Federal Register / Vol. 72, No. 10 / Wednesday, January 17, 2007 / Notices 2081 

Administration, Processing and 

Disbursement Center, 14925 Kingsport 

Road, Fort Worth, TX 76155. 

FOR FURTHER INFORMATION CONTACT: A. 

Escobar, Office of Disaster Assistance, 

U.S. Small Business Administration, 

409 3rd Street, SW., Suite 6050, 

Washington, DC 20416. 

SUPPLEMENTARY INFORMATION: Notice is 

hereby given that as a result of the 

President’s major disaster declaration on 

12/29/2006, private non-profit 

organizations that provide essential 

services of a governmental nature may 

file disaster loan applications at the 

address listed above or other locally 

announced locations. 

The following areas have been 

determined to be adversely affected by 

the disaster: 

Primary Counties: Clatsop, Hood River, 

Lincoln, Tillamook. 

The Interest Rates are: 

Percent 

Other (Including Non-Profit Organizations) With Credit Available 

Elsewhere ................................. 5.250 

Businesses and Non-Profit Organizations Without Credit Available Elsewhere ......................... 4.000 

The number assigned to this disaster 

for physical damage is 10779. 

(Catalog of Federal Domestic Assistance 

Number 59008). 

Herbert L. Mitchell, 

Associate Administrator for Disaster 

Assistance. 

[FR Doc. E7–482 Filed 1–16–07; 8:45 am] 

BILLING CODE 8025–01–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 

Public Law 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 

and/or faxed 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. 

(SSA), Social Security Administration, 

DCFAM, Attn: Reports Clearance 

Officer, 1333 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. Questionnaire about Employment 

or Self-Employment Outside the United 

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

404.417—0960–0050. The information 

collected on the SSA–7163 is needed to 

determine whether work performed by 

beneficiaries outside the United States 

is cause for deductions from their 

monthly Social Security Title II benefits; 

to determine which of two work tests 

(foreign test or regular test) is 

applicable; and to determine the 

months, if any, for which deductions 

should be imposed. The respondents are 

Title II beneficiaries living and working 

outside the United States. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 20,000. 

Frequency of Response: 1. 

Average Burden Per Response: 12 

minutes. 

Estimated Annual Burden: 4,000 

hours. 

2. Complaint Form for Allegations of 

Discrimination in Programs or Activities 

Conducted by the Social Security 

Administration—0960–0585. The 

information collected on form SSA–437 

is used by SSA to investigate and 

formally resolve complaints of 

discrimination based on race, color, sex, 

age, religion, disability, retaliation, and 

national origin, including limited or no 

ability with English in any program or 

activity conducted by SSA. A person 

who believes that he or she has been 

discriminated against on any of the 

above bases may file a written 

complaint of discrimination. The 

information will be used to identify the 

complainant; identify the alleged 

discriminatory act; ascertain the date of 

such alleged act; obtain the identity of 

any individual(s) with information 

about the alleged discrimination; and 

ascertain other relevant information that 

would assist in the investigation and 

resolution of the complaint. The 

respondents are individuals who believe 

they have been discriminated against by 

SSA or by SSA’s employees, contractors 

or agents in programs or activities 

conducted by SSA. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 140. 

Frequency of Response: 1. 

Average Burden Per Response: 60 

minutes. 

Estimated Annual Burden: 140 hours. 

3. Work Incentives Planning and 

Assistance Program (formerly the BPAO 

Program)—0960–0629. Like the Benefits 

Planning Assistance Outreach (BPAO) 

program which it replaces, the Work 

Incentives Planning and Assistance 

(WIPA) program collects identifying 

information from the project sites and 

the community work incentives 

coordinators. In addition, data are 

collected from the beneficiaries on 

background employment, training, 

benefits and work incentives. SSA is 

interested in identifying beneficiary 

outcomes under the WIPA program to 

determine the extent to which 

beneficiaries with disabilities achieve 

their employment, financial and health 

care goals. The data will also be 

valuable to SSA in its analysis and 

future planning for Social Security 

Disability Insurance and Supplemental 

Security Income (SSI) programs. 

Type of Request: Revision of an OMBapproved information collection. 

Estimated Annual Burden: 5,019 

hours. 

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2082 Federal Register / Vol. 72, No. 10 / Wednesday, January 17, 2007 / Notices 

Respondent 

Number of 

annual 

responses 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

annual 

burden hours 

Site ................................................................................................................... 147 1 2 5 

CWIC ............................................................................................................... 422 1 2 14 

Beneficiary ....................................................................................................... 60,000 1 5 5,000 

Totals ........................................................................................................ 60,569 ........................ ........................ 5,019 

4. Expanded Monitoring Site Review 

Questionnaire for Volume and Fee for 

Service Payees (SSA–637); Expanded 

Monitoring Site Review Beneficiary 

Interview Form (SSA–639)—20 CFR 

404.2035, 404.2065, 416.665, 416.701, 

416.708—0960–0633. In situations 

where a Social Security beneficiary or 

SSI recipient is incompetent or 

physically unable to take care of his or 

her own affairs, SSA may pay Social 

Security benefits and/or SSI payments 

to a relative, another person, or an 

organization when the best interest of 

the beneficiary will be served. In certain 

situations, SSA conducts site reviews to 

ensure that payees are carrying out their 

responsibilities according to 

representative payment policies and 

procedures. SSA is also able to identify 

poor payee performance, uncover 

misuse and initiate corrective action. 

Triennial site reviews are conducted for 

fee-for-service payees and all volume 

payees (i.e., organizations serving 100 or 

more beneficiaries and individuals 

serving 20 or more beneficiaries). The 

reviews include a face-to-face meeting 

with the payee (and appropriate staff), 

examination/verification of a sample of 

beneficiary records and supporting 

documentation, and usually include 

beneficiary (if competent adult) or 

custodian (if different from payee) 

interviews. Forms SSA–637 and SSA–

639 are used to record the information 

collected during these interviews. The 

respondents are certain representative 

payees and also competent Social 

Security beneficiaries. 

Type of Request: Revision of an OMBapproved information collection. 

Estimated Annual Burden: 3,538 

hours. 

Form No. Number of 

respondents 

Reports 

annually 

Time per 

response 

(minutes) 

Total hours 

SSA–637 .......................................................................................................... 1,763 1 75 2,204 

SSA–639 .......................................................................................................... 8,001 1 10 1,334 

Totals ........................................................................................................ 9,764 ........................ ........................ 3,538 

5. Direct Deposit Sign-Up Form 

(Country)—31 CFR 210—0960–0686. 

This form captures the direct deposit 

information for an account at a foreign 

financial institution. Our International 

Direct Deposit program allows 

beneficiaries living abroad to have their 

benefits deposited to an account at a 

financial institution outside the U.S. 

Routing account number information 

varies slightly for each country, so we 

use a variation of the SF–1199 A for 

each country. The respondents are 

Social Security beneficiaries residing 

abroad. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 5,000. 

Frequency of Response: 1. 

Average Burden Per Response: 5 

minutes. 

Estimated Annual Burden: 417 hours. 

6. Certification of Prisoner Identity 

Information—20 CFR 422.107—0960–

0688. When a valid agreement is in 

place, prison officials will verify the 

identity of certain incarcerated U.S. 

citizens who need replacement Social 

Security cards. Information the prison 

officials provide will be taken from the 

official prison files and will be 

transcribed on their letterhead. This 

information will be used to establish the 

applicant’s identity in the Social 

Security card process. The respondents 

are prison officials that certify identity 

of prisoners applying for replacement 

Social Security cards. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 1,000. 

Frequency of Response: 200. 

Average Burden Per Response: 3 

minutes. 

Estimated Annual Burden: 10,000 

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. Certification of Period of 

Temporary Institutionalization and 

Need to Maintain Home—20 CFR 

416.212(b)(1)—0960–0516. SSA is 

required by law to collect the 

information necessary to establish 

eligibility for continued SSI payments 

for temporarily institutionalized 

individuals. Sections 1611(e)(1)(G)&(H) 

of the Social Security Act require the 

Commissioner to establish procedures 

for determining that a physician has 

certified that the period of confinement 

is not likely to exceed 3 months, and for 

determining that the recipient needs to 

continue to maintain and provide for 

the expense of a home or living 

arrangement. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 60,000. 

Frequency of Response: 1. 

Average Burden Per Response: 5 

minutes. 

Estimated Annual Burden: 5,000 

hours. 

2. Blood Donor Locator Service 

(BDLS)—20 CFR 401.200—0960–0501. 

This regulation requires requesting State 

agencies to provide the names and 

Social Security Numbers of blood 

donors, and a statement that the donor’s 

blood tested positive for Human 

Immunodeficiency Virus (HIV) to SSA’s 

Blood Donor Locator Service when 

blood donor facilities have identified 

donors as testing positive for HIV. This 

information is used by SSA to furnish 

the State agencies with the blood 

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Federal Register / Vol. 72, No. 10 / Wednesday, January 17, 2007 / Notices 2083 

donors’ address information for the 

purpose of notifying them. Respondents 

are State agencies acting on behalf of 

blood donor facilities. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 10. 

Frequency of Response: 5. 

Number of Responses: 50. 

Average Burden Per Response: 15 

minutes. 

Estimated Annual Burden: 13 hours. 

3. Pre-1957 Military Service—Federal 

Benefit Questionnaire—20 CFR 

404.1301–404.1371—0960–0120. 

Sections 217(a) through (e) of the Social 

Security Act provide for the crediting of 

military service before 1957 to the wage 

earner’s record. This form collects 

specific information about other 

Federal, military or civilian benefits the 

wage earner may receive when the 

applicant indicates both pre-1957 

military service and the receipt of 

Federal benefit. This data is then used 

in the claims adjudication process to 

grant gratuitous military wage credits 

when applicable. This form is used to 

solicit sufficient information to make a 

determination of eligibility. 

Respondents are applicants for Social 

Security benefits on a record where the 

wage earner has pre-1957 military 

service. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 5,000. 

Frequency of Response: 1. 

Average Burden Per Response: 10 

minutes. 

Estimated Annual Burden: 833 hours. 

4. Statement of Household Expenses 

and Contributions—20 CFR 416.1130–

416.1148—0960–0456. SSA needs the 

information about household expenses 

and contributions, which is collected on 

Form SSA–8011–F3, to determine 

whether the individual receives in-kind 

support and maintenance. This is 

necessary to determine eligibility for SSI 

and the amount payable. This form is 

not used for all claims and post 

eligibility determinations; rather, it is 

used only when it is necessary to 

document in-kind support and 

maintenance and only in cases where 

the householder’s corroboration is 

needed. Respondents are SSI applicants 

and/or recipients. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 400,000. 

Frequency of Response: 1. 

Average Burden Per Response: 15 

minutes. 

Estimated Annual Burden: 100,000 

hours. 

Dated: January 10, 2007. 

Elizabeth A. Davidson, 

Reports Clearance Officer, Social Security 

Administration. 

[FR Doc. E7–555 Filed 1–16–07; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF STATE 

[Public Notice 5672] 

30-Day Notice of Proposed Information 

Collection: DS–5090e, Human Rights 

Abuses Reporting Site; OMB No. 1405–

0175 

ACTION: Notice of request for public 

comment and submission to OMB of 

proposed collection of information. 

SUMMARY: The Department of State has 

submitted the following information 

collection request to the Office of 

Management and Budget (OMB) for 

approval in accordance with the 

Paperwork Reduction Act of 1995. 

Title of Information Collection: 

Human Rights Abuses Reporting Site. 

OMB Control Number: 1405–0175. 

Type of Request: Extension of a 

Currently Approved Collection. 

Originating Office: Bureau of Western 

Hemisphere Affairs, Office of Cuban 

Affairs (WHA/CCA). 

Form Number: DS–5090e, Human 

Rights Abuses Reporting Site. 

Respondents: Victims of human rights 

abuses in Cuba. 

Estimated Number of Respondents: 

7,300 annually. 

Estimated Number of Responses: 

7,300 annually. 

Average Hours Per Response: 15 

minutes per response. 

Total Estimated Burden: 1,825 hours. 

Frequency: On occasion. 

Obligation to Respond: Voluntary. 

DATES: Submit comments to the Office 

of Management and Budget (OMB) for 

up to 30 days from January 17, 2007. 

ADDRESSES: Direct comments and 

questions to Katherine Astrich, the 

Department of State Desk Officer in the 

Office of Information and Regulatory 

Affairs at the Office of Management and 

Budget (OMB), who may be reached at 

202–395–4718. You may submit 

comments by any of the following 

methods: 

• E-mail: kastrich@omb.eop.gov. You 

must include the DS form number, 

information collection title, and OMB 

control number in the subject line of 

your message. 

• Mail (paper, disk, or CD–ROM 

submissions): Office of Information and 

Regulatory Affairs, Office of 

Management and Budget, 725 17th 

Street, NW., Washington, DC 20503. 

• Fax: 202–395–6974 

FOR FURTHER INFORMATION CONTACT: You 

may obtain copies of the proposed 

information collection and supporting 

documents from the Coordinator of 

Cuban Affairs; Department of State; 

2201 C Street, NW.; Washington, DC 

20520, who may be reached at 202–647–

9272, or by e-mail at 

CubaHRVL@state.gov. 

SUPPLEMENTARY INFORMATION: We are 

soliciting public comments to permit 

the Department to: 

• Evaluate whether the proposed 

information collection is necessary to 

properly perform 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. 

Abstract of proposed collection: The 

President has asked the interagency 

community to use the temporary 

transfer of power from Fidel Castro to 

his brother Raul Castro in August 2006 

as an historic moment to work to 

encourage a democratic transition in 

Cuba. In keeping with the 

recommendations of the Commission for 

Assistance to a Free Cuba report, the 

State Department will seek information 

from the public about human rights 

abuses committed by Cuban authorities, 

including the military and members of 

the security forces. The information is 

sought in accordance with, inter alia, 22 

U.S.C. 2656 and 2304(a)(1). The 

principal purpose for collecting the 

information is to prepare and maintain 

a database of human rights abusers in 

Cuba. 

The Department may use this 

information in connection with its 

responsibilities for the protection and 

promotion of human rights and for the 

conduct of foreign affairs, as well as for 

other appropriate purposes as a routine 

part of the Department’s activities. 

Methodology: Information will be 

collected through electronic submission. 

Additional Information: None. 

Dated: January 5, 2007. 

Caleb McCarry, 

Cuba Transition Coordinator, Bureau of 

Western Hemisphere Affairs, Department of 

State. 

[FR Doc. E7–513 Filed 1–16–07; 8:45 am] 

BILLING CODE 4710–29–P 

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