....................... 1,000 200 200,000 3 10,000 -------------------------------------------------------------------------------------------------------------------------------------------------------- 9. 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, 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 total Modality of completion Number of Frequency of of response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-132..................................... 326,000 1 2 10,867 ---------------------------------------------------------------------------------------------------------------- 10. Social Security Administration Health IT Partner Program Assessment--Participating Facilities and Available Content Form--20 CFR 404.1614 and 416.1014--0960-0798. The Health Information Technology for Economic and Clinical Health (HITECH) Act promotes the adoption and meaningful use of health information technology (IT), particularly in the context of working with government agencies. Similarly, section 3004 of the Public Health Service Act requires health care providers or health insurance issuers with government contracts to implement, acquire, or upgrade their health IT systems and products to meet adopted standards and implementation specifications. To support expansion of SSA's health IT initiative as defined under HITECH, SSA developed Form SSA-680, the Health IT Partner Program Assessment-- participating Facilities and Available Content Form. The SSA-680 allows healthcare providers to provide the information SSA needs to determine their ability to exchange health information with us electronically. We evaluate potential partners (i.e., healthcare providers and organizations) on: (1) The accessibility of health information they possess; and (2) the content value of their electronic health records' systems for our disability adjudication processes. SSA reviews the completeness of organizations' SSA-680 responses as one part of our careful analysis of their readiness to enter into a health IT partnership with us. The respondents are healthcare providers and organizations exchanging information with the agency. Type of Request: Extension of an OMB-approved information collection. [[Page 26736]] ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of of response annual burden respondents response (hours) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-680..................................... 30 1 5 150 ---------------------------------------------------------------------------------------------------------------- II. SSA submitted the information collection below to OMB for clearance. Your comments regarding this information collection 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 July 9, 2018. Individuals can obtain copies of the OMB clearance packages by writing to [email protected]. Statement of Reclamation Action--31 CFR 210--0960-0734. Regulations governing the Federal Government Participation in the Automated Clearing House: (1) Allow SSA to send Social Security payments to Canada; and (2) mandate the reclamation of funds paid erroneously to a Canadian bank, or financial institution, after the death of a Social Security beneficiary. SSA uses Form SSA-1713, Notice of Reclamation Action, to determine if, how, and when the Canadian bank or financial institution is going to return erroneous payments after the death of a Social Security beneficiary who elected to have payments sent to Canada. Form SSA-1712 (or SSA-1712 CN), Notice of Reclamation-Canada Payment Made in the United States, is the cover sheet SSA prepares to request return of the payment. The respondents are Canadian banks and financial institutions who erroneously received Social Security payments. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden of total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-1712........................................ 8 1 5 1 SSA-1713........................................ 7 1 5 1 --------------------------------------------------------------- Totals...................................... 15 .............. .............. 2 ---------------------------------------------------------------------------------------------------------------- Dated: June 4, 2018. Faye Lipsky, Reports Clearance Director, Social Security Administration. [FR Doc. 2018-12391 Filed 6-7-18; 8:45 am] BILLING CODE 4191-02-P
![26732 Federal Register / Vol. 83, No. 111 / Friday, June 8, 2018 / Notices
improvements to the delivery process, III. Date of Effectiveness of the Washington, DC 20549, on official
consistent with market feedback, recent Proposed Rule Change, Security-Based business days between the hours of
changes to relevant IFEU rules and other Swap Submission and Advance Notice 10:00 a.m. and 3:00 p.m. Copies of the
similar futures contracts, such as the and Timing for Commission Action filing also will be available for
ICE Futures US Coffee Futures Contract. The foregoing rule change has become inspection and copying at the principal
The changes thus facilitate prompt and effective pursuant to Section 19(b)(3)(A) office of ICE Clear Europe and on ICE
accurate clearance and settlement of the of the Act 6 and paragraph (f) of Rule Clear Europe’s website at https://
Robusta Coffee Futures Contracts. 19b–4 7 thereunder. At any time within www.theice.com/publicdocs/regulatory_
60 days of the filing of the proposed rule filings/19b-4_2018_008_ICEU.pdf. All
In addition, Rule 17Ad–22(e)(10) 5
change, the Commission summarily may comments received will be posted
requires that each covered clearing
temporarily suspend such rule change if without change. Persons submitting
agency establish, implement, maintain comments are cautioned that we do not
and enforce written policies and it appears to the Commission that such
action is necessary or appropriate in the redact or edit personal identifying
procedures reasonably designed to information from comment submissions.
establish and maintain written public interest, for the protection of
investors, or otherwise in furtherance of You should submit only information
standards that state its obligations with that you wish to make available
the purposes of the Act.
respect to the delivery of physical publicly. All submissions should refer
instruments. As discussed above, ICE IV. Solicitation of Comments to File Number SR–ICEEU–2018–008
Clear Europe is updating its Delivery Interested persons are invited to and should be submitted on or before
Procedures to reflect the shortened submit written data, views, and June 29, 2018.
delivery period, to remove the ‘‘Early arguments concerning the foregoing, For the Commission, by the Division of
Take Up’’ concept which is no longer including whether the proposed rule Trading and Markets, pursuant to delegated
necessary in light of that shorter period, change, security-based swap submission authority.8
and to make certain other clarifications or advance notice is consistent with the Eduardo A. Aleman,
and updates, consistent with the Act. Comments may be submitted by Assistant Secretary.
delivery terms set out in the IFEU any of the following methods:
[FR Doc. 2018–12323 Filed 6–7–18; 8:45 am]
contract specifications.
Electronic Comments BILLING CODE 8011–01–P
(B) Clearing Agency’s Statement on • Use the Commission’s internet
Burden on Competition comment form (http://www.sec.gov/
rules/sro.shtml) or SOCIAL SECURITY ADMINISTRATION
ICE Clear Europe does not believe the • Send an email to rule-comments@
proposed rule changes would have any [Docket No. SSA–2018–0025]
sec.gov. Please include File Number SR–
impact, or impose any burden, on ICEEU–2018–008 on the subject line.
competition not necessary or Agency Information Collection
appropriate in furtherance of the Paper Comments Activities: Proposed Request and
Comment Request
purposes of the Act. The changes are • Send paper comments in triplicate
being proposed in order to update the to Secretary, Securities and Exchange The Social Security Administration
Delivery Procedures for the IFEU Commission, 100 F Street NE, (SSA) publishes a list of information
Robusta Coffee Futures Contract Washington, DC 20549–1090. collection packages requiring clearance
specifications, as discussed above. ICE All submissions should refer to File by the Office of Management and
Clear Europe does not believe the Number SR–ICEEU–2018–008. This file Budget (OMB) in compliance with
amendments would adversely affect number should be included on the Public Law 104–13, the Paperwork
Clearing Members, materially affect the subject line if email is used. To help the Reduction Act of 1995, effective October
cost of clearing, adversely affect access Commission process and review your 1, 1995. This notice includes revisions,
to clearing in Robusta Coffee Futures comments more efficiently, please use and extensions, of OMB-approved
Contract for Clearing Members or their only one method. The Commission will information collections.
customers, or otherwise adversely affect post all comments on the Commission’s SSA is soliciting comments on the
competition in clearing services. internet website (http://www.sec.gov/ accuracy of the agency’s burden
Accordingly, ICE Clear Europe does not rules/sro.shtml). Copies of the estimate; the need for the information;
believe that the amendments would submission, all subsequent its practical utility; ways to enhance its
impose any impact or burden on amendments, all written statements quality, utility, and clarity; and ways to
competition that is not appropriate in with respect to the proposed rule minimize burden on respondents,
furtherance of the purpose of the Act. change, security-based swap submission including the use of automated
or advance notice that are filed with the collection techniques or other forms of
(C) Clearing Agency’s Statement on Commission, and all written information technology. Mail, email, or
Comments on the Proposed Rule communications relating to the fax your comments and
Change Received From Members, proposed rule change, security-based recommendations on the information
Participants or Others swap submission or advance notice collection(s) to the OMB Desk Officer
between the Commission and any and SSA Reports Clearance Officer at
Written comments relating to the person, other than those that may be the following addresses or fax numbers.
proposed amendments have not been withheld from the public in accordance
amozie on DSK3GDR082PROD with NOTICES1
solicited or received by ICE Clear (OMB)
with the provisions of 5 U.S.C. 552, will
Europe. ICE Clear Europe will notify the be available for website viewing and Office of Management and Budget, Attn:
Commission of any comments received printing in the Commission’s Public Desk Officer for SSA, Fax: 202–395–
with respect to the proposed Reference Room, 100 F Street NE, 6974, Email address: OIRA_
amendments. Submission@omb.eop.gov
6 15 U.S.C. 78s(b)(3)(A).
5 17 CFR 240.17Ad–22(e)(10). 7 17 CFR 240.19b–4(f). 8 17 CFR 200.30–3(a)(12).
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![Federal Register / Vol. 83, No. 111 / Friday, June 8, 2018 / Notices 26733
(SSA) consider your comments, we must 1693. SSA uses the information from the
receive them no later than August 7, SSA–1693 to review the request and
Social Security Administration, OLCA, 2018. Individuals can obtain copies of authorize any fee to representatives who
Attn: Reports Clearance Director, 3100 the collection instruments by writing to seek to charge and collect a fee from a
West High Rise, 6401 Security Blvd., the above email address. claimant. The respondents are the
Baltimore, MD 21235. Fax: 410–966– 1. Fee Agreement for Representation representatives who help claimants
2830 Email address: before the Social Security
OR.Reports.Clearance@ssa.gov through the application process.
Administration—0960—NEW. Under
Or you may submit your comments the Social Security Act (Act), SSA Note: SSA originally published this
online through www.regulations.gov, requires individuals who represent a Notice on November 22, 2017, at 82 FR
referencing Docket ID Number [SSA– claimant before the agency and want to 55707, and received several public
2018–0025]. receive a fee for their services to obtain comments. In response to those public
I. The information collections below SSA’s authorization of the fee. One way comments, SSA revised the SSA–1693,
are pending at SSA. SSA will submit to obtain the authorization is to submit and is republishing this Notice.
them to OMB within 60 days from the the fee agreement. To facilitate this Type of Request: Request for a new
date of this notice. To be sure we process, individuals can use Form SSA– information collection.
Average Estimated total
Number of Frequency of burden of
Modality of completion annual burden
respondents response response (hours)
(minutes)
SSA–1693 ........................................................................................................ 600,000 1 12 120,000
2. State Supplementation Provisions: general, states report their compliance or noncompliance with the
Agreement; Payments—20 CFR supplementary payment information pass-along requirements of the Act to
416.2095–416.2098, and 20 CFR annually by the maintenance-of- determine eligibility for Medicaid
416.2099—0960–0240. Section 1618 of payment levels method. However, SSA reimbursement. If a state fails to keep
the Act requires those states may ask them to report up to four times payments at the required level, it
administering their own supplementary in a year by the total-expenditures becomes ineligible for Medicaid
income payment program(s) to method. Regardless of the method, the reimbursement under Title XIX of the
demonstrate compliance with the Act by states confirm their compliance with the Act. Respondents are state agencies
passing Federal cost-of-living increases requirements, and provide any changes administering supplemental programs.
on to individuals who are eligible for to their optional supplementary
state supplementary payments, and payment rates. SSA uses the Type of Request: Extension of an
informing SSA of their compliance. In information to determine each state’s OMB-approved information collection.
Average Estimated
Number of Frequency of Number of burden per total annual
Modality of completion respondents Response responses response burden
(minutes) (hours)
Total Expenditures ............................................................... 7 4 28 60 28
Maintenance of Payment Levels ......................................... 26 1 26 60 26
Total .............................................................................. 33 ........................ ........................ ........................ 54
3. Substitution of Party Upon Death of may complete Form HA–539, which regarding an oral hearing or decision on
Claimant—20 CFR 404.957(c)(4) and allows them to request to become a the record; and (4) admit the data into
416.1457(c)(4)—0960–0288. An substitute party for the deceased the claimant’s official record as an
administrative law judge (ALJ) may claimant. The ALJs and the hearing exhibit. The respondents are individuals
dismiss a request for a hearing on a office support staff use the information requesting to be substitute parties for a
pending claim of a deceased individual from the HA–539 to: (1) Maintain a deceased claimant.
for Social Security benefits or written record of request; (2) establish
Supplemental Security Income (SSI) the relationship of the requester to the Type of Request: Revision of an OMB-
payments. Individuals who believe the deceased claimant; (3) determine the approved information collection.
dismissal may adversely affect them substituted individual’s wishes
Average Estimated total
Number of Frequency of burden of
Modality of completion annual burden
respondents response response (hours)
(minutes)
amozie on DSK3GDR082PROD with NOTICES1
HA–539 ............................................................................................................ 4,000 1 5 333
4. Claimant Statement about Loan of or Shelter Provided to Another—20 CFR bases an SSI claimant or recipient’s
Food or Shelter; Statement about Food 416.1130–416.1148—0960–0529. SSA eligibility on need, as measured by the
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![26736 Federal Register / Vol. 83, No. 111 / Friday, June 8, 2018 / Notices
Average Estimated total
Number of Frequency of burden of
Modality of completion annual burden
respondents response response (hours)
(hours)
SSA–680 .......................................................................................................... 30 1 5 150
II. SSA submitted the information governing the Federal Government Security beneficiary who elected to have
collection below to OMB for clearance. Participation in the Automated Clearing payments sent to Canada. Form SSA–
Your comments regarding this House: (1) Allow SSA to send Social 1712 (or SSA–1712 CN), Notice of
information collection would be most Security payments to Canada; and (2) Reclamation-Canada Payment Made in
useful if OMB and SSA receive them 30 mandate the reclamation of funds paid the United States, is the cover sheet SSA
days from the date of this publication. erroneously to a Canadian bank, or prepares to request return of the
To be sure we consider your comments, financial institution, after the death of a payment. The respondents are Canadian
we must receive them no later than July Social Security beneficiary. SSA uses banks and financial institutions who
9, 2018. Individuals can obtain copies of Form SSA–1713, Notice of Reclamation erroneously received Social Security
the OMB clearance packages by writing Action, to determine if, how, and when payments.
to OR.Reports.Clearance@ssa.gov. the Canadian bank or financial
Statement of Reclamation Action—31 institution is going to return erroneous Type of Request: Revision of an OMB-
CFR 210—0960–0734. Regulations payments after the death of a Social approved information collection.
Average Estimated total
Number of Frequency of burden of
Modality of completion annual burden
respondents response response (hours)
(minutes)
SSA–1712 ........................................................................................................ 8 1 5 1
SSA–1713 ........................................................................................................ 7 1 5 1
Totals ........................................................................................................ 15 ........................ ........................ 2
Dated: June 4, 2018. estimate; the need for the information; I. The information collections below
Faye Lipsky, its practical utility; ways to enhance its are pending at SSA. SSA will submit
Reports Clearance Director, Social Security quality, utility, and clarity; and ways to them to OMB within 60 days from the
Administration. minimize burden on respondents, date of this notice. To be sure we
[FR Doc. 2018–12391 Filed 6–7–18; 8:45 am] including the use of automated consider your comments, we must
BILLING CODE 4191–02–P collection techniques or other forms of receive them no later than August 7,
information technology. Mail, email, or 2018. Individuals can obtain copies of
fax your comments and the collection instruments by writing to
SOCIAL SECURITY ADMINISTRATION recommendations on the information the above email address.
collection(s) to the OMB Desk Officer 1. Employment Relationship
[Docket No. SSA–2018–0024] and SSA Reports Clearance Officer at Questionnaire—20 CFR 404.1007—
Agency Information Collection the following addresses or fax numbers. 0960–0040. When SSA needs
Activities: Proposed Request and (OMB), Office of Management and information to determine a worker’s
Comment Request Budget, Attn: Desk Officer for SSA, employment status for the purpose of
Fax: 202–395–6974, Email address: maintaining a worker’s earning records,
The Social Security Administration OIRA_Submission@omb.eop.gov. the agency uses Form SSA–7160–F4 to
(SSA) publishes a list of information determine the existence of an employer-
collection packages requiring clearance (SSA), Social Security Administration, employee relationship. We use the
by the Office of Management and OLCA, Attn: Reports Clearance information to develop the employment
Budget (OMB) in compliance with Director, 3100 West High Rise, 6401 relationship; specifically, to determine
Public Law 104–13, the Paperwork Security Blvd., Baltimore, MD 21235, whether a beneficiary is self-employed
Reduction Act of 1995, effective October Fax: 410–966–2830, Email address: or an employee. The respondents are
1, 1995. This notice includes revisions, OR.Reports.Clearance@ssa.gov. individuals seeking to establish their
and one extension, of OMB-approved Or you may submit your comments status as employees, and their alleged
information collections. online through www.regulations.gov, employers.
SSA is soliciting comments on the referencing Docket ID Number [SSA– Type of Request: Revision of an OMB-
accuracy of the agency’s burden 2018–0024]. approved information collection.
Average Estimated total
Number of Frequency of burden per
amozie on DSK3GDR082PROD with NOTICES1
Modality of completion annual burden
respondents response response (hours)
(minutes)
SSA–7160–F4—Individuals ............................................................................. 8,000 1 25 3,333
SSA–7160–F4—Businesses ............................................................................ 7,200 1 25 3,000
SSA–7160–F4—State/Local Governemnt ....................................................... 800 1 25 333
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Document Created: 2018-06-08 01:21:56
Document Modified: 2018-06-08 01:21:56
| 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 | 83 FR 26732 |
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