Federal Register / Vol. 76, No. 58 / Friday, March 25, 2011 / Notices 16849 

2. Sheltered Workshop Wage 

Reporting—0960–0771. Sheltered 

workshops are nonprofit organizations 

or institutions that implement a 

recognized program of rehabilitation for 

workers who have handicaps, or 

provide such workers with 

remunerative employment or other 

occupational rehabilitating activity of an 

educational or therapeutic nature. 

Sheltered workshops perform a service 

for their clients by reporting monthly 

wages directly to SSA. SSA uses the 

information these workshops provide to 

verify and post monthly wages to the 

SSI recipient’s record. Most workshops 

report monthly wage totals to their local 

SSA office so we can adjust the client’s 

SSI payment amount in a timely manner 

and prevent overpayments. Sheltered 

workshops are motivated to report 

wages voluntarily as a service to their 

clients. Respondents are sheltered 

workshops that report monthly wages 

for services performed in the workshop. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 900. 

Frequency of Response: 12. 

Average Burden Per Response: 15 

minutes. 

Estimated Annual Burden: 3,000 

hours. 

3. Request for Medical Treatment in 

an SSA Employee Health Facility: 

Patient Self-Administered or StaffAdministered Care—0960–0772. SSA’s 

Employee Health Clinic (EHC) provides 

emergency care, treatment of on-the-job 

illnesses and injuries, and health care 

for employees with chronic medical 

conditions and allergies who require 

allergy antigens. SSA also permits 

employees to use the EHC for selfadministration of medical treatments for 

a chronic health condition. SSA collects 

information on Form SSA–5072 to 

approve or deny requests for medical 

treatment in an SSA EHC. The 

respondents are the private physicians 

of the SSA employees seeking medical 

treatment in an SSA EHC. 

Type of Request: Information 

Collection in Use without an OMB 

Number. 

Medication dosage changes Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Total annual 

burden (hours) 

Annually ........................................................................................................... 25 1 5 2 

Bi-Annually ....................................................................................................... 75 2 5 13 

Totals ........................................................................................................ 100 ........................ ........................ 15 

Dated: March 22, 2011. 

Faye Lipsky, 

Reports Clearance Officer, Center for Reports 

Clearance, Social Security Administration. 

[FR Doc. 2011–7123 Filed 3–24–11; 8:45 am] 

BILLING CODE 4191–02–P 

SOCIAL SECURITY ADMINISTRATION 

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 an extension 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, e-mail, 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, E-mail address: 

OIRA_Submission@omb.eop.gov. 

(SSA) 

Social Security Administration, 

DCBFM, Attn: Reports Clearance 

Officer, 1333 Annex Building, 6401 

Security Blvd., Baltimore, MD 21235, 

Fax: 410–965–6400, E-mail address: 

OPLM.RCO@ssa.gov. 

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 May 24, 

2011. Individuals can obtain copies of 

the collection instruments by calling the 

SSA Reports Clearance Officer at 410– 

965–8783 or by writing to the above email address. 

1. Questionnaire about Employment 

or Self-Employment outside the United 

States—20 CFR 404.401(b)(1), 404.415 & 

404.417—0960–0050. SSA collects 

information on the SSA–7163 to 

determine: (1) Whether work 

beneficiaries performed outside the 

United States is cause for deductions 

from their monthly benefits; (2) which 

of two work tests (foreign or regular test) 

is applicable; and (3) the number of 

months, if any, SSA should impose 

deductions. Respondents are 

beneficiaries living and working outside 

the United States. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 20,000. 

Frequency of Response: 1. 

Average Burden per Response: 12 

minutes. 

Estimated Annual Burden: 4,000 

hours. 

2. Statement of Income and 

Resources—20 CFR 416.207, 146.301– 

416.310, 416.704, and 416.708–0960– 

0124. SSA collects information about 

income and resources on the SSA– 

8010–BK for Supplemental Security 

Income (SSI) claims and 

redeterminations. SSA uses the 

information to make initial or 

continuing eligibility determinations for 

SSI claimants or recipients who are 

subject to deeming. The respondents are 

persons whose income and resources 

SSA may deem (consider to be 

available) to SSI applicants or 

recipients. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 341,000. 

Frequency of Response: 1. 

Average Burden per Response: 26 

minutes. 

Estimated Annual Burden: 147,767 

hours. 

3. Review of the Disability Hearing 

Officer’s Reconsidered Determinations 

before It Is Issued—20 CFR 404.913– 

404.918, 404.1512–404.1515, 404.1589, 

416.912–416.915, 416.989, 416.1413– 

416.1418, 404.918(d) and 416.1418(d)— 

0960–0709. After SSA approves 


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16850 Federal Register / Vol. 76, No. 58 / Friday, March 25, 2011 / Notices 

claimants for Social Security disability 

benefits or SSI payments, SSA 

periodically conducts a continuing 

disability review (CDR). During a CDR, 

the agency reviews claimants’ status to 

see if their condition improved to the 

point they are capable of working, and 

if so, to reduce or stop their benefits or 

payments. If SSA notifies a claimant the 

agency will stop benefits or payments, 

the claimant may appeal the 

determination. The first appeal gives the 

claimant the opportunity for a full 

evidentiary hearing before a disability 

hearing officer (DHO). 

For quality review purposes, a Federal 

component reviews a small sample of 

the DHO’s determinations. It is rare for 

the reviewing component to reverse a 

DHO determination favorable to the 

claimant. Before SSA can issue an 

unfavorable determination, we give the 

claimant 10 days to provide a written 

statement explaining why SSA should 

not stop payments. The written 

statement is the information SSA 

collects in this process. Respondents are 

CDR claimants whose payments may 

cease. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 8. 

Frequency of Response: 1. 

Average Burden per Response: 60 

minutes. 

Estimated Annual Burden: 8 hours. 

II. SSA submitted the information 

collections listed below to OMB for 

clearance. Your comments on the 

information collections would be most 

useful if OMB and SSA receive them 

within 30 days from the date of this 

publication. To be sure we consider 

your comments, we must receive them 

no later than April 25, 2011. You can 

obtain a copy of the OMB clearance 

package by calling the SSA Reports 

Clearance Officer at 410–965–8783 or by 

writing to the above e-mail address. 

1. Application for Survivors 

Benefits—20 CFR 404.611(a) and (c)— 

0960–0062. Surviving family members 

of armed services personnel can file for 

Social Security and veterans’ benefits at 

SSA or the Veterans Administration 

(VA). Applicants file for title II survivor 

benefits at the VA by completing the 

SSA–24. The VA forwards the form to 

SSA for processing. SSA uses the 

information to determine eligibility for 

benefits. The respondents are survivors 

of deceased armed services personnel 

who are applying for benefits at the VA. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 3,200. 

Frequency of Response: 1. 

Average Burden per Response: 15 

minutes. 

Estimated Annual Burden: 800 hours. 

2. Employee Work Activity 

Questionnaire—20 CFR 404.1574, 

404.1592—0960–0483. Social Security 

disability beneficiaries and SSI 

recipients qualify for payments when a 

verified physical or mental impairment 

prevents them from working. If 

disability claimants attempt to return to 

work after receiving payments, but are 

unable to continue working, they submit 

the SSA–3033, Employee Work Activity 

Questionnaire, so SSA can evaluate 

their work attempt. SSA also uses this 

form to evaluate unsuccessful subsidy 

work and determine applicants’ 

continuing eligibility for disability 

payments. The respondents are 

employers of Social Security disability 

beneficiaries and SSI recipients who 

unsuccessfully attempted to return to 

work. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 15,000. 

Frequency of Response: 1. 

Average Burden per Response: 15 

minutes. 

Estimated Annual Burden: 3,750 

hours. 

Dated: March 22, 2011. 

Faye Lipsky, 

Reports Clearance Officer, Center for Reports 

Clearance, Social Security Administration. 

[FR Doc. 2011–7124 Filed 3–24–11; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF STATE 

[Public Notice 7385] 

60-Day Notice of Proposed Information 

Collection: Agency Form DS–4127, 

NEA/PI Online Performance Reporting 

System (PRS), OMB Control Number 

1405–0183. 

ACTION: Notice of request for public 

comments. 

SUMMARY: The Department of State is 

seeking Office of Management and 

Budget (OMB) approval for the 

information collection described below. 

The purpose of this notice is to allow 60 

days for public comment in the Federal 

Register preceding submission to OMB. 

We are conducting this process in 

accordance with the Paperwork 

Reduction Act of 1995. 

• Title of Information Collection: 

NEA/PI Online Performance Reporting 

System (PRS). 

• OMB Control Number: 1405–0183. 

• Type of Request: Renewal. 

• Originating Office: NEA/PI. 

• Form Number: DS–4127. 

• Respondents: Recipients of NEA/PI 

grants. 

• Estimated Number of Respondents: 

70 respondents annually. 

• Estimated Number of Responses: 

280 per year. 

• Average Hours Per Response: 20. 

• Total Estimated Burden: 5,600 

hours per year. 

• Frequency: Quarterly. 

• Obligation to Respond: Required to 

Obtain or Retain a Benefit. 

DATES: The Department will accept 

comments from the public up to 60 days 

from March 25, 2011. 

ADDRESSES: You may submit comments 

by any of the following methods: 

• E-mail: 

mepidatabasecomments@state.gov. 

• Mail (paper, disk, or CD–ROM 

submissions): Catherine Bourgeois, 

Deputy Director, U.S. Department of 

State, Office of the Middle East 

Partnership Initiative (NEA/PI), Bureau 

of Near Eastern Affairs, NEA Mail 

Room—Room 6258, 2201 C St., NW., 

Washington, DC 20520. 

• Fax: 202–647–8445. 

• Hand Delivery or Courier: 2430 E 

St., NW. (23rd and D St., NW.), Navy 

Hill—SA–4—Central, Second Floor, 

Washington, DC 20037. 

You must include the DS form 

number (if applicable), information 

collection title, and OMB control 

number in any correspondence. 

FOR FURTHER INFORMATION CONTACT: 

Please direct requests for additional 

information regarding the collection 

listed in this notice, including requests 

for copies of the proposed information 

collection and supporting documents, to 

Neil Stormer, U.S. Department of State, 

Office of the Middle East Partnership 

Initiative (NEA/PI), Bureau of Near 

Eastern Affairs, NEA Mail Room—Room 

6258, 2201 C St., NW., Washington, DC 

20520, who may be reached on 202– 

776–8595 or at stormernc@state.gov. 

SUPPLEMENTARY INFORMATION: We are 

soliciting public comments to permit 

the Department to: 

• Evaluate whether the proposed 

information collection is necessary for 

the proper performance of our 

functions. 

• Evaluate the accuracy of our 

estimate of the burden of the proposed 

collection, including the validity of the 

methodology and assumptions used. 

• Enhance the quality, utility, and 

clarity of the information to be 

collected. 

• Minimize the reporting burden on 

those who are to respond, including the 

use of automated collection techniques 

or other forms of technology. 

Abstract of proposed collection: Since 

2002, MEPI has obligated more than 

$600 million to over 550 organizations, 


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