Federal Register / Vol. 72, No. 60 / Thursday, March 29, 2007 / Notices 14845 

3 17 CFR 200.30–3(a)(12). 

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, 100 F Street, NE., Washington, 

DC 20549. Copies of such filing also will 

be available for inspection and copying 

at the principal office of OCC and on 

OCC’s Web site at http:// 

www.optionsclearing.com. 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–OCC–2006–15 and should 

be submitted on or before April 19, 

2007. 

For the Commission by the Division of 

Market Regulation, pursuant to delegated 

authority.3

Florence E. Harmon, 

Deputy Secretary. 

[FR Doc. E7–5753 Filed 3–28–07; 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 new information 

collections, approval of existing 

information collections, revisions to 

OMB-approved 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, 

faxed or e-mailed to the individuals at 

the addresses and fax numbers listed 

below: 

(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, 

DCFAM, 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 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. Certificate of Responsibility for 

Welfare and Care of Child Not in 

Applicant’s Custody—20 CFR 404.330, 

404.339–341 and 404.348–404.349—

0960–0019. SSA uses the information to 

determine if a non-custodial parent who 

is filing for Spouse’s or Mother’s and 

Father’s benefits based on having a 

child in care meets the in-care 

requirements. Respondents are 

applicants for Spouse and/or Mother’s 

and Father’s benefits. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 14,000. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 2,333 

hours. 

2. Request for Waiver of Overpayment 

Recovery or Change in Repayment 

Notice—20 CFR 404.502–.513, 404.515 

and 20 CFR 416.550–.570, 416.572—

0960–0037. The SSA–632–BK is used by 

a beneficiary/claimant to request a 

waiver of recovery of an overpayment 

by explaining why they feel they are 

without fault in causing the 

overpayment and to provide financial 

circumstances so that SSA can 

determine whether recovery would 

cause financial hardship. It is also used 

to request a different rate of recovery. In 

those cases the financial information 

must be provided for SSA to determine 

how much the overpaid person can 

afford to repay each month. 

Respondents are overpaid beneficiaries 

or claimants who are requesting a 

waiver of recovery for overpayment or a 

lesser rate of withholding. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 500,000. 

Estimated Annual Burden: 875,000 

hours. 

Reason for completing form Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

Total annual 

burden 

Request Waiver .................................................................................................... 400,000 1 2 hours ........ 800,000 

Request Change ................................................................................................... 100,000 1 45 minutes .. 75,000 

Totals ............................................................................................................. 500,000 ........................ ..................... 875,000 

3. Supplemental Statement Regarding 

Farming Activities of Person Living 

Outside the U.S.A.—0960–0103. Form 

SSA–7163A is used whenever a 

beneficiary or claimant reports work on 

a farm outside the United States (U.S.). 

It is designed to obtain sufficient 

information to determine whether or not 

foreign work deductions are applicable 

to the claimant’s benefits. Respondents 

are beneficiaries or claimants for Social 

Security benefits who are engaged in 

farming activity outside the U.S. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 1,000. 

Frequency of Response: 1. 

Average Burden per Response: 1 hour. 

Estimated Annual Burden: 1,000 

hours. 

4. Disability Report—Appeal—20 CFR 

404.1512, 416.912, 404.916(c), 

416.1416(c), 405 Subpart C, 422.140—

0960–0144. The SSA–3441–BK is used 


jlentini on PROD1PC65 with NOTICES
14846 Federal Register / Vol. 72, No. 60 / Thursday, March 29, 2007 / Notices 

to secure updated medical and other 

information since the claimant’s last 

disability determination from claimants 

who are appealing an unfavorable 

disability determination. This 

information may be used for 

reconsideration or request for federal 

reviewing official review of initial 

disability determinations and 

continuing disability reviews as well as 

a request for a hearing. This information 

assists the State Disability 

Determination Services, federal 

reviewing officials, and administrative 

law judges in preparing for appeals and 

hearings and in issuing a decision. 

Respondents are individuals who 

appeal denial of Social Security 

disability income and Supplemental 

Security Income (SSI) benefits, cessation 

of benefits, or who are requesting a 

hearing. 

Type of Request: Revision of an OMBapproved information collection. 

Estimated Annual Burden: 1,296,190 

hours. 

Collection method Number of 

respondents 

Frequency of 

response 

Average burden 

per response 

Estimated annual burden 

hours 

SSA–3441 (Paper Form) .................................................................................... 21,282 1 45 minutes .. 15,962 

Electronic Disability Collect System (EDCS) ..................................................... 1,284,019 1 45 minutes .. 963,014

I3441 (Internet Form) ......................................................................................... 158,607 1 120 minutes 317,214 

Totals .......................................................................................................... 1,463,908 ........................ ..................... 1,296,190 

5. Request for Earnings and Benefit 

Estimate Statement—20 CFR 404.810—

0960–0466. SSA uses the information 

the requestor provides on Form SSA–

7004 to identify his or her Social 

Security earnings record, extract posted 

earnings information, calculate potential 

benefit estimates, produce the resulting 

Social Security Statement and mail it to 

the requestor. Respondents are Social 

Security number holders requesting 

information about their Social Security 

earnings records and estimates of their 

potential benefits. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 545,000. 

Frequency of Response: 1. 

Average Burden per Response: 5 

minutes. 

Estimated Average Burden: 45,417 

hours. 

6. Employer Verification of Earnings 

After Death—20 CFR 404.821 and 

404.822—0960–0472. The information 

collected on Form SSA–L4112 is used 

by SSA to determine whether wages 

reported by an employer are correct and 

should be credited to the employee’s 

Social Security number when SSA 

records indicate that the wage earner is 

deceased. The respondents are 

employers who report wages for a 

deceased employee. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 50,000. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 8,333 

hours. 

7. Earnings Record Information—20 

CFR 404.801–404.803 and 404.821–

404.822—0960–0505. The information 

collected by form SSA–L3231–C1 is 

used to ensure that the proper person is 

credited for working when earnings are 

reported for a minor under age seven 

years. The respondents are businesses 

reporting earnings for children under 

age 7. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 20,000. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 3,333 

hours. 

8. Appointment of Representative—20 

CFR 404.1707, 404.1720, 404.1725, 

410.684 and 416.1507—0960–0527. A 

person claiming a right or benefit under 

the Social Security Act must notify SSA 

in writing if he or she appoints an 

individual to represent him or her in 

dealing with SSA. The information 

collected by SSA on form SSAS–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, and it also allows the claimant to 

give permission to their appointed 

representative to designate a person to 

copy claims files. Respondents are 

applicants who notify SSA that they 

have appointed a person to represent 

them in their dealings with SSA when 

claiming a right to benefits and 

representatives of claimants for Social 

Security benefits. 

Type of Request: Revision of an 

approved OMB information collection. 

Number of Respondents: 551,520. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 91,920 

hours. 

9. Community Work Incentive 

Coordinator Application—0960—NEW. 

Section 1149 of the Social Security Act 

established the ‘‘Work Incentives 

Outreach Program.’’ The program was 

reauthorized by Section 407 of the 

Social Security Protection Act of 2004. 

To be eligible to work as a specialist 

under the new improved program, 

individuals must possess a bachelors 

degree or have equivalent qualifications 

derived from training and work 

experience. Through the services of a 

private contractor, SSA will collect the 

requested information to determine if an 

individual is qualified to provide 

services. Respondents are individuals 

who apply to become qualified as 

Community Work Incentive 

Coordinators. 

Type of Request: Request for a new 

information collection. 

Number of Respondents: 500. 

Frequency of Response: 1. 

Average Burden per Response: 60 

minutes. 

Estimated Annual Burden: 500 hours. 

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. Farm Self-Employment 

Questionnaire—20 CFR 404.1095—

0960–0061. Section 211(a) of the Social 

Security Act requires the existence of a 

trade or business as a prerequisite for 

determining whether an individual or 

partnership may have ‘‘net earnings 

from self-employment.’’ Form SSA–

7156 elicits the information necessary to 

determine the existence of an 

agricultural trade or business and 

subsequent covered earnings for Social 

Security entitlement purposes. The 

respondents are applicants for Social 

Security benefits, whose entitlement 

depends on whether the worker has 

covered earnings from self-employment 

as a farmer. 


jlentini on PROD1PC65 with NOTICES
Federal Register / Vol. 72, No. 60 / Thursday, March 29, 2007 / Notices 14847 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 47,500. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 7,917 

hours. 

2. Authorization To Disclose 

Information to the Social Security 

Administration—20 CFR Subpart O, 

404.1512 and Subpart I, 416.912—0960–

0623. SSA must obtain sufficient 

medical evidence to make eligibility 

determinations for the SSDI benefits and 

Supplemental Security Income (SSI) 

payments. For SSA to obtain medical 

evidence, an applicant must authorize 

his or her medical source(s) to release 

the information to SSA. The applicant 

may use form SSA–827 to provide 

consent for release of information. 

Generally, the State DDS completes the 

form(s) based on information provided 

by the applicant, and sends the form(s) 

to the designated medical source(s). The 

respondents are applicants for SSDI and 

SSI payments. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 3,853,928. 

Frequency of Response: 1 (Average 

forms per case 4). 

Average Burden per Response: *13 

minutes. 

Total Annual Responses: 15,415,712. 

Estimated Annual Burden: 835,018 

hours. 

*Please Note: Respondents to the SSA–827 

collection complete a total four forms. SSA 

estimates that it takes a claimant 10 minutes 

to read both sides and sign the initial SSA–

827. However, once a claimant reads the first 

form, it takes considerably less time to date 

and sign the subsequent forms because the 

forms do not have to be read again. SSA 

estimates the signing and dating of the three 

additional forms at one minute per form, 

resulting in three additional minutes. 

Therefore, the total time it takes to complete 

all four SSA–827’s is 13 minutes. 

3. Prisoner Matching Agreements—20 

CFR 404.468 and 20 CFR 416.211 

—0960–NEW. 

Collection Background 

Section 202(x) of the Social Security 

Act (the Act) and regulations at 20 CFR 

404.468 preclude a person from 

receiving a benefit under title II for any 

month during which such individual is 

confined in a jail, prison, or other penal 

institution or correctional facility 

pursuant to his conviction of a criminal 

offense or because he/she is not-guilty 

by reason of insanity. Accordingly, 

Section 1611(e) of the Social Security 

Act and regulations at 20 CFR 416.211, 

provide that no person shall be an 

eligible individual or eligible spouse for 

title XVI with respect to any month if 

throughout such month he is an inmate 

of a public institution. 

Prisoner Matching Collection Activity 

To enforce these provisions of the 

Act, SSA has entered into agreements 

with the Federal Bureau of Prisons, 

along with State and local correctional 

facilities and certain mental health 

institutions, to submit monthly prisoner 

reports to SSA. SSA matches these 

reports against our files to identify 

incarcerated individuals receiving 

Social Security and Supplemental 

Security Income (SSI) payments and 

take action to suspend their payments. 

SSA uses the reports of confinement as 

the basis for stopping payments under 

titles II & XVI. The respondents to the 

collection are State and local 

correctional facilities, the Federal 

Bureau of Prisons and certain mental 

health institutions that have entered 

into prisoner matching agreements with 

SSA. 

Type of Request: Collection in use 

without OMB Control Number. 

Number of Respondents: 3,000. 

Frequency of Response: 12. 

Average Burden per Response: 60 

minutes. 

Estimated Annual Burden: 36,000 

hours. 

4. Fugitive Felon Matching 

Agreements—20 CFR 404.471 and 

416.1339—0960–NEW. 

Collection Background 

Sections 202(x) and 1611(e)(4) of the 

Social Security Act provides that a 

person may not receive a benefit under 

title II and will not be eligible under 

title XVI for any month he or she is 

avoiding prosecution for a felony, is 

avoiding confinement or conviction of a 

felony, or is violating a condition of 

probation or parole. In jurisdictions that 

do not define crimes as felonies this 

nonpayment/ineligibility applies to any 

crime that is punishable by death or 

imprisonment for more than one year, 

regardless of the actual sentence 

imposed. 

Fugitive Felon Matching Collection 

Activity 

To enforce these provisions of the 

Act, SSA has entered agreements with 

the FBI’s National Crime Information 

Center (NCIC), the U.S. Marshall 

Service, 21 individual States, 

Washington DC, and four metropolitan 

law enforcement agencies under which 

these law enforcement agencies submit 

outstanding felony and parole/probation 

violator warrants to SSA. SSA uses the 

reports of outstanding warrants as the 

basis for stopping payments under titles 

II & XVI. The respondents to the 

collection are the Federal, State and 

local law enforcement agencies that 

have entered into Fugitive Felon 

matching agreements with SSA. 

Type of Request: Collection in use 

without OMB Control Number. 

Number of Respondents: 28. 

Frequency of Response: * 7. 

Average Burden per Response: 60 

minutes. 

Estimated Annual Burden: 196 hours. 

*Please Note: Seven responses per 

respondent is the average frequency of 

reporting. The actual response rate per 

respondent varies based on the individual 

need to report. 

Dated: March 23, 2007. 

Elizabeth A. Davidson, 

Reports Clearance Officer, Social Security 

Administration. 

[FR Doc. E7–5728 Filed 3–28–07; 8:45 am] 

BILLING CODE 4191–02–P 

SOCIAL SECURITY ADMINISTRATION 

[Docket No. SSA–2007–0021] 

The Ticket to Work and Work 

Incentives Advisory Panel Meeting 

AGENCY: Social Security Administration 

(SSA). 

ACTION: Notice of quarterly meeting. 

DATES: April 11, 2007–9 a.m. to 5:30 

p.m.; April 12, 2007–1:30 p.m. to 5:30 

p.m.; April 13, 2007–9 a.m. to 12 noon. 

ADDRESSES: Sheraton Crystal City Hotel, 

1800 Jefferson Davis Highway, 

Arlington, VA 22202. Phone: 703–486–

1111. 

SUPPLEMENTARY INFORMATION: 

Type of meeting: On April 11–13, 

2007, the Ticket to Work and Work 

Incentives Advisory Panel (the ‘‘Panel’’) 

will hold a quarterly meeting open to 

the public. 

Purpose: In accordance with section 

10(a)(2) of the Federal Advisory 

Committee Act, the Social Security 

Administration (SSA) announces a 

meeting of the Ticket to Work and Work 

Incentives Advisory Panel. Section 

101(f) of Public Law 106–170 

establishes the Panel to advise the 

President, the Congress, and the 

Commissioner of SSA on issues related 

to work incentive programs, planning, 

and assistance for individuals with 

disabilities as provided under section 

101(f)(2)(A) of the TWWIA. The Panel is 

also to advise the Commissioner on 

matters specified in section 101(f)(2)(B) 

of that Act, including certain issues 

related to the Ticket to Work and SelfSufficiency Program established under 

section 101(a) of that Act. 


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