27036 Federal Register / Vol. 75, No. 92 / Thursday, May 13, 2010 / Notices 

12 In approving this proposal, the Commission has 

considered its impact on efficiency, competition, 

and capital formation. 15 U.S.C 78c(f). 13 15 U.S.C. 78f(b)(4). 

14 Id. 

15 15 U.S.C. 78s(b)(2). 

16 17 CFR 200.30–3(a)(12). 

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 Web site viewing and 

printing in the Commission’s Public 

Reference Room, 100 F Street, NE., 

Washington, DC 20549, on official 

business days between the hours of 10 

a.m. and 3 p.m. Copies of the filing also 

will be available for inspection and 

copying at the principal office of the 

ISE. 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–ISE–2010–38 and should be 

submitted on or before June 3, 2010. 

IV. Commission’s Findings and Order 

Granting Accelerated Approval of 

Proposed Rule Change 

The Commission finds that the 

proposed rule change is consistent with 

the requirements of the Act and the 

rules and regulations thereunder 

applicable to a national securities 

exchange.12 Specifically, the 

Commission finds that the proposed 

rule change is consistent with Section 

6(b)(4) 13 of the Act, which requires that 

the rules of a national securities 

exchange provide for the equitable 

allocation of reasonable dues, fees, and 

other charges among members and 

issuers and other persons using its 

facilities. 

As described more fully above, ISE 

recently amended DECN’s fee schedule 

for ISE Members pursuant to SR–ISE– 

2010–37 (the ‘‘Member Fee Filing’’). The 

fee changes made pursuant to the 

Member Fee Filing became operative on 

May 1, 2010. DECN receives rebates and 

is charged fees for transactions it 

executes on EGDX or EDGA in its 

capacity as an introducing broker for its 

non-ISE member subscribers. The 

current proposal, which will apply 

retroactively to May 1, 2010, will allow 

DECN to pass through the revised 

rebates and fees to the non-ISE member 

subscribers for which it acts an 

introducing broker. The Commission 

finds that the proposal is consistent 

with the Act because it will provide 

rebates and charge fees to non-ISE 

member subscribers that are equivalent 

to those established for ISE member 

subscribers in the Member Fee Filing.14

ISE has requested that the 

Commission find good cause for 

approving the proposed rule change 

prior to the thirtieth day after 

publication of notice of filing thereof in 

the Federal Register. As discussed 

above, the proposal will allow DECN to 

pass through to non-ISE member 

subscribers the revised rebate and fees 

established for ISE member subscribers 

in the Member Fee Filing, resulting in 

equivalent rebates and fees for ISE 

member and non-member subscribers. 

In addition, because the proposal will 

apply the revised rebates and fees 

retroactively to May 1, 2010, the revised 

rebates and fees will have the same 

effective date, thereby promoting 

consistency in the DECN’s fee schedule. 

Accordingly, the Commission finds 

good cause, pursuant to Section 19(b)(2) 

of the Act, for approving the proposed 

rule change prior to the thirtieth day 

after the date of publication of notice of 

filing thereof in the Federal Register. 

V. Conclusion 

It is therefore ordered, pursuant to 

Section 19(b)(2) of the Act,15 that the 

proposed rule change (SR–ISE–2010–38) 

be, and hereby is, approved on an 

accelerated basis. 

For the Commission, by the Division of 

Trading and Markets, pursuant to delegated 

authority.16

Florence E. Harmon, 

Deputy Secretary. 

[FR Doc. 2010–11398 Filed 5–12–10; 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 requiring clearance 

by the Office of Management and 

Budget (OMB) in compliance with 

Public Law (Pub. L.) 104–13, the 

Paperwork Reduction Act of 1995, 

effective October 1, 1995. This notice 

includes revisions and extensions of 

OMB-approved information collections 

and a collection in use without an OMB 

number. 

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, e-mail, or 

fax your comments and 

recommendations on the information 

collection(s) to the OMB Desk Officer 

and SSA Reports Clearance Director to 

the following addresses or fax numbers. 

(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, 

DCBFM, Attn: Director, Center for 

Reports Clearance, 1333 Annex 

Building, 6401 Security Blvd., 

Baltimore, MD 21235, Fax: 410–965– 

0454, E-mail address: 

OPLM.RCO@ssa.gov. 

I. The information collections below 

are pending at SSA. SSA will submit 

them 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 July 12, 2010. 

Individuals can obtain copies of the 

collection instruments by calling the 

SSA Director for Reports Clearance at 

410–965–0454 or by writing to the 

above e-mail address. 

1. Request to Be Selected as a Payee— 

20 CFR 404.2010–404.2055, 416.601– 

416.665—0960–0014. An individual 

applying to be a representative payee for 

a Social Security or Supplemental 

Security Income (SSI) recipient 

completes Form SSA–11–BK. SSA 

obtains information from applicant 

payees regarding their relationship to 

the beneficiary, personal qualifications, 

concern for the beneficiary’s well-being, 

and intended use of benefits if 

appointed as payee. 

The respondents are individuals, 

private sector businesses and 

institutions, and state and local 

government institutions and agencies. 

Type of Request: Revision of an OMBapproved information collection. 


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Collection method Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

annual burden 

(hours) 

Individuals/Households 

Representative Payee System (RPS) ............................................................. 135,000 1 10.5 23,625 

RPS/Signature Proxy ....................................................................................... 765,000 1 9.5 121,125

Paper Version .................................................................................................. 450,000 1 10.5 78,750 

Totals ........................................................................................................ 1,350,000 ........................ ........................ 223,500 

Private Sector 

RPS .................................................................................................................. 13,500 1 10.5 2,363 

RPS/Signature Proxy ....................................................................................... 76,500 1 9.5 12,113 

Paper Version .................................................................................................. 45,000 1 10.5 7,875 

Totals ........................................................................................................ 135,000 ........................ ........................ 22,351 

State/Local/Tribal Government 

RPS .................................................................................................................. 1,500 1 10.5 263 

RPS/Signature Proxy ....................................................................................... 8,500 1 9.5 1,346 

Paper Version .................................................................................................. 5,000 1 10.5 875

Totals ........................................................................................................ 15,000 ........................ ........................ 2,484 

Grand Total: ...................................................................................... 1,500,000 ........................ ........................ 248,335 

2. Representative Payee Evaluation 

Report—20 CFR 404.2065 & 416.665— 

0960–0069. Sections 205(j) and 

1631(a)(2) of the Social Security Act 

provide that SSA may appoint a 

representative payee to receive Title II 

benefits and/or Title XVI payments on 

behalf of individuals unable to manage 

those funds themselves. SSA requires 

the appointed representative payee to 

report once per year on how he or she 

used or conserved those funds. When a 

representative payee fails to adequately 

report to SSA, SSA conducts a face-toface interview with the payee and 

completes Form SSA–624, 

Representative Payee Evaluation Report, 

to determine the continued suitability of 

the representative payee to serve as a 

payee. The respondents are individuals 

or organizations serving as 

representative payees for individuals 

receiving Title II benefits and/or Title 

XVI payments, and who fail to comply 

with SSA’s statutory annual reporting 

requirement. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 266,000. 

Frequency of Response: 1. 

Average Burden per Response: 30 

minutes. 

Estimated Annual Burden: 133,000 

hours. 

3. Waiver of Your Right to Personal 

Appearance before an Administrative 

Law Judge—20 CFR 404.948(b)(l)(i) and 

416.1448(b)(l)(i)—0960–0284. 

Applicants for Social Security benefits 

and SSI payments have the statutory 

right to appear in person (or through a 

representative) and present evidence 

about their claims at a hearing before an 

Administrative Law Judge (ALJ). If 

claimants wish to waive this right to 

appear before an ALJ, they must 

complete a written request. The 

applicants may use SSA Form HA–4608 

for this purpose. The ALJ uses the 

information to document an 

individual’s claim to show that an oral 

hearing is not preferred in the appellate 

process. 

Respondents are claimants or their 

representatives for Title II benefits and/ 

or Title XVI payments who request to 

waive their right to appear in person 

before an ALJ. 

Type of Request: Revision of an 

approved-OMB information collection. 

Number of Respondents: 12,000. 

Frequency of Response: 1. 

Average Burden per Response: 2 

minutes. 

Estimated Annual Burden: 400 hours. 

4. Request for Change in Time/Place 

of Disability Hearing—20 CFR 

404.914(c)(2) and 416.1414(c)(2)—0960– 

0348. At the request of the claimant or 

their representative, SSA schedules 

evidentiary hearings at the 

reconsideration level for claimants of 

Title II benefits and/or Title XVI 

payments when we deny their claims 

for disability. When claimants or their 

representatives find they are unable to 

attend the hearing, they complete Form 

SSA–769 to request a change in time or 

place of the hearing. SSA uses the 

information as a basis for granting or 

denying requests for changes and for 

rescheduling disability hearings. 

Respondents are claimants or their 

representative who wish to request a 

change in the time and/or place of their 

hearing. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 7,483. 

Frequency of Response: 1. 

Average Burden per Response: 8 

minutes. 

Estimated Annual Burden: 998 hours. 

5. Agency/Employer Government 

Pension Offset Questionnaire—20 CFR 

404.408(a)—0960–0470. When an 

individual is concurrently receiving 

Social Security spousal or surviving 

spousal benefits and a Government 

pension, the individual may have the 

amount of Social Security benefits 

reduced by the Government pension 

amount. This is the Government 

Pension Offset (GPO). SSA uses Form 

SSA–L4163 to collect accurate pension 

information from the Federal or state 

government agency paying the pension 

for purposes of applying the pension 

offset provision. The form is used only 

when: (1) The claimant does not have 

the information; and (2) the pensionpaying agency has not cooperated with 

the claimant. Respondents are state 

government agencies that have 

information SSA needs to determine if 

the GPO applies and the amount of 

offset. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 1,000. 


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Frequency of Response: 1. 

Average Burden per Response: 3 

minutes. 

Estimated Annual Burden: 50 hours. 

6. Child Care Dropout 

Questionnaire—20 CFR 404.211(e)(4)— 

0960–0474. The Social Security Act and 

SSA’s regulations permit the exclusion, 

from a disability computation period, of 

the years an individual was caring for 

his or her (or the spouse’s) child under 

age 3 if he or she had no earnings in the 

benefit computation years. We call this 

the child-care dropout exclusion. 

SSA uses the information from Form 

SSA–4162 to determine if an individual 

qualifies for this exclusion. Respondents 

are applicants for Title II disability 

benefits. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 2000. 

Frequency of Response: 1. 

Average Burden per Response: 5 

minutes. 

Estimated Annual Burden: 167 hours. 

7. Requests for Self-Employment 

Information, Employee Information, 

Employer Information—20 CFR 

422.120—0960–0508. SSA collects 

information on Forms SSA–L2765, 

SSA–L3365, and SSA–L4002 to credit 

the reported earnings to the proper 

earnings record. When SSA cannot 

identify Form W–2 wage data for an 

individual, we place the data in the 

earnings suspense file and send one of 

the forms cited above to the employee 

(and in certain instances to the 

employer) to obtain the correct name 

and Social Security number (SSN). If the 

respondent furnishes the name and SSN 

information that agrees with SSA’s 

records, or provides information that 

resolves the discrepancy, SSA adds the 

reported earnings to the respondent’s 

Social Security record. While SSA does 

not require respondents to provide the 

information to keep a benefit, if they do 

not furnish the missing or corrected 

information, we cannot credit the wages 

or self-employment income to the 

proper earnings record. The respondents 

are self-employed individuals and 

employees whose name and SSN 

information do not agree with SSA’s 

records and their employers. 

Type of Request: Revision of an OMBapproved information collection. 

Collection method Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

annual burden 

(hours) 

SSA–L2765 .................................................................................................... 7,870 1 10 1,312 

SSA–L3365 .................................................................................................... 158,334 1 10 26,389 

SSA–L4002 .................................................................................................... 218,891 1 10 36,482 

Totals ...................................................................................................... 385,095 ........................ ........................ 64,183 

8. Appointment of Representative—20 

CFR 404.1707, 404.1720, 404.1725, 

410.684 and 416.1507—0960–0527. 

Persons claiming rights or benefits 

under the Social Security Act must 

notify SSA in writing when they 

appoint an individual to represent them 

in dealings with SSA. SSA uses the 

information collected on Form SSA– 

1696–U4 to verify the appointment of a 

representative. It also allows SSA to 

inform the representative of items that 

affect the recipient’s claim, and allows 

the claimant to give permission to his or 

her appointed representative to 

designate a person to copy claims files. 

Respondents are applicant/recipients of 

Social Security benefits who notify SSA 

they have appointed a person to 

represent them in their dealings with 

SSA. 

Number of Respondents: 551,520. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 91,920 

hours. 

9. Function Report—Child: Birth to 

1st Birthday (SSA–3375), Age 1 to 3rd 

Birthday (SSA 3376), Age 3 to 6th 

Birthday (SSA–3377), Age 6 to 12th 

Birthday (SSA–3378), and Age 12 to 

18th Birthday (SSA–3379)—20 CFR 

416.912—0960–0542. Forms SSA–3375– 

BK through SSA–3379–BK request 

information from the child’s parent 

about the child’s day-to-day 

functioning. The five different versions 

of the form contain questions about 

functioning appropriate to a particular 

age group; thus, respondents use only 

one version for each child. 

The adjudicative team (disability 

examiners and medical/psychological 

consultants) of state Disability 

Determination Services (DDS) offices 

collect the information on the 

appropriate version of this form (in 

conjunction with medical and other 

evidence) to form a complete picture of 

the child’s ability to function and his or 

her impairment-related limitations. The 

adjudicative team uses the completed 

profile to determine whether the child’s 

impairment(s) results in marked and 

severe functional limitations and 

whether the child is disabled. The 

respondents are parents and/or 

guardians of child applicants for SSI 

payments. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 500,000. 

Frequency of Response: 1. 

Average Burden per Response: 20 

minutes. 

Estimated Annual Burden: 166,667 

hours. 

10. Disability Report–Child—20 CFR 

416.912—0960–0577—When claimants 

file a claim for childhood disability 

benefits under the SSI program, they 

must furnish medical and other 

evidence to prove they are disabled. 

Form SSA–3820 collects various types 

of information about a child’s condition 

from treating sources and/or other 

medical sources of evidence. The DDS 

evaluators use the information to 

develop medical and school evidence 

and to assess the alleged disability. The 

information, together with medical 

evidence, forms the evidentiary basis 

upon which SSA makes its initial 

disability evaluation. The respondents 

are claimants seeking SSI childhood 

disability payments. 

Type of Request: Revision of an OMBapproved information collection. 

Collection method Number of 

respondents 

Frequency of 

response 

Average 

burden 

per response 

(minutes) 

Estimated 

annual burden 

(hours) 

SSA–3820 (Paper Form) ............................................................................... 500 1 60 500 


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Collection method Number of 

respondents 

Frequency of 

response 

Average 

burden 

per response 

(minutes) 

Estimated 

annual burden 

(hours) 

Electronic Disability Collection System (EDCS) ............................................ 422,000 1 34 239,133 

i3820 (Internet) .............................................................................................. 93,293 1 120 186,586 

Totals ...................................................................................................... 515,793 ........................ ........................ 426,219 

11. eData Registration—20 CFR 

401.45—0960–0757—The eData 

Services Web site allows various 

external organizations to submit files to 

a variety of SSA systems and in some 

cases receive return files. The users 

include state/local government agencies, 

other Federal agencies, and some 

private sector business entities. The 

SSA systems that process data 

transferred via eData include, but are 

not limited to, systems responsible for 

disability processing and benefit 

determination or termination. A sponsor 

within SSA who knows the requestor 

completes the registration form, SSA– 

118, and submits the information to 

SSA’s User Interface Team (UIT). SSA 

uses the information on Form SSA–118 

(Government-to-Government Services 

Online Web site Registration Form) to 

maintain the identity of the requestor 

within eData. Once this is completed, 

SSA provides the requestor with the 

new password and conducts a 

walkthrough of the eData Web site as 

necessary. The organization can also 

modify its online account (e.g., address 

change) by completing an online Form 

SSA–119 (Government-to-Government 

Service Online Web site Account 

Modification/Deletion Form). 

Type of Request: Revision of an OMBapproved information collection. 

Collection method Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

annual burden 

(hours) 

SSA–118 ........................................................................................................ 925 1 15 231 

SSA–119 ........................................................................................................ 2,500 1 15 625 

Totals ...................................................................................................... 3,425 ........................ ........................ 856 

12. Technical Updates to 

Applicability of the Supplemental 

Security Income (SSI) Reduced Benefit 

Rate for Individuals Residing in Medical 

Treatment Facilities—20 CFR 

404.708(k)—0960–0758. Section 

1611(e)(1)(A) of the Social Security Act 

states that no resident of a public 

institution is eligible for SSI benefits. 

However, Sections 1611(e)(1)(B) and (G) 

list certain exceptions to this provision 

that make it necessary for SSA to collect 

information about any SSI recipient 

who enters or leaves a medical 

treatment facility or other public or 

private institution. SSA’s regulation, 20 

CFR 404.708(k), establishes the 

reporting guidelines that implement this 

legislative requirement. SSA uses the 

information to determine eligibility for 

SSI and the payment amount. The 

respondents are SSI recipients who 

enter or leave an institution. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 34,200. 

Frequency of Response: 1. 

Average Burden per Response: 7 

minutes. 

Estimated Annual Burden: 3,990 

hours. 

13. Statement for Certificate of 

Election for Reduced Widower(er)’s and 

Surviving Divorced Spouse’s Benefits— 

20 CFR 404.335—0960–0759. Section 

202(q) of the Social Security Act 

provides for the authority to reduce 

benefits under certain conditions when 

elected by a Title II beneficiary. 

However, reduced benefits are not 

payable to an already entitled spouse (or 

divorced spouse) who: 

• Is at least age 62 and under full 

retirement age in the month of the 

number holder’s death; and 

• Is receiving reduced spouse’s (or 

divorced spouse’s) benefits and either 

retirement or disability benefits in the 

month before the month of the number 

holder’s death. 

To elect reduced widow(er) benefits, 

a recipient completes Form SSA–4111. 

SSA uses the information collected on 

Form SSA–4111 to pay a qualified 

dually entitled widow(er) (or surviving 

divorced spouse) who elects to receive 

a reduced widow(er) benefit. The 

respondents are qualified dually 

entitled widow(er)s (or surviving 

divorced spouse) who elect to receive a 

reduced widow(er) benefit. 

Type of Request: Extension of an 

OMB-approved information collection. 

Number of Respondents: 24,000. 

Frequency of Response: 1. 

Average Burden per Response: 15 

minutes. 

Estimated Annual Burden: 6,000 

hours. 

II. SSA has submitted the information 

collections listed below to OMB for 

clearance. Your comments on the 

information collections would be most 

useful if OMB and SSA receive them 

within 30 days from the date of this 

publication. To be sure we consider 

your comments, we must receive them 

no later than June 14, 2010. You can 

obtain a copy of the OMB clearance 

packages by calling the SSA Director for 

Reports Clearance at 410–965–0454 or 

by writing to the above e-mail address. 

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 information from 

Form SSA–781 to determine if noncustodial parents who are filing for 

spouse’s or mother’s and father’s 

benefits based on having a child in their 

care meet the in-care requirements. 

Respondents are applicants for Title II 

spouse’s and/or mother’s and father’s 

benefits. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 14,000. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 2,333 

hours. 

2. Disability Report-Appeal—20 CFR 

404.1512, 416.912, 404.916(c), 

416.1416(c), 405 Subpart C, 422.140— 


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0960–0144. SSA requires disability 

claimants who are appealing an 

unfavorable disability determination to 

complete Form SSA–3441–BK. This 

form allows claimants to disclose any 

changes to their disability or resources 

that might influence SSA’s unfavorable 

determination. SSA may use the 

information to: (1) Reconsider and 

review an initial disability 

determination; (2) review a continuing 

disability; and (3) evaluate a request for 

a hearing. This information assists the 

DDS offices and ALJs in: (1) Preparing 

for the appeals and hearings; and (2) 

issuing a determination or decision on 

an individual’s entitlement (initial or 

continuing) to disability benefits. 

Respondents are individuals who 

appeal a denial, reduction, or cessation 

of Social Security disability income and 

SSI payments, or who are requesting a 

hearing before an ALJ. 

Type of Request: Revision of an OMBapproved information collection. 

Collection method Number of 

respondents 

Frequency of 

response 

Average 

burden per 

response 

(minutes) 

Estimated 

annual burden 

(hours) 

SSA–3441 (Paper Form) ............................................................................... 12,604 1 45 9,453 

Electronic Disability Collect System (EDCS) ................................................. 843,090 1 45 632,318 

I3441 (Internet Form) ..................................................................................... 417,268 1 120 834,536

Totals ...................................................................................................... 1,272,962 ........................ ........................ 1,476,307 

3. Request for Hearing by 

Administrative Law Judge—20 CFR 

404.929, 404.933, 416.1429, 404.1433, 

405.722, 418.1350—0960–0269. When 

SSA denies applicants’ or beneficiaries’ 

requests for new or continuing benefits, 

those applicants/beneficiaries are 

entitled to request a hearing to appeal 

the decision. SSA uses Form HA–501 to 

document such requests. Although SSA 

collects this information, actual 

hearings take place before ALJs 

employed by the Department of Health 

and Human Services (HHS). The 

respondents are: (1) Applicants for or 

current recipients of various Social 

Security benefits who want to appeal 

SSA’s denial of their requests for new or 

continued benefits; and (2) Medicare 

Part B recipients who must pay the 

Medicare Part B Income-Related 

Monthly Adjustment Amount and want 

to appeal SSA’s decision at a hearing 

before an HHS ALJ. 

Note: This is a correction notice. SSA 

published this information collection as an 

extension on March 4, 2010 at 75 FR 9992. 

Since we are revising the Privacy Act 

Statement, this is now a revision of an OMBapproved information collection. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 669,469. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 111,578 

hours. 

4. Information about Joint Checking/ 

Savings Accounts—20 CFR 416.120, 

416.1208—0960–0461. SSA considers a 

person’s resources when evaluating 

eligibility for SSI payments. Generally, 

we consider funds in checking and 

savings accounts to be resources owned 

by the individuals whose names appear 

on the account. Individuals applying for 

SSI, however, may rebut this 

assumption of ownership in a joint 

account if they submit certain evidence 

that establishes the funds do not belong 

to them. SSA uses Form SSA–2574 to 

collect information from SSI applicants/ 

recipients who object to the assumption 

that they own all or part of the funds in 

a joint checking or savings account 

bearing their names. SSA collects 

information about the account from both 

the SSI applicant/recipient and other 

account holder(s). After receiving the 

completed form, SSA determines if we 

should consider the account to be a 

resource for the SSI applicant/recipient. 

The respondents are applicants and 

recipients of SSI and individuals who 

list themselves as joint owners of 

financial accounts with SSI applicants/ 

recipients. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 200,000. 

Frequency of Response: 1. 

Average Burden per Response: 7 

minutes. 

Estimated Annual Burden: 23,333 

hours. 

5. SSI Monthly Wage Reporting 

(Telephone)—20 CFR 416.701–732— 

0960–0715. SSA requires SSI recipients 

to report changes that could affect their 

eligibility for and the amount of their 

SSI payments, such as changes in 

income, resources, and living 

arrangements. The SSITWR, formerly 

the Statement for SSI Monthly Wage 

Reporting (Telephone), enables SSI 

recipients to meet these requirements by 

providing them with a fully automated 

mechanism to report their monthly 

wages by telephone, instead of 

contacting their local field offices. The 

SSITWR allows callers to report their 

wages by speaking their responses 

through voice recognition technology or 

by keying in responses using the 

telephone key pad. To ensure the 

security of the information provided, 

SSITWR asks callers to provide 

information SSA can compare against 

our records for authentication purposes. 

Once the system authenticates the 

identity of the callers, the callers can 

speak or key in their wage data. The 

respondents are SSI recipients, deemors, 

and representative payees of recipients. 

Note: This is a correction notice: SSA 

published the incorrect burden information 

for this collection at 75 FR 9992, on March 

4, 2010. We are correcting this error here. 

Type of Request: Revision of an OMBapproved information collection. 

Collection method Frequency of 

reporting 

Number of 

respondents 

Estimated 

completion 

time 

(minutes) 

Burden 

(hours) 

Training/Instruction .......................................................................................... 1 85,000 35 49,583 

SSITWR ........................................................................................................... 12 85,000 5 85,000 

Total .......................................................................................................... ........................ * 85,000 ........................ 134,583 


sroberts on DSKD5P82C1PROD with NOTICES
Federal Register / Vol. 75, No. 92 / Thursday, May 13, 2010 / Notices 27041 

Note:* The same 85,000 respondents are 

completing both activities, so the actual total 

number of respondents is only 85,000. 

6. Treating Physician Consultative 

Examination Interest Form—20 CFR 

404.1519g–i—0960–0751. When an 

applicant for Social Security disability 

benefits has not consulted a physician 

for a specified period preceding the 

application, SSA will ask the applicant 

to complete a consultative examination 

(CE). If the applicant has a treating 

physician (TP), SSA sends a medical 

evidence of record request letter and 

Form SSA–84 to the applicant’s TP; the 

TP completes the SSA–84 and returns it 

to SSA to indicate interest in 

conducting the CE. If the TP does not 

return the SSA–84, SSA assumes the TP 

is not interested in performing the CE. 

Respondents are disability benefit 

applicants’ treating physicians. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 168. 

Frequency of Response: 1. 

Average Burden per Response: 5 

minutes. 

Estimated Annual Burden: 14 hours. 

7. Claimant Travel Reimbursement 

Request—20 CFR 404.999a–d—0960– 

0752. SSA sends Form SSA–104 to 

Social Security benefits recipients with 

a CE appointment notice. To receive 

reimbursement for their travel expenses 

to the CE, recipients must: (1) Submit an 

itemized list of expenditures for their 

trip; and (2) complete, sign, and return 

the SSA–104 to SSA. SSA collects this 

information to determine eligibility for 

and the amount of reimbursement. 

Respondents are applicants for 

disability claims applying for 

reimbursement of travel expenses to a 

CE. 

Type of Request: Revision of an OMBapproved information collection. 

Number of Respondents: 11,092. 

Frequency of Response: 1. 

Average Burden per Response: 10 

minutes. 

Estimated Annual Burden: 1,849 

hours. 

Dated: May 7, 2010. 

Faye I. Lipsky, 

Acting Center Director, Center for Reports 

Clearance, Social Security Administration. 

[FR Doc. 2010–11190 Filed 5–12–10; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF STATE 

[Public Notice 7001] 

Bureau of Educational and Cultural 

Affairs (ECA) Request for Grant 

Proposals: Edmund S. Muskie 

Graduate Fellowship Program 

Announcement Type: New 

Cooperative Agreement. 

Funding Opportunity Number: ECA/ 

A/E/EUR 11–01. 

Catalog of Federal Domestic Assistance 

Number: 19.011 

Key Dates: 

Application Deadline: June 23, 2010. 

Executive Summary: 

The Muskie Program selects 

outstanding citizens from Armenia, 

Azerbaijan, Belarus, Georgia, 

Kazakhstan, Kyrgyzstan, Moldova, 

Russia, Ukraine, Uzbekistan, Tajikistan 

and Turkmenistan (herein referred to as 

Eurasia) to receive fellowships for 

Master’s level study in the United States 

in the fields of business administration, 

economics, law, public administration, 

and public policy. Candidates from 

countries other than Russia and Ukraine 

will be also considered in additional 

fields of education, environmental 

management, international affairs, 

library and information science, 

journalism/mass communications, and 

public health per guidelines outlined in 

the Project Objectives, Goals, and 

Implementation (POGI) document. 

Muskie Program fellows will be enrolled 

in graduate degree, certificate, and nondegree programs lasting one to two 

academic years. Funding should 

support a minimum of 140 fellows for 

Master’s level fellowships under the FY 

2011 program. Every effort should be 

made to maximize the number of 

awards granted. 

I. Funding Opportunity Description 

Authority 

Overall grant making authority for 

this program is contained in the Mutual 

Educational and Cultural Exchange Act 

of 1961, Public Law 87–256, as 

amended, also known as the FulbrightHays Act. The purpose of the Act is ‘‘to 

enable the Government of the United 

States to increase mutual understanding 

between the people of the United States 

and the people of other countries * * *; 

to strengthen the ties which unite us 

with other nations by demonstrating the 

educational and cultural interests, 

developments, and achievements of the 

people of the United States and other 

nations * * * and thus to assist in the 

development of friendly, sympathetic 

and peaceful relations between the 

United States and the other countries of 

the world.’’ The funding authority for 

the program above is provided through 

legislation. 

Purpose 

The Muskie Program is designed to 

promote mutual understanding, build 

democracy and foster the transition to 

market economies in Eurasia through 

intensive academic study and 

professional training. The academic 

component of the program will begin in 

the fall semester of academic year 2011– 

2012. Fellows may participate in a nine, 

twelve, eighteen, or twenty-four month 

academic program leading to a Master’s 

degree. Fellows also take part in an 

eight to twelve week internship during 

the summer following the first academic 

year, with an option for a second 

internship following the second year of 

study. At the end of their designated 

academic and/or internship programs, 

fellows are required to return 

immediately to their home countries. 

Applicant organizations must 

demonstrate the ability to administer all 

aspects of the Muskie Program— 

recruitment, selection, university 

placements, orientation, monitoring and 

support of FY 2011 fellows including all 

logistics, financial management, 

evaluation, follow-on, and alumni. 

Applicant organizations must 

demonstrate the ability to recruit and 

select a diverse pool of candidates from 

various geographic regions in Eurasia. 

The cooperating organization will serve 

as the principal liaison with Muskie 

Program host institutions for the 

Bureau. Further details on specific 

program responsibilities can be found in 

the Project Objectives, Goals, and 

Implementation (POGI), which is part of 

the formal solicitation package. 

Interested organizations should read the 

entire Federal Register announcement 

for all information prior to preparing 

proposals. 

The Bureau will award one 

cooperative agreement for this program. 

Should an applicant organization wish 

to work with other organizations in the 

implementation of this program, the 

Bureau requests that a sub-award 

agreement be developed. The same 

requirements apply to the sub-recipient 

as to the recipient organization. 

In a cooperative agreement, the Office 

of Academic Exchange Programs, 

European and Eurasian Branch (ECA/E/ 

E/EUR) is substantially involved in 

program activities above and beyond 

routine grant monitoring. ECA/A/E/EUR 

activities and responsibilities for this 

program are as follows: 

1. Participating in the design and 

direction of program activities; 

2. Approval of key personnel; 


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