[Federal Register Volume 60, Number 9 (Friday, January 13, 1995)]
[Notices]
[Page 3253]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-924]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Social Security Administration


Agency Forms Submitted to the Office of Management and Budget for 
Clearance

    Normally on Fridays, the Social Security Administration publishes a 
list of information collection packages that have been submitted to the 
Office of Management and Budget (OMB) for clearance in compliance with 
Public Law 96-511, The Paperwork Reduction Act. The following clearance 
packages have been submitted to OMB since the last list was published 
in the Federal Register on Friday, November 25, 1994.

(Call Reports Clearance Officer on (410) 965-4142 for copies of 
package.)

    1. Supplemental Security Income Notice of Interim Assistance 
Reimbursement (TWO FORMS)--0960-NEW. Forms SSA-8125 and SSA-L8125 will 
collect interim assistance reimbursement (IAR) information from States 
which provide such reimbursement. Form SSA-8125 will be used in most 
cases. The use of form SSA-L8125 will be limited to situations where a 
person is collecting Supplemental Security Income payments because of 
disability due to drug abuse or alcoholism. The respondents will be 
States who provide IAR.

    Number of Respondents: 140,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 23,333 hours.
    2. Pre-1957 Military Service Federal Benefit Questionnaire--0960-
0120. The information on form SSA-2512 is used by the Social Security 
Administration to establish whether the wage earner's military service 
may be used to determine entitlement to or the amount of any Social 
Security benefit payable. The respondents are claimants who are 
applying for Social Security benefits on a record where the wage earner 
has pre-1957 military service.

    Number of Respondents: 56,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 9,333 hours.
    3. Reconsideration Report for Disability Cessation--0960-0350. The 
information on form SSA-782 is used by the Social Security 
Administration to obtain additional information and evidence to support 
requests for reconsideration. The respondents are claimants under Title 
II and Title XVI of the Social Security Act who file a request for 
reconsideration of disability benefits.

    Number of Respondents: 11,550.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 5,775 hours.
    OMB Desk Officer: Laura Oliven.
    Written comments and recommendations regarding these information 
collections should be sent directly to the appropriate OMB Desk Officer 
designated above at the following address: Office of Management and 
Budget, OIRA, New Executive Office Building, Room 10230, Washington, 
D.C. 20503.

    Dated: January 9, 1995.
Charlotte Whitenight,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 95-924 Filed 1-12-95; 8:45 am]
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