[Federal Register Volume 86, Number 168 (Thursday, September 2, 2021)]
[Notices]
[Pages 49403-49408]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-18988]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2021-0034]


Agency Information Collection Activities: Proposed Request and 
Comment 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 an extension 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-2021-0034].

(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: <a href="/cdn-cgi/l/email-protection#83ccd1add1e6f3ecf1f7f0adc0efe6e2f1e2ede0e6c3f0f0e2ade4ecf5"><span class="__cf_email__" data-cfemail="49061b671b2c39263b3d3a670a252c283b28272a2c093a3a28672e263f">[email protected]</span></a>

    Or you may submit your comments online through https://www.reginfo.gov/public/do/PRAMain, referencing Docket ID Number [SSA-
2021-0034].
    I. The information collection below is pending at SSA. SSA will 
submit it 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 
November 1, 2021. Individuals can obtain copies of the collection 
instrument by writing to the above email address.
    Registration for Appointed Representative Services and Direct 
Payment--0960-0732. SSA uses Form SSA-1699 to register appointed 
representatives of claimants before SSA who:
    <bullet> Want to register for direct payment of fees;
    <bullet> Registered for direct payment of fees prior to 10/31/09, 
but need to update their information;
    <bullet> Registered as appointed representatives on or after 10/31/
09, but need to update their information; or
    <bullet> Received a notice from SSA instructing them to complete 
this form.
    By registering these individuals, SSA: (1) Authenticates and 
authorizes them to do business with us; (2) allows them to access our 
records for the claimants they represent; (3) facilitates direct 
payment of authorized fees to appointed representatives; and, (4) 
collects the information we need to meet Internal Revenue Service (IRS) 
requirements to issue specific IRS forms if we pay an appointed 
representative in excess of a specific amount ($600). The respondents 
are appointed representatives who want to use Form SSA-1699 for any of 
the purposes cited in this Notice.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 49404]]



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                                                                                                                        Average
                                                                                  Average  burden  Estimated total    theoretical        Total annual
            Modality of completion                 Number of       Frequency of    per  response    annual burden     hourly cost      opportunity cost
                                                  respondents        response        (minutes)         (hours)           amount          (dollars) **
                                                                                                                      (dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-1699......................................          10,382                1               20            3,461         * $71.59          ** $247,773
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average Lawyers hourly wages, as reported by Bureau of Labor Statistics data (www.bls.gov/oes/current/oes231011.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.

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding these information collections would 
be most useful if OMB and SSA receive them 30 days from the date of 
this publication. To be sure we consider your comments, we must receive 
them no later than October 4, 2021. Individuals can obtain copies of 
these OMB clearance packages by writing to 
<a href="/cdn-cgi/l/email-protection#90dfc2bec2f5e0ffe2e4e3bed3fcf5f1e2f1fef3f5d0e3e3f1bef7ffe6"><span class="__cf_email__" data-cfemail="3a756814685f4a55484e491479565f5b485b54595f7a49495b145d554c">[email protected]</span></a>.
    1. Request for Withdrawal of Application--20 CFR 404.640--0960-
0015. Form SSA-521, Request for Withdrawal of Application, allows 
claimants to specify which application they want to withdraw and the 
reason for the withdrawal. Form SSA-521 is our preferred instrument for 
a withdrawal request; however, any written request for withdrawal 
signed by the claimant or a proper applicant on the claimant's behalf 
will suffice. Individuals who wish to withdraw their applications for 
benefits complete Form SSA-521, or sign the completed form for each 
request to withdraw. SSA uses the information from Form SSA-521 to 
process the request for withdrawal. The respondents are applicants for 
Retirement, Survivors, Disability, and Health Insurance benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                          Average
                                                                                          Average        Estimated      theoretical      Total annual
               Modality of completion                    Number of     Frequency of     burden per     total annual     hourly cost    opportunity cost
                                                        respondents      response        response     burden (hours)      amount         (dollars) **
                                                                                         (minutes)                      (dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
Respondents applying for or receiving Retirement,             60,753               1               5           5,063        * $10.95          ** $55,440
 Survivors, or Health Insurance benefits............
Respondents applying for or receiving Disability              14,374               1               5           1,198         * 10.95           ** 13,118
 benefits...........................................
                                                     ---------------------------------------------------------------------------------------------------
    Totals..........................................          75,127  ..............  ..............           6,261  ..............           ** 68,558
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf).
** 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.

    2. Statement of Employer--20 CFR 404.801-404.803--0960-0030. When 
workers report they were paid wages but cannot provide proof of those 
earnings, and the wages do not appear in SSA's records of earnings, SSA 
uses Form SSA-7011-F4, Statement of Employer, to document the alleged 
wages. Specifically, the agency uses the form to resolve discrepancies 
in the individual's Social Security earnings record and to process 
claims for Social Security benefits. We only send Form SSA-7011-F4 to 
employers if we are unable able to locate the earnings information 
within our own records. The respondents are employers who can verify 
wage allegations made by wage earners.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                            Average
                                                                                      Average  burden  Estimated total    theoretical      Total annual
              Modality of completion                   Number of       Frequency of    per  response    annual burden     hourly cost      opportunity
                                                      respondents        response        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-7011-F4.......................................             500                1               30              250         * $27.07        ** $6,768
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-0000).
** 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. Request for Workers' Compensation/Public Disability Benefit 
Information--20 CFR 404.408(e)--0960-0098. Individuals who received 
both Social Security disability payments and Worker's Compensation/
Public Disability Benefits (WC/PDB) must notify SSA about their WC/PDB, 
so that the agency can reduce the claimants' Social Security disability 
payments accordingly. Recipients may submit evidence of their WC/PDB, 
such as a copy of their award notice or benefit check, or have their 
WC/PDB provider complete Form SSA-1709 to document their WC/PDB to SSA. 
The respondents are Federal, State, and local agencies, insurance 
carriers, and public or private self-insured companies administering 
WC/PDB benefits to disability recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 49405]]



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                                                                                                                        Average
                                                                                  Average  burden  Estimated total    theoretical        Total annual
            Modality of completion                 Number of       Frequency of    per  response    annual burden     hourly cost      opportunity cost
                                                  respondents        response        (minutes)         (hours)           amount          (dollars) **
                                                                                                                      (dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-1709......................................         120,000                1               15           30,000         * $26.65          ** $799,500
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure by averaging both the average Federal, State, and Local Government hourly wages (https://www.bls.gov/oes/current/naics3_999000.htm), and the average Insurance Claims and Policy Processing Clerks hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes439041.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.

    4. A Statement of Care and Responsibility for Beneficiary--20 CFR 
404.2020, 404.2025, 408.620, 408.625, 416.620, and 416.625--0960-0109. 
SSA uses the information from Form SSA-788, Statement of Care and 
Responsibility for Beneficiary, to verify payee applicants' statements 
of concern, and to identify other potential payees. SSA is concerned 
with selecting the most qualified representative payee who will use 
Social Security benefits in the beneficiary's best interest. SSA 
considers factors such as the payee applicant's capacity to perform 
payee duties; awareness of the beneficiary's situation and needs; 
demonstration of past, and current concern for the beneficiary's well-
being. If the payee applicant does not have custody of the beneficiary, 
SSA obtains information from the custodian for evaluation against 
information the applicant provides. Respondents are individuals who 
have custody of the beneficiary in cases where someone else has filed 
to be the beneficiary's representative payee.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Average
                                                                                  Average  burden  Estimated total    theoretical        Total annual
            Modality of completion                 Number of       Frequency of    per  response    annual burden     hourly cost      opportunity cost
                                                  respondents        response        (minutes)         (hours)           amount          (dollars) **
                                                                                                                      (dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-788.......................................         134,000                1               10           22,333         * $27.07          ** $604,554
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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#00-00000).
** 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. Third Party Liability Information Statement--42 CFR 433.136-
433.139--0960-0323. To reduce Medicaid costs, Medicaid state agencies 
identify third party insurers liable for medical care or services for 
Medicaid beneficiaries. Regulations at 42 CFR 433.136-433.139 require 
Medicaid state agencies to obtain this information on Medicaid 
applications and redeterminations as a condition of Medicaid 
eligibility. States may enter into agreements with the Commissioner of 
Social Security to make Medicaid eligibility determinations for aged, 
blind, and disabled beneficiaries in those states. Applications for and 
redeterminations of Supplemental Security Income (SSI) eligibility in 
jurisdictions with such agreements are applications and 
redeterminations of Medicaid eligibility.
    Under these agreements, SSA obtains third party liability 
information using Form SSA-8019-U2, Third Party Liability Information 
Statement, and provides that information to the Medicaid state 
agencies. The Medicaid state agencies use the information to bill third 
parties liable for medical care, support, or services for a beneficiary 
to guarantee that Medicaid remains the payer of last resort. The 
respondents are SSI claimants and recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                       Average wait
                                                                                                          Average      time in field
                                         Number of     Frequency of   Average burden     Estimated      theoretical    office or for     Total annual
       Modality of completion           respondents      response      per response    total annual     hourly cost     teleservice    opportunity cost
                                                                         (minutes)    burden (hours)      amount          centers        (dollars) ***
                                                                                                        (dollars) *    (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-8019-U2 (Paper).................             200               1               6              20        * $19.01  ..............            *** $380
SSI Claims System (Intranet)........          35,257               1               6           3,526         * 19.01           ** 21         *** 301,613
                                     -------------------------------------------------------------------------------------------------------------------
    Totals..........................          35,457  ..............  ..............           3,546  ..............  ..............         *** 301,993
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on averaging both the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf), and the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
** We based this figure on averaging both the average FY 2021 wait times for field offices and teleservice centers, 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.

    6. Certificate of Election for Reduced Spouse's Benefits--20 CFR 
404.421--0960-0398. SSA cannot pay reduced Social Security benefits to 
an already entitled spouse unless the spouse elects to receive reduced 
benefits and is (1) at least age 62, but under full retirement age; and 
(2) no longer caring for a child. In this situation, spouses who decide 
to elect reduced benefits must file Form SSA-25, Certificate of 
Election for Reduced Spouse's Benefits. SSA uses the information to pay 
qualified spouses who elect to receive reduced benefits. Respondents 
are entitled spouses seeking reduced Social Security benefits.

[[Page 49406]]

    Type of Request: Revision of an OMB approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Average
                                                                                   Average burden  Estimated total    theoretical        Total annual
            Modality of completion                 Number of       Frequency of     per response    annual burden     hourly cost      opportunity cost
                                                  respondents        response        (minutes)         (hours)           amount          (dollars) **
                                                                                                                      (dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-25........................................          30,000                1               13            6,500         * $27.07          ** $175,955
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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#00-00000)
** 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.

    7. Coverage of Employees of State and Local Governments--20 CFR 
part 404, subpart M--0960-0425. The regulations at 20 CFR part 404, 
subpart M prescribe the rules for States to submit reports of deposits 
and recordkeeping to SSA. SSA requires States (and interstate 
instrumentalities) to provide wage and deposit contribution information 
for pre-1987 tax years. Since not all States have completely satisfied 
their pending wage report and contribution liability with SSA for pre-
1987 tax years, SSA needs these regulations until we collect all 
pending items with the States, and to allow for collection of this 
information in the future, if necessary. The respondents are State and 
local governments or interstate instrumentalities.
    Type of Request: Extension of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                          Average burden                    theoretical    Total annual
                   Regulation section                        Number of     Frequency of    per response    Total annual     hourly cost     opportunity
                                                            respondents      response        (minutes)    burden (hours)      amount      cost (dollars)
                                                                                                                            (dollars) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
404. 1204 (a) & (b).....................................              52               1              30              26        * $28.74         ** $747
404.1215................................................              52               1              60              52         * 28.74        ** 1,494
404. 1216 (a) & (b).....................................              52               1              60              52         * 28.74        ** 1,494
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................             156  ..............  ..............             130  ..............        ** 3,735
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on an average of both the State Government hourly wages (https://www.bls.gov/oes/current/naics4_999200.htm), and the average
  Local Government hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/naics4_999300.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.

    8. Permanent Residence in the United States Under Color of Law 
(PRUCOL)--20 CFR 416.1615 and 416.1618--0960-0451. Under 20 CFR 
416.1415 and 416.1618, SSA requires claimants or recipients to submit 
evidence of their alien status when they apply for SSI payments, and 
periodically thereafter as part of the eligibility determination 
process for SSI. When SSA cannot verify evidence of alien status 
through the regular claimant interview process, SSA verifies the 
validity of the evidence of PRUCOL for grandfathered nonqualified 
aliens with the Department of Homeland Security (DHS) using the DHS 
Systemic Alien Verification for Entitlements (SAVE) program. SSA 
determines if the individual qualifies for PRUCOL status based on the 
SAVE program response. SSA does not maintain any forms or applications 
for respondents to use, rather, the regulations listed in 20 CFR 
416.1615 and 416.1618 specify the information respondents need to 
submit to SSA to show evidence of PRUCOL. Without this information, SSA 
is unable to determine whether the PRUCOL individual is eligible for 
SSI payments. Respondents are qualified and unqualified aliens who 
apply for SSI payments under PRUCOL.
    Type of Request: Extension of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            Average
                                                                                       Average burden  Estimated total    theoretical      Total annual
              Modality of completion                   Number of       Frequency of     per response    annual burden     hourly cost      opportunity
                                                       responses         response        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Personal Interview................................           1,049                1                5               87         * $27.07        ** $2,355
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-0000).
** 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.

    9. Request for Deceased Individual's Social Security Record--20 CFR 
402.130--0960-0665. The Freedom of Information Act (FOIA), at 5 U.S.C. 
552(a)(3) of the U.S. Code, provides instructions for members of the 
public to request records from Federal Agencies. When a member of the 
public requests an individual's Social Security record under FOIA, SSA 
needs the name and address of the requestor as well as a description of 
the requested record to process the request. SSA uses the information 
the respondent provides on Form SSA-711, Request for Deceased 
Individual's Social Security Record, or via an internet request through 
SSA's electronic Freedom of Information Act (eFOIA) website, to: (1) 
Verify the wage earner is deceased; and (2) access the correct Social 
Security record.

[[Page 49407]]

Respondents are members of the public requesting deceased individuals' 
Social Security records.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                       Average wait
                                                                                                          Average      time in field
                                         Number of     Frequency of   Average burden     Estimated      theoretical    office or for     Total annual
       Modality of completion           respondents      response      per response    total annual     hourly cost     teleservice    opportunity cost
                                                                         (minutes)    burden (hours)      amount          centers        (dollars) ***
                                                                                                        (dollars) *    (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Internet Request through eFOIA......          49,800               1               7           5,810        * $27.07  ..............        *** $157,277
SSA-711 (paper).....................             200               1               7              23         * 27.07           ** 24           *** 2,788
                                     -------------------------------------------------------------------------------------------------------------------
    Total...........................          50,000  ..............  ..............           5,833  ..............  ..............         *** 160,065
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-0000).
** We based this figure on the average FY 2021 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.

    10. Representative Payment--20 CFR 404.2011, 404.2025, 416.611, and 
416.625--0960-0679. The regulations at 20 CFR 404.2011 and 416.611 
allow SSA to make payments to recipients' representative payees if it 
may cause substantial harm for the beneficiaries to receive their 
payments directly. The regulations allow beneficiaries to dispute a 
finding that substantial harm exists by providing SSA with evidence to 
reevaluate the determination. In addition, sections 20 CFR 404.2025 and 
416.625 describe the information representative payees must provide SSA 
about their continuing relationship and responsibility for the 
recipients, and explain how they use the recipients' payments to verify 
payee performance. The respondents are Title II and Title XVI 
recipients, and their representative payees.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                          Average burden     Estimated      theoretical    Total annual
                   Regulation section                        Number of     Frequency of    per response    total annual     hourly cost     opportunity
                                                            respondents      response        (minutes)    burden (hours)      amount      cost (dollars)
                                                                                                                            (dollars) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
404.2011(a)(1); 416.611(a)(1)...........................             260               1              15              65        * $19.01       ** $1,236
404.2025; 416.625.......................................           3,090               1               6             309         * 19.01        ** 5,874
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................           3,350  ..............  ..............             374  ..............        ** 7,110
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on averaging both the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf), and the average U.S. worker's hourly wages, 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.

    11. Function Report--Adult--20 CFR 404.1512 & 416.912--0960-0681. 
Individuals receiving or applying for Social Security disability 
insurance (SSDI) or SSI must provide medical evidence and other proof 
SSA requires to prove their disability. SSA staff, and, on SSA's 
behalf, State Disability Determination Services' (DDS) employees, 
collect the information via paper Form SSA-3373, or through an in-
person or telephone interview for cases where we need information about 
a claimant's activities and abilities to evaluate the claimant's 
disability. We use the information to document how claimants' 
disabilities affect their ability to function, and to determine 
eligibility, or continued eligibility, for SSI and SSDI claims. The 
respondents are adult Title II and Title XVI claimants, or current 
recipients undergoing redeterminations of benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                            Average wait
                                                                                                                                             Average       time in field
                                                                        Number of       Frequency of    Average burden  Estimated total    theoretical     office or for        Total annual
                       Modality of completion                          respondents        response       per response    annual burden     hourly cost      teleservice       opportunity cost
                                                                                                          (minutes)         (hours)           amount          centers          (dollars) ***
                                                                                                                                           (dollars) *      (minutes) **
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3373...........................................................       1,734,635                1               61        1,763,546         * $10.95            ** 21        *** $25,958,815
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf).
** We based this figure on averaging both the average FY 2021 wait times for field offices and teleservice centers, 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.

    12. Request for Business Entity Taxpayer Information--0960-0731. 
SSA requires law firms or other business entities to complete Form SSA-
1694, Request for Business Entity Taxpayer Information, if they wish to 
serve as appointed representatives and receive direct payment of fees 
from SSA. SSA uses the information to issue a Form 1099-MISC. SSA also 
uses the information to allow business entities to designate 
individuals to serve as entity administrators authorized to perform 
certain administrative duties on their behalf, such as providing bank 
account

[[Page 49408]]

information, maintaining entity information, and updating individual 
affiliations. Respondents are law firms or other business entities with 
attorneys or other qualified individuals as partners or employees who 
represent claimants before SSA.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                          Average burden     Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of    per response    total annual     hourly cost     opportunity
                                                            respondents      response        (minutes)    burden (hours)      amount      cost (dollars)
                                                                                                                            (dollars) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-1694 (Paper)........................................             366               1              20             122        * $61.03       ** $7,446
BSO online submission...................................             103               1              20              34         * 61.03        ** 2,075
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................             469  ..............  ..............             156  ..............        ** 9,521
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average legal occupation's hourly salary, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-00000).
** 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.

    13. Financial Disclosure for Civil Monetary Penalty (CMP) Debt--20 
CFR 498--0960-0776. When SSA imposes a CMP on individuals for various 
fraudulent conduct related to SSA-administrated programs, those 
individuals may request to pay the CMP through benefit withholding, or 
an installment agreement. To negotiate a monthly payment amount, fair 
to both the individual and the agency, SSA needs financial information 
from the individual. SSA uses Form SSA-640, to obtain the information 
necessary to determine a monthly installment repayment rate for 
individuals owing a CMP. The respondents are recipients of Social 
Security benefits and non-entitled individuals who must repay a CMP to 
the agency and choose to do so using an installment plan.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                           Average
                                                                      Average burden  Estimated total    theoretical      Average wait     Total annual
      Modality of completion          Number of       Frequency of     per response    annual burden     hourly cost     time in field     opportunity
                                     respondents        response        (minutes)         (hours)           amount           office       cost (dollars)
                                                                                                         (dollars) *      (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-640..........................              10                1              120               20         * $19.01            ** 24         *** $456
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on averaging both the average DI payments based on SSA's current FY 2021 data (https://www.ssa.gov/legislation/2021FactSheet.pdf), and the average U.S. worker's hourly wages, 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 2021 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: August 30, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-18988 Filed 9-1-21; 8:45 am]
BILLING CODE 4191-02-P


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