[Federal Register Volume 65, Number 189 (Thursday, September 28, 2000)]
[Notices]
[Pages 58300-58301]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-24903]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    In compliance with Public Law 104-13, the Paperwork Reduction Act 
of 1995, SSA is providing notice of its information collections that 
require submission to the Office of Management and Budget (OMB). 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.
    I. The information collections listed below will be submitted to 
OMB within 60 days from the date of this notice. Therefore, comments 
and recommendations regarding the information collections would be most 
useful if received by the Agency within 60 days from the date of this 
publication. Comments should be directed to the SSA Reports Clearance 
Officer at the address listed at the end of this publication. You can 
obtain a copy of the collection instruments by calling the SSA Reports 
Clearance Officer on (410) 965-4145, or by writing to him at the 
address listed at the end of this publication.
    1. National Teacher Questionnaire (SSA-5665-BK), and Information 
About the Working Age Child (SSA-5665-SUPP)-0960-New. The information 
collected on forms SSA-5665-BK and SSA-5665-Sup is used by the Social 
Security Administration (SSA) and the State Disability Determination 
Services (DDS) to obtain descriptions of children claiming SSI benefits 
based on disability and their ability to function on a daily basis. The 
forms will be used for initial determinations of eligibility, in 
appeals and in initial continuing disability reviews.
    These forms are being developed because the forms currently used by 
the DDSs vary a great deal in format and content. It was decided that 
for the sake of a uniform national childhood program (and with this 
information in hand and the sensitivity of this population), there is a 
need for a National Teacher Questionnaire and Information About the 
Working Age Child. The respondents are the educational Community and 
small businesses that educate and/or employ applicants for Supplemental 
Security Income for the aged, blind, and Disabled.

[[Page 58301]]



 
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                                                       SSA-5665-BK                         SSA-5665-Sup
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Number of Respondents..................  475,000................................  125,000.
Frequency of Response..................  1......................................  1.
Average Burden Per Response............  15-20 minutes..........................  5-10 minutes.
Estimated Annual Burden................  158,333 hours..........................  20,833 hours.
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    2. Beneficiary Recontact Report-0960-0536. SSA collects the 
information on Form SSA-1587 to ensure that eligibility for benefits 
continues after entitlement is established. SSA asks children ages 15-
17 information about marital status to detect overpayments and avoid 
continuing payment to those no longer entitled. Studies show that 
representative payees of children who marry fail to report the 
marriage, which is a terminating event. The responents are payees who 
receive Title II (Old-Age, Survivors and Disability Insurance) benefits 
on behalf of children ages 15-17.
    Number of Respondents: 982,357.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 49,118 hours.

    3. Questionnaire About Employment or Self-Employment Outside the 
United States--0960-0050. This information is used by SSA to determine 
whether work performed by beneficiaries outside the United States 
(U.S.) is cause for deductions from their monthly benefits; to 
determine which of two work tests (foreign or regular) is applicable; 
and to determine the months, if any, for which deductions should be 
imposed. The respondents are beneficiaries living and working outside 
the U.S.
    Number of Respondents: 20,000.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 4,000 hours.
    II. The information collections listed below have been submitted to 
OMB for clearance. Written comments and recommendations on the 
information collections would be most useful if received within 30 days 
from the date of this publication. Comments should be directed to the 
SSA Reports Clearance Officer and the OMB Desk Officer at the addresses 
listed at the end of this publication. You can obtain a copy of the OMB 
clearance packages by calling the SSA Reports Clearance Officer on 
(410) 965-4145, or by writing to him.
    1. Claimant's Statement About Loan of Food or Shelter (SSA-5062), 
and Statement About Food or Shelter Provided to Another (SSA-L5063)--
0960-0529. Forms SSA-5062 and SSA-L5063 are used to obtain statements 
about food and/or shelter provided to an SSI claimant. SSA uses the 
information to determine whether food and/or shelter are a bona fide 
loan or should be counted as income. This determination can affect 
eligibility for SSI and the amount of SSI benefits payable. The 
respondents are claimants for SSI benefits and individuals who provide 
(loan) food or shelter to SSI Claimants.

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                                             SSA-5062                    SSA-L5063
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Number of Respondents..........  65,540.........................  65,540.
Frequency of Response..........  1..............................  1.
Average Burden Per Response....  10 minutes.....................  10 minutes.
Estimated Annual Burden........  10,923 hours...................  10,923 hours.
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(SSA Address) Social Security Administration, DCFAM, Attn: Frederick W. 
Brickenkamp 1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 
21235.
(OMB Address) Office of Management and Budget, OIRA, Attn: Desk Officer 
for SSA, New Executive Office Building, Room 10230, 725 17th St., NW, 
Washington, D.C. 20503.

    Dated: September 22, 2000.
Frederick W. Brickenkamp,
Social Security Administration, Reports Clearance Officer.
[FR Doc. 00-24903 Filed 9-27-00; 8:45 am]
BILLING CODE 4191-02-P