Federal Register: November 4, 2002 (Volume 67, Number 213)
DOCID: FR Doc 02-27974
SOCIAL SECURITY ADMINISTRATION
Social Security Administration
NOTICE: NOTICES
ACTION: Agency information collection activities:
SUBJECT CATEGORY:
Agency Information Collection Activities: Proposed Request and Comment Request
DOCUMENT SUMMARY:
The Social Security Administration (SSA) publishes a list of information collection packages that will require clearance by the Office of Management and Budget (OMB) in compliance with P.L. 10413 effective October 1, 1995, The Paperwork Reduction Act of 1995. The information collection packages that may be included in this notice are for new information collections, revisions to OMBapproved information collections and extensions (no change) of OMBapproved 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
[[Page 67233]]
quality, utility and clarity; and on ways to minimize burden on
respondents, including the use of automated collection techniques or
other forms of information technology. Written comments and
recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed and/or faxed to the individuals at the addresses and fax numbers listed below:
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA, New
Executive Office Building, Room 10235, 725 17th St., NW., Washington, DC 20503, Fax: 2023956974;
(SSA) Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, 1A21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 21235, Fax: 4109656400.
I. The information collections listed below are pending at SSA and will be submitted to OMB within 60 days from the date of this notice. Therefore, your comments should be submitted to SSA within 60 days from the date of this publication. You can obtain copies of the collection instruments by calling the SSA Reports Clearance Officer at 410965 0454, or by writing to the address listed above.
1. Statement of Funds You Provided to Another, Statement of Funds You Received20 CFR 416.1103(f)09600481. Supplemental Security Income (SSI) entitlement, and the amount of the SSI payment, is affected by any other income the applicant has. Forms SSA2854 and SSA 2855 are used by SSA to collect information in situations where the SSI applicant alleges that money was borrowed on an informal basis from a noncommercial lender, e.g., a relative or friend, etc. These statements are completed by the borrower/claimant and by the lender and are required to determine whether the proceeds from the transaction are/are not income to the borrower/claimant. If the transaction constitutes a bona fide loan, the proceeds are not income to the SSI borrower/ claimant. The respondents are applicants for SSI payments who borrow money on an informal (noncommercial) basis and by individuals who lend money informally to SSI applicants.
Type of Request: Extension of an OMBapproved information collection.
Number of Respondents: 40,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 6,667 hours.
II. The information collection listed below has been submitted to OMB for clearance. Your comments on the information collections would be most useful if received by OMB and SSA within 30 days from the date of this publication. You can obtain a copy of the OMB clearance package by calling the SSA Reports Clearance Officer at 4109650454, or by writing to the address listed above.
1. The Internet Social Security Benefits Application (ISBA)20 CFR Subpart D, 404.310404.311 and 20 CFR Subpart F, 404.601404.6030960 0618. One of the requirements for obtaining Social Security benefits is the filing of an application so that a determination may be made on the applicant's eligibility for monthly benefits. ISBA, which is available at SSA's Internet site, is one method that an individual can choose to file an application for benefits. Individuals can use ISBA to apply for retirement insurance benefits (RIB), disability insurance benefits (DIB) and spouse's insurance benefits based on age. SSA gathers only information relevant to the individual applicant's circumstances and will use the information collected by ISBA to entitle individuals to RIB, DIB and/or spouses benefits. The respondents are applicants for RIB, DIB and/or spouses benefits. Below is an estimate of the public reporting burden:
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 169,000.
Frequency of Response: 1.
Average Burden Per Response: 21.4 minutes.
Estimated Annual Burden: 60,277 hours.
2. Application for Disability Insurance Benefits20 CFR Subpart P404.15011512 and Subpart D404.315404.32209600060. Section 223 of the Social Security Act allows payment of disability insurance benefits to any individual who is insured for disability benefits by virtue of covered employment under Social Security; has not attained full retirement age; has filed an application for disability insurance benefits; and is under a disability as defined by the Act. Form SSA16 F6 obtains the information necessary to determine whether the provisions of the Act have been satisfied with respect to an applicant for disability benefits and detects whether the applicant has dependents who would qualify for benefits on his or her earnings record. The information collected on form SSA16 helps to determine eligibility for social security disability benefits. The respondents are applicants for Social Security disability benefits.
Type of Request: Revision of an OMBApproved Information Collection.
Number of Respondents: 1,513,677.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 504,559 hours.
3. Worker's Compensation/Public Disability Benefit Questionnaire 20 CFR Subpart E, 404.40809600247. Section 224 of the Social Security Act provides for the reduction of disability insurance benefits (DIB) when the combination of DIB benefits and any worker's compensation (WC) and/or certain Federal, State or Local public disability benefits (PDB) exceeds 80% of the worker's predisability earnings. SSA546 collects the information to determine whether or not the worker's receipt of WC/PDB payments will cause a reduction of DIB. The respondents are applicants for title II DIB.
Type of Request: Extension of an OMBapproved information collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 25,000 hours.
4. Medical Report on Adult with Allegation of Human Immune Deficiency Virus Infection and Medical Report on Child with Allegation of Human Immune Deficiency Virus Infection20 CFR Subpart I, 416.933 09600500. The information collected on forms SSA4814F5 and SSA4815 F6 assist the field offices/disability determination services to make findings of presumptive disability that confirms the claimants' disease manifestations meet the severity of listinglevel criteria for Human Immunodeficency Virus (HIV) infection. The respondents are medical sources of claimants for title XVI disability payments based on HIV infection.
Type of Request: Extension of an OMBapproved information collection.
Number of Respondents: 59,100.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 9,850 hours.
Dated: October 29, 2002.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 0227974 Filed 11102; 8:45 am]
BILLING CODE 419102P
SUMMARY:
Proposed collection and submission for OMB review; comment request,
DOCUMENT BODY 2:
The Social Security Administration (SSA) publishes a list of information collection packages that will require clearance by the Office of Management and Budget (OMB) in compliance with P.L. 10413 effective October 1, 1995, The Paperwork Reduction Act of 1995. The information collection packages that may be included in this notice are for new information collections, revisions to OMBapproved information collections and extensions (no change) of OMBapproved 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
[[Page 67233]]
quality, utility and clarity; and on ways to minimize burden on
respondents, including the use of automated collection techniques or
other forms of information technology. Written comments and
recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed and/or faxed to the individuals at the addresses and fax numbers listed below:
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA, New
Executive Office Building, Room 10235, 725 17th St., NW., Washington, DC 20503, Fax: 2023956974;
(SSA) Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, 1A21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 21235, Fax: 4109656400.
I. The information collections listed below are pending at SSA and will be submitted to OMB within 60 days from the date of this notice. Therefore, your comments should be submitted to SSA within 60 days from the date of this publication. You can obtain copies of the collection instruments by calling the SSA Reports Clearance Officer at 410965 0454, or by writing to the address listed above.
1. Statement of Funds You Provided to Another, Statement of Funds You Received20 CFR 416.1103(f)09600481. Supplemental Security Income (SSI) entitlement, and the amount of the SSI payment, is affected by any other income the applicant has. Forms SSA2854 and SSA 2855 are used by SSA to collect information in situations where the SSI applicant alleges that money was borrowed on an informal basis from a noncommercial lender, e.g., a relative or friend, etc. These statements are completed by the borrower/claimant and by the lender and are required to determine whether the proceeds from the transaction are/are not income to the borrower/claimant. If the transaction constitutes a bona fide loan, the proceeds are not income to the SSI borrower/ claimant. The respondents are applicants for SSI payments who borrow money on an informal (noncommercial) basis and by individuals who lend money informally to SSI applicants.
Type of Request: Extension of an OMBapproved information collection.
Number of Respondents: 40,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 6,667 hours.
II. The information collection listed below has been submitted to OMB for clearance. Your comments on the information collections would be most useful if received by OMB and SSA within 30 days from the date of this publication. You can obtain a copy of the OMB clearance package by calling the SSA Reports Clearance Officer at 4109650454, or by writing to the address listed above.
1. The Internet Social Security Benefits Application (ISBA)20 CFR Subpart D, 404.310404.311 and 20 CFR Subpart F, 404.601404.6030960 0618. One of the requirements for obtaining Social Security benefits is the filing of an application so that a determination may be made on the applicant's eligibility for monthly benefits. ISBA, which is available at SSA's Internet site, is one method that an individual can choose to file an application for benefits. Individuals can use ISBA to apply for retirement insurance benefits (RIB), disability insurance benefits (DIB) and spouse's insurance benefits based on age. SSA gathers only information relevant to the individual applicant's circumstances and will use the information collected by ISBA to entitle individuals to RIB, DIB and/or spouses benefits. The respondents are applicants for RIB, DIB and/or spouses benefits. Below is an estimate of the public reporting burden:
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 169,000.
Frequency of Response: 1.
Average Burden Per Response: 21.4 minutes.
Estimated Annual Burden: 60,277 hours.
2. Application for Disability Insurance Benefits20 CFR Subpart P404.15011512 and Subpart D404.315404.32209600060. Section 223 of the Social Security Act allows payment of disability insurance benefits to any individual who is insured for disability benefits by virtue of covered employment under Social Security; has not attained full retirement age; has filed an application for disability insurance benefits; and is under a disability as defined by the Act. Form SSA16 F6 obtains the information necessary to determine whether the provisions of the Act have been satisfied with respect to an applicant for disability benefits and detects whether the applicant has dependents who would qualify for benefits on his or her earnings record. The information collected on form SSA16 helps to determine eligibility for social security disability benefits. The respondents are applicants for Social Security disability benefits.
Type of Request: Revision of an OMBApproved Information Collection.
Number of Respondents: 1,513,677.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 504,559 hours.
3. Worker's Compensation/Public Disability Benefit Questionnaire 20 CFR Subpart E, 404.40809600247. Section 224 of the Social Security Act provides for the reduction of disability insurance benefits (DIB) when the combination of DIB benefits and any worker's compensation (WC) and/or certain Federal, State or Local public disability benefits (PDB) exceeds 80% of the worker's predisability earnings. SSA546 collects the information to determine whether or not the worker's receipt of WC/PDB payments will cause a reduction of DIB. The respondents are applicants for title II DIB.
Type of Request: Extension of an OMBapproved information collection.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 25,000 hours.
4. Medical Report on Adult with Allegation of Human Immune Deficiency Virus Infection and Medical Report on Child with Allegation of Human Immune Deficiency Virus Infection20 CFR Subpart I, 416.933 09600500. The information collected on forms SSA4814F5 and SSA4815 F6 assist the field offices/disability determination services to make findings of presumptive disability that confirms the claimants' disease manifestations meet the severity of listinglevel criteria for Human Immunodeficency Virus (HIV) infection. The respondents are medical sources of claimants for title XVI disability payments based on HIV infection.
Type of Request: Extension of an OMBapproved information collection.
Number of Respondents: 59,100.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 9,850 hours.
Dated: October 29, 2002.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 0227974 Filed 11102; 8:45 am]
BILLING CODE 419102P