Federal Register / Vol. 86, No. 3 / Wednesday, January 6, 2021 / Notices 667 

21 17 CFR 200.30–3(a)(12). 

For the Commission, by the Division of 

Trading and Markets, pursuant to delegated 

authority.21

J. Matthew DeLesDernier, 

Assistant Secretary. 

[FR Doc. 2020–29284 Filed 1–5–21; 8:45 am] 

BILLING CODE 8011–01–P 

SOCIAL SECURITY ADMINISTRATION 

[Docket No: SSA–2020–0067] 

Agency Information Collection 

Activities: Proposed 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 new 

information collections, and revisions 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 

Comments: https://www.reginfo.gov/ 

public/do/PRAMain. Submit your 

comments online, referencing Docket ID 

Number [SSA–2020–0067]. 

(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: 

OR.Reports.Clearance@ssa.gov 

Or you may submit your comments 

online through https://www.reginfo.gov/ 

public/do/PRAMain, referencing Docket 

ID Number [SSA–2020–0067]. 

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 March 8, 2021. Individuals 

can obtain copies of the collection 

instruments by writing to the above 

email address. 

1. Retaining Employment and Talent 

After Injury/Illness Network (RETAIN)— 

0960–NEW. 

Background 

The Social Security Administration 

(SSA) and the U.S. Department of Labor 

(DOL) are undertaking the Retaining 

Employment and Talent After Injury/ 

Illness Network (RETAIN) 

demonstration. The RETAIN 

demonstration will test the impact of 

early intervention strategies to improve 

stay-at-work/return-to-work (SAW/ 

RTW) outcomes of individuals who 

experience work disability while 

employed. We define ‘‘work disability’’ 

as an injury, illness, or medical 

condition that has the potential to 

inhibit or prevent continued 

employment or labor force participation. 

SAW/RTW programs succeed by 

returning injured or ill workers to 

productive work as soon as medically 

possible during their recovery process, 

and by providing interim part-time or 

light duty work and accommodations, as 

necessary. The RETAIN demonstration 

is loosely modeled after promising 

programs operating in Washington 

State, including the Centers of 

Occupational Health and Education 

(COHE), the Early Return to Work 

(ERTW), and the Stay at Work programs. 

While these programs operate within 

the state’s workers’ compensation 

system, and are available only to people 

experiencing work-related injuries or 

illnesses, the RETAIN demonstration 

provides opportunities to improve 

SAW/RTW outcomes for both 

occupational and non-occupational 

injuries and illnesses of people who are 

employed, or at a minimum in the labor 

force, when their injury or illness 

occurs. 

The primary goals of the RETAIN 

demonstration are: 

1. To increase employment retention 

and labor force participation of 

individuals who acquire, or are at risk 

of developing, work disabilities; and 

2. To reduce long-term work disability 

among RETAIN service users, including 

the need for Social Security Disability 

Insurance and Supplemental Security 

Income. 

The ultimate purpose of the 

demonstration is to validate and expand 

implementation of evidence-based 

strategies to accomplish these goals. 

DOL is funding the intervention 

approaches and programmatic technical 

assistance for the demonstration. SSA is 

funding evaluation support, including 

technical assistance and the full 

evaluation for the demonstration. 

Project Description 

The demonstration consists of two 

phases. The first involves the 

implementation and assessment of 

cooperative awards to eight states to 

conduct planning and start-up activities, 

including the launch of a small pilot 

demonstration. During phase 1, SSA 

will provide evaluation-related 

technical assistance and planning, and 

conduct evaluability assessments to 

assess which states’ projects would 

allow for a rigorous evaluation if 

continued beyond the pilot phase. DOL 

will select a subset of the states to 

continue to phase 2, full 

implementation. 

Phase 2 will include a subset of states 

for full implementation and evaluation. 

During phase 2, DOL will fund the 

operations and program technical 

assistance activities for the 

recommended states, and SSA will fund 

the full set of evaluation activities. 

SSA is requesting clearance for the 

collection of data needed to implement 

and evaluate RETAIN. The four 

components of this evaluation, 

completed during site visits, interviews 

with RETAIN service users, surveys of 

RETAIN enrollees, and surveys of 

RETAIN service providers, include: 

• The participation analysis: Using 

RETAIN service user interviews and 

surveys, this analysis will provide 

insights into which eligible workers 

choose to participate in the program, in 

what ways they participate, and how 

services received vary with participant 

characteristics. Similarly, it will assess 

the characteristics of, and if possible, 

reasons for non-enrollment of nonparticipants. 

• The process analysis: Using staff 

interviews and logs, this analysis will 

produce information about operational 

features that affect service provision; 

perceptions of the intervention design 

by service users, providers, 

administrators, and other stakeholders; 

the relationships among the partner 

organizations; each program’s fidelity to 

the research design; and lessons for 

future programs with similar objectives. 

• The impact analysis: This analysis 

will produce estimates of the effects of 

the interventions on primary outcomes, 

including employment and Social 

Security disability applications, and 

secondary outcomes, such as health and 

service usage. SSA will identify 

evaluation designs for each state to 

generate impact estimates. The 

evaluation design could include 

experimental or non-experimental 

designs. 

• The cost-benefit analysis: This 

analysis will assess whether the benefits 


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of RETAIN justify its costs. We conduct 

this assessment from a range of 

perspectives, including those of the 

participants, state and Federal 

governments, SSA, and society as a 

whole. 

The proposed data collections to 

support these analyses include 

qualitative and quantitative data. At this 

time, SSA requests clearance for all of 

these data collection activities. The 

qualitative data collection consists of: 

(1) Semi-structured interviews with 

program staff and service users; and (2) 

staff activity logs. The program staff will 

complete interviews during two rounds 

of site visits. They will focus on staff’s 

perceptions of the successes and 

challenges of implementing each state’s 

program. The staff activity logs will 

house information on staff’s time to 

inform the benefit-cost analysis. The 

service user interviews will inform 

SSA’s understanding of users’ 

experiences with program services. The 

quantitative data include SSA’s program 

records and survey data. The survey 

data collection consists of: (1) Two 

rounds of follow-up surveys, focusing 

on individual-level outcomes, with 

enrollees, all of whom who have 

experienced a disability onset; and (2) 

two rounds of surveys with RETAIN 

providers. 

The respondents are staff members 

selected for staff interviews and staff 

activity logs, and RETAIN service users, 

enrollees, and providers. 

Type of Request: Request for a new 

information collection. 

Modality of completion Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

Average 

theoretical 

hourly cost 

amount 

(dollars) * 

Average wait 

time in 

field office 

(minutes) ** 

Total annual 

opportunity 

cost 

(dollars) *** 

RETAIN 2021 Burden Figures 

Enrollee Survey Round 1 (Respondents) ..... 320 1 15 80 * $25.72 ** 24 *** $5,350 

Enrollee Survey Round 1 (Nonrespondents) 80 1 3 4 * 25.72 ** 24 *** 926 

Totals ..................................................... 400 ........................ ........................ 84 ........................ ........................ *** 6,276 

RETAIN 2022 Burden Figures 

Staff Interviews (state administrators/directors) ............................................................ 4 1 105 7 * 45.23 24 *** 407 

Staff Interviews (program line staff) .............. 72 1 75 90 * 32.58 ** 24 *** 3,870 

Service User Interviews (Respondents) ....... 60 1 36 36 * 25.72 ** 24 *** 1,543 

Service User Interviews (Nonrespondents) .. 540 1 6 54 * 25.72 ** 24 *** 6,945 

Staff Activity Logs (state administrators/directors) ....................................................... 4 1 70 5 * 45.23 ** 24 *** 298 

Staff Activity Logs (program line staff) .......... 48 1 70 56 32.58 ** 24 *** 2,450 

Enrollee Survey Round 1 (Respondents) ..... 3,840 1 15 960 * 25.72 ** 24 *** 64,197 

Enrollee Survey Round 1 (Nonrespondents) 960 1 3 48 * 25.72 ** 24 *** 11,111 

Enrollee Survey Round 2 (Respondents) ..... 960 1 21 336 25.72 ** 24 *** 18,518 

Enrollee Survey Round 2 (Nonrespondents) 240 1 3 12 25.72 24 *** 2,778 

Provider Survey Round 2 (Respondents) ..... 320 1 17 91 * 32.58 ** 24 *** 7,135 

Provider Survey Round 2 (Nonrespondents) 80 1 3 4 * 32.58 ** 24 *** 1,173 

Totals ..................................................... 7,128 ........................ ........................ 1,699 ........................ ........................ *** 120,425 

RETAIN 2023 Burden Figures 

Enrollee Survey Round 1 (Respondents) ..... 3,840 1 15 960 * 25.72 ** 24 *** 64,197 

Enrollee Survey Round 1 (Nonrespondents) 960 1 3 48 25.72 24 *** 11,111 

Enrollee Survey Round 2 (Respondents) ..... 3,840 1 21 1,344 * 25.72 ** 24 *** 74,074 

Enrollee Survey Round 2 (Nonrespondents) 960 1 3 48 * 25.72 ** 24 *** 11,111 

Provider Survey Round 2 (Respondents) ..... 320 1 17 91 * 32.58 ** 24 *** 7,135 

Provider Survey Round 2 (Nonrespondents) 80 1 3 4 * 32.58 ** 24 *** 1,173 

Totals ..................................................... 10,000 ........................ ........................ 2,495 ........................ ........................ *** 168,801 

RETAIN 2024 Burden Figures 

Enrollee Survey Round 1 (Respondents) ..... 1,600 1 15 400 * 25.72 ** 24 *** 26,749 

Enrollee Survey Round 1 (Nonrespondents) 400 1 3 20 * 25.72 ** 24 *** 4,629 

Enrollee Survey Round 2 (Respondents) ..... 3,840 1 21 1,344 * 25.72 ** 24 *** 74,074 

Enrollee Survey Round 2 (Nonrespondents) 960 1 3 48 * 25.72 ** 24 *** 11,111 

Totals ..................................................... 6,800 ........................ ........................ 1,812 ........................ ........................ *** 116,563 

RETAIN 2025 Burden Figures 

Enrollee Survey Round 2 (Respondents) ..... 960 1 21 336 * 25.72 ** 24 *** 18,518 

Enrollee Survey Round 2 (Nonrespondents) 240 1 3 12 * 25.72 ** 24 *** 2,778 

Totals ..................................................... 1,200 ........................ ........................ 348 ........................ ........................ *** 21,296 

RETAIN Grand Total Burden Figures 

Totals ..................................................... 25,528 ........................ ........................ 6,438 ........................ ........................ *** 433,361 

* We based these figures on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm), and 

average local Government Management and staff hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes110000.htm) & 

(https://www.bls.gov/oes/current/oes131071.htm). 

** We based this figure on the average FY 2020 wait times for field offices, based on SSA’s current management information data.

*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the 

application. 


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2. Internet and Telephone 

Appointment Applications—20 CFR 

404.620–404.630, and 416.330– 

416.340—0960–NEW. SSA offers both 

internet and telephone appointment 

options for individuals who wish to 

request an appointment when they are 

unable to complete one of SSA’s online 

or automated telephone applications 

because they failed the initial 

verification checks,—or who state their 

reading language preference is other 

than English. 

iAppointment: iAppointment is an 

online process that allows members of 

the public an easy-to-use method to 

schedule an appointment with the 

servicing office of their choice. Since 

the application date can affect when a 

claimant’s benefit begins, iAppointment 

establishes a protective filing date and 

provides respondents information 

related to the date by which they must 

file their actual application. The 

iAppointment application propagates 

information the applicant already 

entered onto any of SSA’s internet 

applications for SSN, name, date of 

birth, and gender. Applicants must 

provide minimal additional 

information: Mailing address; telephone 

number; language preference; type of 

appointment (Disability, Retirement, 

Medicare); and whether they prefer a 

telephone interview or in-office 

appointment. iAppointment is a 

customer-centric application. If the 

available appointment times do not 

meet the customer’s needs, 

iAppointment allows the user to enter a 

different zip code to identify another 

field office, which may offer different 

appointment times. At this time, SSA 

only allows domestic first party 

applicants to use iAppointment. If users 

indicate they are filing as third parties, 

iAppointment provides a message 

directing them to call the National 800 

Number for assistance. If a foreign first 

party user is unable to complete iClaim, 

iAppointment directs them to contact a 

Social Security representative, and 

provides a link to SSA’s Service Around 

the World website. 

Enhanced Leads and Appointment 

System (eLAS): eLAS is an Intranetbased version of the iAppointment 

screens for use by SSA technicians both 

in the field offices and call centers. 

eLAS interacts with iAppointment to 

ensure we always record the same 

information whether an individual 

requests an appointment through our 

internet screens or via telephone. eLAS 

is a non-public facing system that 

allows SSA employees in the field 

offices, workload support units, and 

teleservice centers to use an telephone 

interview process to schedule 

appointments and document an 

individual’s intent to file using a script 

and asking the same questions to each 

individual. We use eLAS with 

individuals who use our automated 

telephone system or who prefer not to 

use iAppointment to set up their 

appointment. 

The respondents are individuals who 

are unable to use our internet or 

automated telephone systems because 

they failed the initial verification 

checks; or because they state their 

reading language preference is other 

than English. 

Type of Request: Request for a new 

information collection. 

Modality of completion Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

Average 

theoretical 

hourly cost 

amount 

(dollars) * 

Average 

combined 

wait time in 

field office 

or for 

teleservice 

center 

(minutes) ** 

Total annual 

opportunity 

cost 

(dollars) *** 

iAppointment ................................................. 17,621 1 10 2,937 * $25.72 ........................ *** $75,540 

eLAS .............................................................. 5,157,780 1 10 859,630 * 25.72 ** 21 *** 68,540,019 

Totals ..................................................... 5,175,401 ........................ ........................ 862,567 ........................ ........................ *** 68,615,559 

* We based these figures on average U.S. worker’s hourly wages (based on BLS.gov data, https://www.bls.gov/oes/current/oes_nat.htm). 

** We based this figure on the combined average FY 2020 wait times for field offices (approximately 24 minutes per respondent) and teleservice centers (approximately 17 minutes per respondent), based on SSA’s current management information data. 

*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the 

application. 

3. Statement of Living Arrangements, 

In-Kind Support, and Maintenance—20 

CFR 416.1130–416.1148—0960–0174. 

SSA determines Supplemental Security 

Income (SSI) payment amounts based 

on individuals’ needs. We measure 

individuals’ needs, in part, by the 

amount of income they receive, 

including in-kind support and 

maintenance in the form of food and 

shelter provided by other persons. SSA 

uses Form SSA–8006 to determine if inkind support and maintenance exists for 

SSI applicants and recipients. This 

information also assists SSA in 

determining the income value of in-kind 

support and maintenance. The 

respondents are individuals who apply 

for SSI payments, or who complete an 

SSI eligibility redetermination. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of completion Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

Average 

theoretical 

hourly cost 

amount 

(dollars) * 

Average 

combined 

wait time in 

field office 

or for 

teleservice 

center 

(minutes) ** 

Total annual 

opportunity 

cost 

(dollars) *** 

SSA–8006—Intranet version (SSI Claims 

System) ...................................................... 109,436 1 7 12,768 * $10.73 ** 17 *** $469,706 

SSA—8006–Paper version ........................... 12,160 1 7 1,419 * 10.73 ** 24 *** 67,417 

Totals ..................................................... 121,596 ........................ ........................ 14,187 ........................ ........................ *** 537,123 

* We based this figure on average DI payments based on SSA’s current FY 2020 data (https://www.ssa.gov/legislation/2020Fact%20Sheet.pdf). 

** We based this figure on the average FY 2020 wait times for field offices (24 minutes) and wait times for teleservice centers (17 minutes), based on SSA’s current 

management information data. 


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*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the 

application. 

4. Statement of Funds You Provided 

to Another and Statement of Funds You 

Received—20 CFR 416.1103(f)—0960– 

0481. SSA uses Forms SSA–2854 

(Statement of Funds You Provided to 

Another) and SSA–2855 (Statement of 

Funds You Received) to gather 

information to verify if a loan is bona 

fide for SSI recipients. The SSA–2854 

asks the lender for details on the 

transaction, and Form SSA–2855 asks 

the borrower the same basic questions 

independently. Agency personnel then 

compare the two statements, gather 

evidence if needed, and make a decision 

on the validity of the bona fide status of 

the loan. 

For SSI purposes, we consider a loan 

bona fide if it meets these requirements: 

• Must be between a borrower and 

lender with the understanding that the 

borrower has an obligation to repay the 

money; 

• Must be in effect at the time the 

cash goes to the borrower, that is, the 

agreement cannot come after the cash is 

paid; and 

• Must be enforceable under State 

law, as often there are additional 

requirements from the State. 

SSA collects this information at the 

time of initial application for SSI, or at 

any point when an individual alleges 

being party to an informal loan while 

receiving SSI. SSA collects information 

on the informal loan through both 

interviews and mailed forms. The 

agency’s field personnel conduct the 

interviews and mail the form(s) for 

completion, as needed. The respondents 

are SSI recipients and applicants, and 

individuals who lend money to them. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of completion Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

Average 

theoretical 

hourly cost 

amount 

(dollars) * 

Average 

combined 

wait time in 

field office 

or for 

teleservice 

center 

(minutes) ** 

Total annual 

opportunity 

cost 

(dollars) ** 

SSA–2854 ..................................................... 20,000 1 15 5,000 * $25.72 ** 24 *** $334,360 

SSA–2855 ..................................................... 20,000 1 15 5,000 * 25.72 ** 24 *** 334,360 

Totals ..................................................... 40,000 ........................ ........................ 10,000 ........................ ........................ *** 668,720 

* We based this figure on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm). 

** We based this figure on the average FY 2020 wait times for field offices, based on SSA’s current management information data.

*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the 

application. 

5. Medicare Subsidy Quality Review 

Forms—20 CFR part 418—0960–0707. 

The Medicare Modernization Act of 

2003 mandated the creation of the 

Medicare Part D prescription drug 

coverage program and provides certain 

subsidies for eligible Medicare 

beneficiaries to help pay for the cost of 

prescription drugs. As part of its 

stewardship duties of the Medicare Part 

D subsidy program, SSA must conduct 

periodic quality review checks of the 

information Medicare beneficiaries 

report on their subsidy applications 

(Form SSA–1020). SSA uses the 

Medicare Quality Review program to 

conduct these checks. The respondents 

are applicants for the Medicare Part D 

subsidy whom SSA chose to undergo a 

quality review. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of completion Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

Average 

theoretical 

hourly cost 

amount 

(dollars) * 

Total annual 

opportunity 

cost 

(dollars) *** 

SSA–9301 (Medicare Subsidy Quality Review Case Analysis 

Form ...................................................................................... 3,500 1 30 1,750 * $40.64 ** $71,120 

SSA–9302 (Notice of Quality Review Acknowledgment Form 

for those with Phones) .......................................................... 3,500 1 15 875 * 25.72 ** 22,505 

SSA–9303 (Notice of Quality Review Acknowledgment Form 

for those without Phones) ..................................................... 350 1 15 88 * 25.72 ** 2,263 

SSA–9308 (Request for Information) ........................................ 7,000 1 15 1,750 * 25.72 ** 45,010 

SSA–9310 (Request for Documents) ....................................... 3,500 1 5 292 * 25.72 ** 7,510 

SSA–9311 (Notice of Appointment—Denial—Reviewer Will 

Call) ....................................................................................... 450 1 15 113 * 25.72 ** 2,906 

SSA–9312 (Notice of Appointment—Denial—Please Call Reviewer) ................................................................................... 50 1 15 13 * 25.72 ** 334 

SSA–9313 (Notice of Quality Review Acknowledgment Form 

for those with Phones) .......................................................... 2,500 1 15 625 * 25.72 ** 16,075 

SSA–9314 (Notice of Quality Review Acknowledgement Form 

for those without Phones) ..................................................... 500 1 15 125 * 25.72 ** 3,215 

Total ................................................................................... 21,350 ........................ ........................ 5,631 ........................ ** 170,938 

* We based this figures on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm). 

** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the 

application. 


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6. Redetermination of Eligibility for 

Help with Medicare Prescription Drug 

Plan Costs—20 CFR 418.3125—0960– 

0723. Under the Medicare 

Modernization Act of 2003, SSA 

conducts low-income subsidy eligibility 

redeterminations for Medicare 

beneficiaries who currently receive 

Medicare Part D subsidy and who meet 

certain criteria. Respondents complete 

Form SSA–1026–OCR–SM–REDE under 

the following circumstances: (1) When 

individuals became entitled to the 

Medicare Part D subsidy during the past 

12 months; (2) if they were eligible for 

the Part D subsidy for more than 12 

months; or (3) if they reported a change 

in income, resources, or household size. 

Part D beneficiaries complete Form 

SSA–1026–OCR–SM–SCE when they 

need to report a potentially subsidychanging event, including the following: 

(1) Marriage; (2) spousal separation; (3) 

divorce; (4) annulment of a marriage; (5) 

spousal death; or (6) moving back in 

with one’s spouse following a 

separation. The respondents are current 

recipients of Medicare Part D lowincome subsidy who will undergo an 

eligibility redetermination for one of the 

reasons mentioned above. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of completion Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

Average 

theoretical 

hourly cost 

amount 

(dollars) * 

Average 

wait time in 

field office 

(minutes)** 

Total annual 

opportunity 

cost 

(dollars) *** 

SSA–1026–OCR–SM–REDE ........................ 120,220 1 18 36,066 * $25.72 ........................ *** $927,618 

SSA–1026–OCR–SM–SCE .......................... 3,462 1 18 1,039 * 25.72 ........................ *** 26,723 

REDE Field Office Interview ......................... 50,879 1 18 15,264 * 25.72 ** 24 *** 916,033 

SCE Field Office Interview ............................ 4,441 1 18 1,332 * 25.72 ** 24 *** 79,948 

Totals ..................................................... 179,002 ........................ ........................ 53,701 ........................ ........................ *** 1,950,322 

* We based this figure on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm). 

** We based this figure on the average FY 2020 wait times for field offices, based on SSA’s current management information data.

*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the 

application. 

Dated: December 20, 2020. 

Naomi Sipple, 

Reports Clearance Officer, Social Security 

Administration. 

[FR Doc. 2020–29207 Filed 1–5–21; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF STATE 

[Public Notice 11277] 

30-Day Notice of Proposed Information 

Collection: Request for Approval of 

Special Validation for Travel to a 

Restricted Country or Area 

ACTION: Notice of request for public 

comment and submission to OMB of 

proposed collection of information. 

SUMMARY: The Department of State has 

submitted the information collection 

described below to the Office of 

Management and Budget (OMB) for 

approval. In accordance with the 

Paperwork Reduction Act of 1995 we 

are requesting comments on this 

collection from all interested 

individuals and organizations. The 

purpose of this Notice is to allow 30 

days for public comment. 

DATES: Submit comments up to 

February 5, 2021. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

SUPPLEMENTARY INFORMATION: 

• Title of Information Collection: 

Request for Approval for Multiple-Entry 

Travel to a Restricted Country or Area. 

• OMB Control Number: 1405–0228. 

• Type of Request: Revision of a 

Currently Approved Collection. 

• Originating Office: Bureau of 

Consular Affairs, Passport Services, CA/ 

PPT/S/A. 

• Form Number: No form. 

• Respondents: Individuals single or 

multiple-entry special validation, in 

accordance with 22 CFR 51.64, to use a 

U.S. passport to travel to, in, or through 

a country or area as to which U.S. 

passports have been declared invalid for 

such travel pursuant to 22 U.S.C. 211a 

and Executive Order 11295 (August 5, 

1966) and in accordance with 22 CFR 

51.63(a). 

• Estimated Number of Respondents: 

150. 

• Estimated Number of Responses: 

150. 

• Average Time per Response for a 

single entry validation request: 45 

minutes. 

• Average Time per Response for 

multiple-entry validation request: 90 

minutes. 

• Total Estimated Burden Time: 150 

hours. 

• Frequency: Once per year when the 

individual wishes to travel to the 

restricted country or area, whether for 

single- or multiple-entry validation 

request. 

• Obligation to Respond: Required to 

Obtain or Retain a Benefit. 

We are soliciting public comments to 

permit the Department to: 

• Evaluate whether the proposed 

information collection is necessary for 

the proper functions of the Department. 

• Evaluate the accuracy of our 

estimate of the time and cost burden for 

this 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 information 

technology. 

Please note that comments submitted 

in response to this Notice are public 

record. Before including any detailed 

personal information, you should be 

aware that your comments as submitted, 

including your personal information, 

will be available for public review. 

Abstract of Proposed Collection 

The Secretary of State may exercise 

authority, under 22 U.S.C. 211a, 

Executive Order 11295 (August 5, 1966), 

and 22 CFR 51.63, to invalidate all U.S. 

passports for travel to a country or area 

if he determines that any of three 

conditions exist: The country is at war 

with the United States; armed hostilities 

are in progress in the country or area; 

or there is imminent danger to the 

public health or physical safety of U.S. 

travelers in the country or area. The 

regulations of the Department of State 

provide that an individual’s passport 

may be considered for validation for 


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