Federal Register / Vol. 82, No. 166 / Tuesday, August 29, 2017 / Notices 41085 

[FR Doc. 2017–18308 Filed 8–28–17; 8:45 am] 

BILLING CODE 8011–01–P 

SOCIAL SECURITY ADMINISTRATION 

[Docket No: SSA–2017–0045] 

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 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, 

Fax: 202–395–6974,Email address: 

OIRA_Submission@omb.eop.gov. 

(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: 

OR.Reports.Clearance@ssa.gov. 

Or you may submit your comments 

online through www.regulations.gov, 

referencing Docket ID Number [SSA– 

2017–0045]. 

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 October 30, 

2017. Individuals can obtain copies of 

the collection instruments by writing to 

the above email address. 

1. Partnership Questionnaire—20 CFR 

404.1080–404.1082(e)—0960–0025. SSA 

considers partnership income in 

determining entitlement to Social 

Security benefits. SSA uses information 

from Form SSA–7104 to determine 

several aspects of eligibility for benefits, 

including the accuracy of reported 

partnership earnings; the veracity of a 

retirement; and lag earnings where SSA 

needs this information to determine the 

status of the insured. The respondents 

are applicants for, and recipients of, 

Title II Social Security benefits who are 

reporting partnership earnings. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of 

completion 

Number of 

respondents 

Frequency of 

response 

Average burden 

per response 

(minutes) 

Estimated total 

annual burden 

(hours) 

SSA–7104 12,350 1 30 6,175 

2. Supplement to Claim of Person 

Outside the United States—20 CFR 

422.505(b), 404.460, 404.463, and 42 

CFR 407.27(c)—0960–0051. Claimants 

or beneficiaries (both United States 

(U.S.) citizens and aliens entitled to 

benefits) living outside the U.S. 

complete Form SSA–21 as a supplement 

to an application for benefits. SSA 

collects the information to determine 

eligibility for U.S. Social Security 

benefits for those months an alien 

beneficiary or claimant is outside the 

U.S., and to determine if tax 

withholding applies. In addition, SSA 

uses the information to: (1) Allow 

beneficiaries or claimants to request a 

special payment exception in an SSA 

restricted country; (2) terminate 

supplemental medical insurance 

coverage for recipients who request it, 

because they are, or will be, out of the 

United States; and (3) allow claimants to 

collect a lump sum death benefit if the 

number holder died outside the U.S. 

and we do not have information to 

determine whether the lump sum death 

benefit is payable under the Social 

Security Act (Act). The respondents are 

Social Security claimants, or 

individuals entitled to Social Security 

benefits, who are, were, or will be 

residing outside the U.S. three months 

or longer. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of 

completion 

Number of 

respondents 

Frequency of 

response 

Average burden 

per response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

Paper SSA–21—U.S. Residents ..................................................................... 510 1 14 119 

Paper SSA–21—Residents of a Tax Treaty Country ...................................... 2,751 1 9 413 

Paper SSA–21—Nonresident aliens ............................................................... 1,835 1 8 245 

Modernized Claims System (MCS) Macros SSA–21—U.S. Residents .......... 1,325 1 11 243 

MCS Macros SSA 21—Residents of a Tax Treaty Country ........................... 7,153 1 6 715 

MCS Macros SSA 21—Nonresident aliens ..................................................... 4,769 1 5 397 

Totals ........................................................................................................ 18,343 ........................ ........................ 2,132 

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 

September 28, 2017. Individuals can 

obtain copies of the OMB clearance 

packages by writing to 

OR.Reports.Clearance@ssa.gov. 

1. Application for Search of Census 

Records for Proof of Age—20 CFR 

404.716—0960–0097. When preferred 

evidence of age is not available, or the 

available evidence is not convincing, 

SSA may ask the U.S. Department of 

Commerce, Bureau of the Census, to 

search its records to establish a 

claimant’s date of birth. SSA collects 

information from claimants using Form 

SSA–1535–U3 to provide the Census 

Bureau with sufficient identification 


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41086 Federal Register / Vol. 82, No. 166 / Tuesday, August 29, 2017 / Notices 

information to allow an accurate search 

of census records. Additionally, the 

Census Bureau uses a completed, signed 

SSA–1535–U3 to bill SSA for the 

search. The respondents are applicants 

for Social Security benefits who need to 

establish their date of birth as a factor 

of entitlement. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of 

completion 

Number of 

respondents 

Frequency of 

response 

Average 

burden 

per response 

(minutes) 

Estimated 

total annual 

burden 

(hours) 

SSA–1535–U3 ................................................................................................. 18,030 1 12 3,606 

2. State Death Match Collections—20 

CFR 404.301, 404.310–404.311, 404.316, 

404.330–404.341, 404.350–404.352, 

404.371, and 416.912—0960–0700. SSA 

uses the State Death Match Collections 

to ensure the accuracy of payment files 

by detecting unreported or inaccurate 

deaths of beneficiaries. Under the Act, 

entitlement to retirement, disability, 

wife’s, husband’s, or parent’s benefits 

terminate when the beneficiary dies. 

The states furnish death certificate 

information to SSA via the manual 

registration process, or the Electronic 

Death Registration process (EDR). Both 

death match processes are automated 

electronic transfers between the states 

and SSA. The respondents are the 

states’ bureaus of vital statistics. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of 

completion 

Number of 

respondents 

Frequency of 

response 

Number of 

responses 

Average cost 

per record 

request 

Estimated 

total annual 

burden 

(hours) 

State Death Match—CyberFusion/GSO: Non-EDR 

Records from EDR sites .................................................. 45 3,700 166,500 $.88 $146,520 

State Death Match—CyberFusion/GSO: Non-EDR sites .... 12 48,000 576,000 .88 506,880 

Total: Non-EDR ............................................................ 57 ........................ ........................ ........................ 653,400 

State Death Match-EDR ...................................................... 45 48,500 2,182,500 3.17 6,918,525 

States Expected to Become—State Death Match-EDR 

Within the Next 3 Years ................................................... 7 62,600 438,200 3.17 1,389,094 

Total: EDR and Expected EDR .................................... 52 ........................ ........................ ........................ 8,307,619 

Grand Totals .......................................................... 109 ........................ ........................ ........................ *8,961,019 

* Please note that both of these data matching processes are electronic and there is only a cost burden, and no hourly burden for the respondent to provide this information. 

3. Application for Access to SSA 

Systems—20 CFR 401.45—0960–0791. 

SSA uses Form SSA–120, Application 

for Access to SSA Systems, to allow 

limited access to SSA’s information 

resources for SSA employees and nonFederal employees (contractors). SSA 

requires supervisory approval, and local 

or component Security Officer review, 

prior to granting this access. The 

respondents are SSA employees and 

non-Federal Employees (contractors) 

who require access to SSA systems to 

perform their jobs. 

Note: Because SSA employees are Federal 

workers exempt from the requirements of the 

Paperwork Reduction Act, the burden below 

is only for SSA contractors. 

Type of Request: Revision of an OMBapproved information collection. 

Modality of 

completion 

Number of 

respondents 

Frequency 

of response 

Average 

burden 

per response 

(minutes) 

Estimated total 

annual burden 

(hours) 

SSA–120 (paper version) ................................................................................ 685 1 2 23 

SSA–120 (Internet version) ............................................................................. 1,482 1 1.5 37 

Totals ........................................................................................................ 2,167 ........................ ........................ 60 

Dated: August 24, 2017. 

Naomi R. Sipple, 

Reports Clearance Officer, Social Security 

Administration. 

[FR Doc. 2017–18248 Filed 8–28–17; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF STATE 

[Public Notice: 10102] 

Certification Pursuant to Section 

7045(A)(4)(A) of the Department of 

State, Foreign Operations, and Related 

Programs Appropriations Act, 2017 

By virtue of the authority vested in 

me as the Secretary of State, including 

pursuant to section 7045(a)(4)(A) of the 

Department of State, Foreign 

Operations, and Related Programs 

Appropriations Act, 2017 (Div. J, Pub. L. 

115–31), I hereby certify that the central 

government of Guatemala is taking 

effective steps, which are in addition to 

those steps taken since the certification 

and report submitted during the prior 

year, to: 

• Inform its citizens of the dangers of 

the journey to the southwest border of 

the United States; 


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