Federal Register / Vol. 69, No. 237 / Friday, December 10, 2004 / Notices 71863

16 In approving this rule, the Commission notes 

that it has considered its impact on efficiency, 

competition and capital formation. 15 U.S.C. 78c(f).

17 15 U.S.C. 78f(b).

18 15 U.S.C. 78f(b)(5).

19 15 U.S.C. 78s(b)(2).

20See Securities Exchange Act Release No. 47959 

(May 30, 2003), 68 FR 34441 (June 9, 2003) (SR–

CBOE–2002–05).

21 15 U.S.C. 78s(b)(2). 22 17 CFR 200.30–3(a)(12).

C. Self-Regulatory Organization’s 

Statement on Comments on the 

Proposed Rule Change Received from 

Members, Participants, or Others 

No written comments were either 

solicited or received. 

III. Solicitation of Comments 

Interested persons are invited to 

submit written data, views, and 

arguments concerning the foregoing, 

including whether the proposed rule 

change, as amended, is consistent with 

the Act. Comments may be submitted by 

any of the following methods: 

Electronic Comments 

• Use the Commission’s Internet 

comment form (http://www.sec.gov/

rules/sro.shtml); or 

• Send an e-mail to rulecomments@sec.gov. Please include File 

Number SR–Phlx–2004–57 on the 

subject line. 

Paper Comments 

• Send paper comments in triplicate 

to Jonathan G. Katz, Secretary, 

Securities and Exchange Commission, 

450 Fifth Street, NW., Washington, DC 

20549–0609. 

All submissions should refer to File 

Number SR–Phlx–2004–57. This file 

number should be included on the 

subject line if e-mail is used. To help the 

Commission process and review your 

comments more efficiently, please use 

only one method. The Commission will 

post all comments on the Commission’s 

Internet Web site (http://www.sec.gov/

rules/sro.shtml). Copies of the 

submission, all subsequent 

amendments, all written statements 

with respect to the proposed rule 

change that are filed with the 

Commission, and all written 

communications relating to the 

proposed rule change between the 

Commission and any person, other than 

those that may be withheld from the 

public in accordance with the 

provisions of 5 U.S.C. 552, will be 

available for inspection and copying in 

the Commission’s Public Reference 

Section, 450 Fifth Street, NW., 

Washington, DC 20549. Copies of such 

filing also will be available for 

inspection and copying at the principal 

offices of the Exchange. All comments 

received will be posted without change; 

the Commission does not edit personal 

identifying information from 

submissions. You should submit only 

information that you wish to make 

available publicly. All submissions 

should refer to File Number SR–Phlx–

2004–57 and should be submitted on or 

before January 3, 2005. 

IV. Commission’s Findings and Order 

Granting Accelerated Approval of 

Proposed Rule Change 

After careful consideration, the 

Commission finds that the proposed 

rule change is consistent with the 

requirements of the Act and the rules 

and regulations thereunder, applicable 

to a national securities exchange,16 and, 

in particular, with the requirements of 

section 6(b) of the Act 17 and the rules 

and regulations thereunder. The 

Commission finds that the proposed 

rule change, which establishes a new 

allocation algorithm, is consistent with 

section 6(b)(5) of the Act,18 which 

requires that the rules of an exchange be 

designed to promote just and equitable 

principles of trade, remove 

impediments to and perfect the 

mechanism of a free and open market 

and a national securities system, and, in 

general, protect investors and the public 

interest.

Specifically, the Commission believes 

that the proposed allocation algorithm 

may enhance incentives to quote 

competitively by providing all market 

participants with the opportunity to 

participate in the allocation of trade, 

regardless of their disseminated size, if 

they are quoting at the disseminated 

price. The proposal also should provide 

incentives for Phlx XL participants to 

quote in greater size to obtain a larger 

allocation under Component B of the 

proposed allocation algorithm. 

The Commission finds good cause, 

pursuant to section 19(b)(2) of the Act,19

for approving the proposed rule change 

prior to the 30th day after the date of 

publication of the notice of the filing 

thereof in the Federal Register. The 

Commission notes that the proposal is 

substantially similar to the Chicago 

Board Options Exchange, Inc. Rule 

6.45A,20 which was previously 

approved by the Commission after 

notice and comment, and, therefore, 

does not raise any new regulatory 

issues.

V. Conclusion 

It is therefore ordered, pursuant to 

section 19(b)(2) of the Act,21 that the 

proposed rule change and Amendments 

Nos. 1, 2, 3, and 4 thereto (SR–Phlx–

2004–57) are hereby approved on an 

accelerated basis.

For the Commission, by the Division of 

Market Regulation, pursuant to delegated 

authority.22

Jill M. Peterson, 

Assistant Secretary.

[FR Doc. E4–3594 Filed 12–9–04; 8:45 am] 

BILLING CODE 8010–01–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 that will require 

clearance by the Office of Management 

and Budget (OMB) in compliance with 

Pub. L. 104–13, the Paperwork 

Reduction Act of 1995, effective October 

1, 1995. The information collection 

packages that may be included in this 

notice are for 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 

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, Fax: 202–395–6974. 

(SSA), Social Security 

Administration, DCFAM, Attn: Reports 

Clearance Officer, 1338 Annex Building, 

6401 Security Blvd., Baltimore, MD 

21235; Fax: 410–965–6400. 

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 410–

965–0454 or by writing to the address 

listed above. 

1. Quarterly Statistical Report on 

Recipients and Payments Under StateAdministered Assistance Programs for 

71864 Federal Register / Vol. 69, No. 237 / Friday, December 10, 2004 / Notices 

Aged, Blind and Disabled (Individuals 

and Couples) Recipients—20 CFR 

416.2010, 20 CFR 416.2098—0960–

0130. The purpose of the statistical 

report is to obtain State data on 

expenditures and caseloads of Stateadministered supplementation under 

the Supplemental Security Income (SSI) 

program. The statistics are needed to 

complement information available for 

the federally administered programs and 

to more fully explain the impact of the 

public income support programs on the 

needy, aged, blind, and disabled. In 

addition, the expenditure data are used 

to monitor State compliance with the 

mandatory pass-along provision. 

States use our publications, which are 

prepared from data submitted on this 

statistical report, for administrative 

purposes to compare their expenditures 

and caseloads with those of other States, 

to determine the feasibility of program 

change, and to keep abreast of program 

developments in other States. Federal 

personnel request data about Stateadministered supplementation programs 

to compare various State programs, to 

examine the relationship of State 

supplementation expenditures and 

caseloads to federally financed 

programs such as Medicaid, and to 

determine the effect of changes in SSI 

and other Federal programs on State 

supplementation programs. In addition, 

Federal and State personnel have used 

data obtained from this report in 

developing legislative proposals and 

budget estimates. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 31. 

Frequency of Response: 4. 

Average Burden Per Response: 60 

minutes. 

Estimated Annual Burden: 124 hours.

2. Application for Survivors 

Benefits—20 CFR 404.611 (a) and (c)—

0960–0062. The information collected 

by form SSA–24 is needed to satisfy the 

‘‘Joint Prescribed Application’’ of Title 

38 U.S.C. 5105. That provision requires 

that survivors who file with either SSA 

or the Veteran’s Administration (VA) 

shall be deemed to have filed with both 

agencies, and that each agency’s forms 

must request sufficient information to 

constitute an application for both SSA 

and VA benefits. The respondents are 

survivors of members or former 

members of the armed services. When 

form SSA–24 is received by SSA from 

the VA, an earnings record is requested 

to determine if insured status exists so 

that the claimant will 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. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 3,200. 

Frequency of Response: 1. 

Average Burden Per Response: 15 

minutes. 

Estimated Annual Burden: 800 hours. 

3. Continuing Disability Review 

Report—20 CFR 404.1589, 20 CFR 

416.989—0960–0072. We use form 

SSA–454–BK to collect information 

from individuals receiving disability 

benefits or their representatives. We 

evaluate the information to determine 

whether the individuals remain eligible 

for benefit payments. Adults are 

considered eligible for payment if they 

continue to be unable to do substantial 

gainful activity (SGA) by reason of their 

impairments. Title XVI children are 

considered eligible for payment if they 

still have marked and severe functional 

limitations by reason of their 

impairments. We obtain information 

concerning sources of medical 

treatment, participation in vocational 

rehabilitation programs (if any), 

attempts to work (if any), and the 

opinions of individuals regarding 

whether their conditions have 

improved. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 792,020. 

Frequency of Response: 1. 

Average Burden Per Response: 45 

minutes. 

Estimated Annual Burden: 594,015 

hours. 

4. Statement Regarding Marriage—20 

CFR 404.726—0960–0017. Form SSA–

753 elicits information from third 

parties to verify the applicant’s 

statement about intent, cohabitation, 

and holding out to the public as 

married, which are basic tenets of a 

common-law marriage. The responses 

are used by SSA to determine if a valid 

marital relationship exists and to make 

an accurate determination regarding 

entitlement to spouse/widow(er) 

benefits. The respondents are 

individuals who are familiar with and 

can provide confirmation of an 

applicant’s common-law marriage. 

Type of Request: Extension of an 

OMB-approved information collection.

Number of Respondents: 40,000. 

Frequency of Response: 1. 

Average Burden Per Response: 9 

minutes. 

Estimated Annual Burden: 6,000 

hours. 

5. Advance Notice of Termination of 

Child’s Benefits and Student’s 

Statement Regarding School 

Attendance—20 CFR 404.350–404.352, 

404.367–404.368—0960–0105. The 

information collected on form SSA–

1372 is needed to determine whether 

children of an insured worker are 

eligible for student benefits. The data 

allows SSA to determine student 

entitlement and whether entitlement 

will end. The respondents are student 

claimants for Social Security benefits, 

their respective schools and, in some 

cases, their payees. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 200,000. 

Frequency of Response: 1. 

Average Burden Per Response: 10 

minutes. 

Estimated Average Burden: 33,333 

hours. 

6. Request for Address Information 

From Motor Vehicles Records; Request 

for Address Information From 

Employment Commissions Records—4 

CFR 104.2 —0960–0341. SSA sends 

form SSA–L711 to State Motor Vehicle 

Administrations to obtain the last 

known address from driver’s license and 

registration records. SSA sends form 

SSA–L712 to State Employment 

Commissions to obtain the last known 

address from State unemployment/

employment wage records. SSA uses the 

information to locate debtors to arrange 

for payment of debts owed to SSA. The 

respondents are State Motor Vehicle 

Administrations and State Employment 

Commissions. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 2,400. 

Frequency of Response: 1. 

Average Burden Per Response: 2 

minutes. 

Estimated Average Burden: 80 hours. 

7.General Request for Social Security 

Records, eFOIA—20 CFR 402.130 

—0960–NEW. SSA uses the information 

collected on this electronic request for 

Social Security records to respond to the 

public’s request for information under 

the rights provided by the Freedom of 

Information Act (FOIA), and to track 

those requests by amount received, type 

of request, fees charged and responses 

sent within the required 20 days. 

Respondents are individuals or agencies 

requesting documents under FOIA. 

Type of Request: New information 

collection. 

Number of Respondents: 300,000. 

Frequency of Response: 1. 

Average Burden Per Response: 3 

minutes. 

Estimated Annual Burden: 15,000 

hours.

8. Social Security Number 

Verification Service (SSNVS)—0960–

0660 

Federal Register / Vol. 69, No. 237 / Friday, December 10, 2004 / Notices 71865

Background 

Under Internal Revenue Service 

regulations, employers are obligated to 

provide wage and tax data to SSA using 

form W-2, Wage and Tax Statement or 

its electronic equivalent. As part of this 

process, the employer must furnish the 

employee’s name and their Social 

Security Number (SSN). This 

information must match SSA’s records 

in order for the employee’s wage and tax 

data to be properly posted to their 

Earnings Record. Information that is 

incorrectly provided to the Agency must 

be corrected by the employer using an 

amended reporting form, which is a 

labor-intensive and time-consuming 

process for both SSA and the employer. 

Therefore, to help ensure that employers 

provide accurate name and SSN 

information, SSA piloted SSNVS with 

100 employers and now plans to 

implement the service nationally. 

SSNVS Collection 

SSNVS is an optional free and secure 

Internet service for employers that 

allows them to perform advance 

verification of their employees’ name 

and SSN information against SSA 

records. SSA will use the information 

collected through the SSNVS to verify 

that employee name and SSN 

information, provided by employers, 

matches SSA records. SSA will respond 

to the employer informing them only of 

matches and mismatches of submitted 

information. Respondents are employers 

who provide wage and tax data to SSA 

and elected to use the service. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 200,000. 

Frequency of Response: 120. 

Average Burden Per Response: 5 

minutes. 

Estimated Annual Burden: 2,000,000 

hours. 

9. Report of Death by Funeral 

Director—20 CFR 404.715, 404.720, 

416.635—0960–0142. SSA uses the 

information on form SSA–721 to make 

timely and accurate decisions based on 

the report of death including: (1) 

proving the death of an insured 

individual, (2) learning of the death of 

a beneficiary whose benefits should 

terminate, and (3) determining who is 

eligible for the Lump-Sum Death 

Payment (LSDP) or may be eligible for 

benefits. The respondents are funeral 

directors with knowledge of the fact of 

death. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 741,113. 

Frequency of Response: 1. 

Average Burden Per Response: 3.5 

minutes. 

Estimated Annual Burden: 43,231 

hours. 

10. Application for SSI—20 CFR 

416.305–335—0960–0229. 

SSA uses the information collected on 

form SSA–8000–BK or its electronic 

equivalent, the Modernized SSI Claims 

System (MSSICS), to determine 

eligibility for SSI and the amount of 

benefits payable to the applicant. During 

the personal interview process the 

MSSICS system takes less time to 

complete because the system propagates 

like information and only asks relevant 

questions of the applicant. 

Approximately 97% of SSI applications 

are taken via MSSICS. The respondents 

are applicants for SSI payments. 

Type of Request: Revision of an OMBapproved information collection. 

Form SSA–8000 

Number of Respondents: 33,851. 

Frequency of Response: 1. 

Average Burden Per Response: 41 

minutes. 

Estimated Annual Burden: 23,132 

hours. 

MSSICS 

Number of Respondents: 1,094,523. 

Frequency of Response: 1. 

Average Burden Per Response: 36 

minutes. 

Estimated Annual Burden: 656,714 

hours. 

Total Burden Hours: 679,846. 

II. The information collections listed 

below have 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 packages by calling 

the SSA Reports Clearance Officer at 

410–965–0454, or by writing to the 

address listed above. 

1. Work Activity Report (SelfEmployed)—20 CFR 404.1520(b) 20 CFR 

1571–.1576 20 CFR 404.1584–.1593 20 

CFR 416.971–.976—0960–0598. The 

information on form SSA–820–F4 is 

used by SSA to determine initial or 

continuing eligibility for SSI or Social 

Security disability benefits. Under Title 

II and Title XVI of the Act, applicants 

for disability benefits must prove an 

inability to perform any kind of 

substantial gainful activity (SGA) 

generally available in the national 

economy for which they might be 

expected to qualify on the basis of age, 

education, and work experience. SSA 

needs to secure information about this 

work in order to ascertain whether the 

applicant was (or is) engaging in SGA. 

Work after a claimant becomes entitled 

can cause the cessation of disability 

benefits. The information obtained from 

form SSA–820–F4 is needed to 

determine if a cessation of benefits 

should occur. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 100,000. 

Frequency of Response: 1. 

Average Burden Per Response: 30 

minutes. 

Estimated Annual Burden: 50,000 

hours. 

2. Cessation or Continuance of 

Disability or Blindness Determination—

20 CFR 404.1615–20 CFR 404.1512–20 

CFR 404.1588–1599—0960–0443. The 

information on form SSA–832–U3/C3 is 

used by SSA to document 

determinations as to whether an 

individual’s disability benefits should 

be terminated or continued on the basis 

of his/her impairment. The respondents 

are State Disability Determination 

Services (DDS) employees adjudicating 

Title XVI disability claims.

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 392,191. 

Frequency of Response: 1. 

Average Burden Per Response: 30 

minutes. 

Estimated Annual Burden: 196,096 

hours. 

3. Representative Payee Report—20 

CFR 404.2035, 404.2065, 416.635, and 

416.665—0960–0068. The information 

on forms SSA–623 and SSA–6230 is 

used by SSA to determine whether 

payments certified to a representative 

payee have been used for the 

beneficiary’s current maintenance and 

personal needs and to determine 

whether the representative payee 

continues to be concerned with the 

beneficiary’s welfare. The respondents 

are representative payees. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 5,250,000. 

Frequency of Response: 1. 

Average Burden Per Response: 15 

minutes. 

Estimated Annual Burden: 1,312,500 

hours. 

4. Modified Benefit Formula 

Questionnaire—0960–0395. SSA uses 

the information collected by form SSA–

150 to determine the correct formula to 

be used in computing the Social 

Security benefit for someone who 

receives a pension from employment 

not covered by Social Security. The 

Windfall Elimination Provision (WEP) 

requires use of a benefit formula that 

replaces a smaller percentage of a 

worker’s pre-retirement earnings. 

However, the difference in the benefit 

computed using the modified and 

regular formulas cannot be greater than 

71866 Federal Register / Vol. 69, No. 237 / Friday, December 10, 2004 / Notices 

one-half the amount of the pension 

received in the first month an 

individual is entitled to both the 

pension and the Social Security benefit. 

Form SSA–150 collects the information 

needed to make all the necessary benefit 

computations. The respondents are 

claimants for Social Security benefits 

who are entitled to both benefits. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 90,000. 

Frequency of Response: 1. 

Average Burden Per Response: 8 

minutes. 

Estimated Average Burden: 12,000 

hours. 

5. Modified Benefit Formula 

Questionnaire-Employer—0960–0477. 

The information collected on form SSA–

58 is used by SSA to verify the 

claimant’s allegations on form SSA–150 

(OMB #0960–0395). SSA must make a 

determination regarding whether the 

modified benefit formula is applicable 

and when to first apply it to a person’s 

benefit. This form will be sent to an 

employer for pension-related 

information if the claimant is unable to 

provide it. The respondents are people 

who are eligible after 1985 for both 

Social Security benefits and a pension 

based on work not covered by SSA. 

Type of Request: Extension of an 

OMB-approved information collection.

Number of Respondents: 30,000. 

Frequency of Response: 1. 

Average Burden Per Response: 20 

minutes. 

Estimated Average Burden: 10,000 

hours. 

6. Acknowledgement of Receipt 

(Notice of Hearing)—part 404, subpart J, 

404.936(d), (e) and (f); 404.938(c); 

404.950(a); part 416, subpart N, 

416.1436(d), (e) and (f); 416.1438(c); 

416.1450(a)—0960–0671. The 

information collected under 20 CFR 

404.938(c) and 416.1438(c) through 

form HA–504 is used by SSA to process 

requests for hearings on unfavorable 

determinations of entitlement or 

eligibility to disability payments. SSA 

needs the information to determine if 

the individual received the notice of 

hearing issued by an Administrative 

Law Judge (ALJ) and whether the 

individual intends to appear at the 

scheduled time and place. The 

respondents are applicants for Social 

Security and SSI disability payments 

who want to have a hearing to appeal 

an unfavorable decision. 

Information collected under 20 CFR 

404.936(d), (e) and (f) and 416.1436(d), 

(e) and (f) (not on a prescribed form, but 

in writing, if possible) is used to 

determine if the individual objects to 

the scheduled time and place for his or 

her hearing and, if so, the individual’s 

reasons for objecting and the time and 

place he or she would like to have the 

hearing held. Documentary evidence 

that a party presents at his or her 

hearing under 20 CFR 404.950(a) and 

416.1450(a) is used in deciding if the 

individual qualifies for benefits. For 

those collections cleared through SSA 

forms, the public reporting burden is 

accounted for in the ICRs for the various 

forms. Consequently, a 1-hour 

placeholder burden is being assigned to 

the specific reporting requirements 

contained in the rule.

Section 

Annual

number of

responses 

Frequency of 

response 

Average

burden per

response

(minutes) 

Estimated

annual burden 

(hours) 

404.936(d), (e) & (f) ......................................................................................... 92,000 1 10 15,333

404.938(c) & 416.1438(c)–HA–504 ................................................................. 550,000 1 1 9,166 

404.950(a) ........................................................................................................ 210,000 1 30 105,000 

416.1436(d), (e) & (f) ....................................................................................... 75,000 1 10 12,500 

416.1450(a) ...................................................................................................... 172,000 1 30 86,000 

Total ...................................................................................................... 1,099,000 ........................ ........................ 227,999 

Type of Request: Extension of an 

OMB-approved information collection. 

7. State Death Match—20 CFR 

404.301, 20 CFR 404.310–311, 20 CFR 

404.316, 20 CFR 404.330–341, 20 CFR 

404.350–352, 20 CFR 404.371, and 20 

CFR 416.912—0960–NEW. 

Background 

Section 205(r) of the Social Security 

Act requires SSA to contract with the 

States to obtain death certificate 

information in order to compare it to 

SSA’s payment files. This match 

ensures the accuracy of our payment 

files by detecting unreported or 

inaccurate deaths of beneficiaries. 

Entitlement to retirement, disability, 

wife’s, husband’s or parent’s benefits 

under the provisions of the Social 

Security Act terminates when the 

beneficiary dies. About 2.5 million 

people die in the United States each 

year. Approximately 2.0 million are 

SSA beneficiaries. Therefore, the 

information is instrumental in 

maintaining payment integrity. 

SSA is seeking clearance of both the 

current state death match reporting 

process and the new Web-based 

Electronic Death Registration (EDR) 

process described below: 

State Death Match—Current Process 

The first participants in the death 

registration process, usually funeral 

directors, are charged by State law to 

complete the demographic information 

on the decedent and obtain necessary 

physicians’ signatures to complete the 

death registration. Once the death 

registration information is completed, 

the first participant sends the 

information to the State’s bureau of vital 

statistics (SBVS). The SBVS officially 

registers the death and is the official 

keeper of the death record. 

Each State then furnishes this 

information to SSA, using current 

technology including Vital Information 

Systems Network (VISN), electronic 

Vital Information Systems Network 

(eVISN), and ConnectDirect. 

Under this process SSA must 

independently verify the State death 

data before taking a termination action. 

The respondents are the SBVS. 

State Death Match—EDR Online 

Verification of the SSN in State Death 

Registration Process 

The States are now updating and 

further automating the death registration 

processes. This State reengineering 

effort is widely known as the EDR 

initiative. The EDR system permits 

electronic transfer of the death 

certificate. Under EDR the first 

participant completes a portion and 

electronically sends the document to the 

next participant for completion and 

submission to the SBVS. 

An additional feature of EDR is the 

Online Verification System (OVS) 

developed by the National Association 

for Public Health Statistics and 

Information System (NAPHSIS) in 

conjunction with SSA. The process 

allows the first participants in the death 

registration process to enter the 

Federal Register / Vol. 69, No. 237 / Friday, December 10, 2004 / Notices 71867

decedent’s demographic information 

including the SSN into the EDR system. 

The system will verify the SSN online 

in real time and creates an electronic 

death certificate as well as a fact of 

death report. The States have agreed 

that the on-line verification of the SSN 

at the first point of collection in the 

registration process will satisfy the 

requirement to independently verify the 

SSN.

EDR reduces the processing time 

needed to register deaths and greatly 

improves the business practices of the 

various participants in death 

registration process. EDR will result in 

the State’s ability to send SSA the report 

with a verified SSN within 5 days of the 

date of death and within 24 hours of 

receipt in the State repository. SSA is 

using a phased-in approach to EDR. 

When fully implemented, SSA will save 

significant program dollars and work 

years annually. The respondents are the 

SBVS. 

Type of Request: New information 

collection. 

Estimated Annual Cost for all 

respondents:

Collection format Number of

respondents 

Frequency of 

responses

(per state) 

Average cost 

per record

request 

Estimated

annual cost

burden 

State Death Match—Current Registration process ......................................... 52 50,000 $.67 $1,742,000

State Death Match—Electronic Death Registration (EDR) ............................. 3 50,000 2.48 372,000 

Please note that both of these data 

matching processes are entirely 

electronic and there is no hourly burden 

for the respondent to provide this 

information. 

III. Agency Information Collection 

Activities: Emergency Consideration 

Request. In compliance with Public Law 

104–13, the Paperwork Reduction Act of 

1995, SSA is providing notice that it is 

submitting to OMB information 

collections for emergency consideration. 

SSA is revising these forms as a result 

of the Social Security Protection Act of 

2004. SSA is requesting emergency 

consideration from OMB by January 10, 

2005 of the information collections 

listed below. Therefore, comments 

should be submitted to OMB and SSA 

by that date. 

1. Petition To Obtain Approval Of A 

Fee For Representing A Claimant Before 

the Social Security Administration—20 

CFR Subpart R, 404.1720, 404.1725; 

Subpart F, 410.686b; Subpart O, 

416.1520 and 416.1525—0960–0104. A 

representative of a claimant for Social 

Security benefits must file either a fee 

petition or a fee agreement with SSA in 

order to charge a fee for representing a 

claimant in proceedings before SSA. 

The representative uses form SSA–

1560–U4 to petition SSA for 

authorization to charge and collect a fee. 

A claimant may also use the form to 

agree or disagree with the requested fee 

amount or other information the 

representative provides on the form. 

SSA uses the information to determine 

a reasonable fee that a representative 

may charge and collect for his or her 

services. The respondents are claimants, 

their attorneys and other persons 

representing them. 

Type of Request: Emergency. 

Number of Respondents: 34,624. 

Frequency of Response: 1. 

Average Burden Per Response: 30 

minutes. 

Estimated Annual Burden: 17,312 

hours. 

2. Appointment of Representation—

20 CFR 404.1707, 404.1720, 404.1725, 

410.684 and 416.1507—0960–0527. The 

information collected by SSA on form 

SSA–1696–U4 is used to verify the 

applicant’s appointment of a 

representative. It allows SSA to inform 

the representative of items which affect 

the applicant’s claim. The affected 

public consists of applicants who notify 

SSA that they have appointed a person 

to represent them in their dealings with 

SSA when claiming a right to benefits. 

Type of Request: Emergency. 

Number of Respondents: 551,520. 

Frequency of Response: 1. 

Average Burden Per Response: 10 

minutes. 

Estimated Annual Burden: 91,920 

hours.

Dated: December 3, 2004. 

Elizabeth A. Davidson, 

Reports Clearance Officer, Social Security 

Administration.

[FR Doc. 04–26998 Filed 12–9–04; 8:45 am] 

BILLING CODE 4191–02–P

DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration 

Notice of Intent To Rule on Application 

To Impose and Use the Revenue From 

a Passenger Facility Charge (PFC) at 

St. Petersburg-Clearwater International 

Airport, Clearwater, FL

AGENCY: Federal Aviation 

Administration (FAA), DOT.

ACTION: Notice of intent to rule on 

application. 

SUMMARY: The FAA proposes to rule and 

invites public comment on the 

application to impose and use the 

revenue from a PFC at St. PetersburgClearwater International Airport under 

the provisions of the Aviation Safety 

and Capacity Expansion Act of 1990 

(Title IX of the Omnibus Budget 

Reconciliation Act of 1990) (Pub. L. 

101–508) and part 158 of the Federal 

Aviation Regulations (14 CFR part 158).

DATES: Comments must be received on 

or before January 10, 2005.

ADDRESSES: Comments on this 

application may be mailed or delivered 

in triplicate to the FAA at the following 

address: Orlando Airports District 

Office, 5950 Hazeltine National Drive, 

Suite 400; Orlando, Florida 32822. 

In addition, one copy of any 

comments submitted to the FAA must 

be mailed or delivered to Mr. Noah 

Lagos, Airport Director of the Board of 

County Commissioners of Pinellas 

County at the following address: St. 

Petersburg-Clearwater International 

Airport, 14700 Terminal Blvd., Suite 

221, Clearwater, Florida 33762. 

Air carriers and foreign air carriers 

may submit copies of written comments 

previously provided to the Pinellas 

County under section 158.23 of part 

158.

FOR FURTHER INFORMATION CONTACT: Mr. 

Vernon P. Rupinta, Program Manager, 

Orlando Airports District Office, 5950 

Hazeltine National Drive, Suite 400; 

Orlando, Florida 32822, (407) 812–6331, 

Extension 124. The application may be 

reviewed in person at this same 

location.

SUPPLEMENTARY INFORMATION: The FAA 

proposes to rule and invites public 

comment on the application to impose 

and use the revenue from a PFC at St. 

Petersburg-Clearwater International 

Airport under the provisions of the 

Aviation Safety and Capacity Expansion 

Act of 1990 (Title IX of the Omnibus 

Budget Reconciliation Act of 1990) 

(Pub. L. 101–508) and part 158 of the 

Federal aviation Regulations (14 CFR 

part 158).