Information Collection Activities: Proposed Collection Requests and Comment Requests

SOCIAL SECURITY ADMINISTRATION

Information Collection Activities: Proposed Collection Requests

and Comment Requests

This notice lists information collection packages that will require

submission to the Office of Management and Budget (OMB), as well as

information collection packages submitted to OMB for clearance, in

compliance with Pub. L. 104-13 effective October 1, 1995, The Paperwork

Reduction Act of 1995.

I. The information collection(s) listed below require(s)

extension(s) of the current OMB approval(s) or are proposed new

collection(s).

1. Statement of Death by Funeral Director--0960-0142. The Social

Security Administration (SSA) uses the information collected on Form

SSA-721 to verify the death of an individual insured under the Social

Security Act and to determine if there is a survivor eligible for a

lump-sum death payment. The respondents are funeral directors with

knowledge of the death of a person insured for Social Security

benefits.

Number of Respondents: 900,000.

Frequency of Response: 1.

Average Burden Per Response: 3.5 minutes.

Estimated Average Burden: 52,500 hours.

2. Statement Regarding Marriage--0960-0017. SSA uses the

information collected on Form SSA-753 to make determinations regarding

entitlement to spouse's benefits when a common-law marriage is alleged.

The respondents are third parties who can supply evidence concerning

the existence of a common-law marriage.

Number of Respondents: 40,000.

Frequency of Response: 1.

Average Burden Per Response: 9 minutes.

Estimated Average Burden: 6,000 hours.

Written comments and recommendations regarding the information

collection(s) should be sent within 60 days from the date of this

publication, directly to the SSA Reports Clearance Officer at the

following address: Social Security Administration, DCFAM, Attn:

Frederick W. Brickenkamp, 6401 Security Blvd., 1-A-21 Operations Bldg.,

Baltimore, MD 21235.

In addition to your comments on the accuracy of the agency's burden

estimate, we are soliciting comments on the need for the information;

its practical utility; ways to enhance its 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.

II. The information collection(s) listed below have been submitted

to OMB.

1. Modified Benefits Formula Questionnaire, Employer--0960-0477.

The information collected on Form SSA-50 is used by SSA to verify that

a pension based on noncovered employment after 1956 was allegedly

received by the claimant. The form also shows whether or not the

individual became eligible for that pension before 1985. The

respondents are persons who are eligible for both Social Security

benefits and a pension from noncovered employment after 1985.

Number of Respondents: 30,000.

Frequency of Response: 1.

Average Burden Per Response: 20 minutes.

Estimated Average Burden: 10,000 hours.

2. Report of Continuing Disability Interview--0960-0072. SSA uses

the information collected on Form SSA-454 to determine whether a person

who receives Social Security Disability benefits is still unable to

work because of an existing disability. The form will also be used to

make a determination as

[[Page 59618]]

to whether the disability benefits should continue or be terminated.

The respondents are Social Security Disability benefit recipients.

Number of Respondents: 830,175.

Frequency of Response: 1.

Average Burden Per Response: 30 minutes.

Estimated Average Burden: 415,088 hours.

3. Statement by School Official About Student's Attendance;

Statement to U.S. Social Security Administration by School Outside the

U.S. About Student's Attendance--0960-0090. The information collected

on Forms SSA-1371 and SSA-1371-FC is used by SSA to verify a student's

alleged full-time attendance at an educational institution, in order to

determine the student's eligibility for Social Security student

benefits. The respondents are the school officials who provide the

information on these forms.

Number of Respondents: 5,000.

Frequency of Response: 1.

Average Burden Per Response: 10 minutes.

Estimated Average Burden: 833 hours.

4. Reconsideration Disability Report--0960-0144. SSA uses the

information collected on Form SSA-3441 to determine if the claimant's

medical or vocational situation changed after the initial disability

determination, when the claimant requests a reconsideration of a denied

disability claim. The form also elicits additional sources of medical

and vocational evidence, which was not considered in the initial

determination. The respondents are disability beneficiaries who request

a reconsideration.

Number of Respondents: 400,000.

Frequency of Response: 1.

Average Burden Per Response: 30 minutes.

Estimated Average Burden: 200,000 hours.

5. Agreement to Sell Property--0960-0127. The information on Form

SSA-8060-U3 is used by SSA field office personnel to authorize payment

of conditional benefits to individuals or couples who are otherwise

eligible for Supplemental Security Income (SSI) benefits (but whose

resources exceed the allowable limit), and at the end of the

conditional payment period, to institute overpayment recovery

procedures. Form SSA-8060-U3 documents this agreement and ensures that

the individuals understand their obligations. The respondents are

applicants for and recipients of SSI benefits.

Number of Respondents: 20,000.

Frequency of Response: 1.

Average Burden Per Response: 10 minutes.

Estimated Average Burden: 3,333 hours.

6. Modified Benefit Formula Questionnaire--0960-0395. The

information collected on Form SSA-150 is needed by SSA to determine the

correct formula to use in computing Social Security benefits for

someone who also receives benefits from employment not covered by

Social Security. The respondents consist of claimants for Social

Security benefits who are also entitled to benefits not covered by

Social Security.

Number of Respondents: 90,000.

Frequency of Response: 1.

Average Burden Per Response: 4 minutes.

Estimated Average Burden: 6,000 hours.

7. Application for Survivors Benefits--0960-0062. SSA collects the

information on Form SSA-24 to determine whether insured status exists

in order for the claimant to complete the appropriate SSA survivor

application. If entitlement does not exist, SSA may disallow the claim.

If an SSA survivor application has already been filed, Form SSA-24 is

treated as a duplicate application. The respondents are survivors of

military service veterans filing for Social Security benefits.

Number of Respondents: 3,200.

Frequency of Response: 1.

Average Burden Per Response: 15 minutes.

Estimated Average Burden: 800 hours.

8. Medical Report (Individual With Childhood Impairment)--0960-

0102. The information collected on Form SSA-3827 is used by SSA to

determine whether an individual with a childhood impairment medically

qualifies for benefits or payments under the provisions of the Social

Security Act, based on the medical aspects of an individual's claim or

application. The respondents are attending physicians/medical sources.

Number of Respondents: 12,000.

Frequency of Response: 1.

Average Burden Per Response: 30 minutes.

Estimated Average Burden: 6,000 hours.

Written comments and recommendations regarding the information

collection(s) should be directed within 30 days to the OMB Desk Officer

and SSA Reports Clearance Officer at the following addresses:

(OMB)

Office of Management and Budget, OIRA, Attn: Desk Officer for SSA, New

Executive Office Building, Room 10230, 725 17th St., NW, Washington,

D.C. 20503

(SSA)

Social Security Administration, DCFAM, Attn: Frederick W. Brickenkamp,

1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 21235

To receive a copy of any of the forms or clearance packages, call

the SSA Reports Clearance Officer on (410) 965-4145 or write to him at

the address listed above.

Dated: October 29, 1998.

Frederick W. Brickenkamp,

Reports Clearance Officer, Social Security Administration.

[FR Doc. 98-29508 Filed 11-3-98; 8:45 am]

BILLING CODE 4190-29-P