[Federal Register Volume 66, Number 84 (Tuesday, May 1, 2001)]
[Notices]
[Pages 21805-21806]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-10632]


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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 effective October 1, 1995, The Paperwork Reduction Act of 1995. 
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 at the following addresses:
(OMB)
Office of Management and Budget, Attn: Desk Officer for SSA, New 
Executive Office Building, Room 10230, 725 17th St., NW, Washington, 
DC. 20503
(SSA)
Social Security Administration, DCFAM, Attn: Frederick W. Brickenkamp, 
1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 21235

    I. The information collections listed below 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 410-965-4145, or by 
writing to him at the address listed above.
    1. Disability Hearing Officer's Report of Disability Hearing (DC)--
0960-0507. The information collected on form SSA-1204-BK is used by the 
Disability Hearing Officer (DHO) to conduct and document disability 
hearings, and to provide a structured format that concerns all 
conceivable issues relating to SSI claims for disabled children. The 
completed form SSA-1204-BK will aid the DHO in preparing the disability 
decision and will provide a record of what transpired at the hearing. 
The respondents are DHO's in the State Disability Determination 
Services.
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 100,000 hours.

    2. Report of Student Beneficiary About to Attain Age 19--0960-0274. 
The information collected on form SSA-1390 is used by SSA to determine 
a student's eligibility for Child's Social Security benefits for those 
turning age 19. The respondents are student Title II beneficiaries 
about to attain age 19.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 4,167 hours.
    3. Disability Hearing Officer's Report of Disability Hearing--0960-
0440. The information on Form SSA-1205-BK is used by the Disability 
Hearing Officers (DHOs) at the Social Security Administration (SSA) as 
a guide to conducting and recording disability hearings. It ensures 
that all of the pertinent issues are considered. The respondents are 
DHOs in the State Disability Determination Services and Federal DHOs.
    Number of Respondents: 100,000.
    Frequency of Response:
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 100,000 hours.

    4. Application For Benefits Under The Italy-U.S. International 
Social Security Agreement--0960-0445. The information collected on Form 
SSA-2528 is required by SSA in order to determine entitlement to 
benefits. The respondents are applicants for old-age, survivors or 
disability benefits that reside in Italy.
    Number of Respondents: 200.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 67 hours.

    5. Request for Claimant Conference--0960-0608. The information 
collected on form SSA-378 is used by the Disability Adjudicator to 
complete processing of a claimant's disability claim. Depending on the 
response, the Disability Adjudicator schedules/conducts the Claimant 
Conference, awaits the receipt of additional evidence, requests 
additional evidence from the source, or finalizes the determination on 
the case. The respondents are applicants for Social Security disability 
and Supplemental Security Income benefits whose initial determination 
of disability will be less than fully favorable.
    Number of Respondents: 210,500.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 10,525 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 on (410) 965-
4145, or by writing to him at the address listed above.
    1. Waiver of Your Right to Personal Appearance Before an 
Administrative Law Judge, HA-4608--0960-0284. Each claimant has a 
statutory right to appear in person (or through a representative) and 
present evidence about his/her claim at a hearing before an 
Administrative Law Judge (ALJ). If a claimant wishes to waive his/her 
statutory right to appear before an ALJ, he/she must complete a written 
request. The claimant may use form HA-4608

[[Page 21806]]

for this request. The information collected is used to document an 
individual's claim to show that an oral hearing is not preferred in the 
appellate process. The respondents are applicants for Social Security 
and Supplemental Security Income benefits who request a hearing.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden Per Response: 2 minutes.
    Estimated Annual Burden: 400 hours.

    2. Request for SSI Benefit Estimate--0960-0492. SSA uses Form SSA-
3716 for Supplemental Security Income (SSI) beneficiaries who wish to 
request a 5-month estimate of what their benefits would be if they 
should return to work in the future. The respondents are SSI Recipients 
or Applicants for SSI Benefits.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 4,167 hours.

    3. Supplemental Statement Regarding Farming Activities Of Person 
Living Outside The U.S.A.--0960-0103. Form SSA-7163A-F4 is used by SSA 
to collect needed information whenever a Social Security beneficiary or 
claimant reports work on a farm outside the U.S. The information is 
used to make a determination for work deduction purposes. The 
respondents are Social Security beneficiaries or claimants who are 
engaged in farming activities outside the U.S.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 1,000 hours.

    Dated: April 24, 2001.
Frederick W. Brickenkamp,
Reports Clearance Officer.
[FR Doc. 01-10632 Filed 4-30-01; 8:45 am]
BILLING CODE 4191-02-P