Change Requests

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Claim for Compensation by a Dependent Information Reports

Key Information

Abstract

The forms included in this information collection are used to request information for entitlement to claim benefits under the Federal Employees’ Compensation from federal employees, as well as their dependents or survivors, to prove continued eligibility for benefits, to show entitlement to remaining compensation payments of a deceased employee, and to show dependency.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

5 USC 8145	View Law

5 USC 8124	View Law

5 USC 8110	View Law

5 USC 8149	View Law

Presidential Action:

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Conditions of Participation: Requirements for Approval and Reapproval of Transplant Centers to Perform Organ Transplants and Supporting Regulations (CMS-10266)

Key Information

Abstract

The CoPs and accompanying requirements specified in the regulations are used by our surveyors as a basis for determining whether a transplant center qualifies for approval or re-approval under Medicare. CMS and the healthcare industry believe that the availability to the facility of the type of records and general content of records, which this regulation specifies, is standard medical practice and is necessary in order to ensure the well-being and safety of patients and professional treatment accountability.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1395aa	View Law

42 USC 1302	View Law

42 USC 1395hh	View Law

42 USC 1395bb	View Law

42 USC 1395rr	View Law

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Federal Write-In Absentee Ballot (FWAB)

Key Information

Abstract

The Uniformed and Overseas Citizens Absentee Voting Act(UOCAVA),42 USC 1973ff, requires the Presidential designee (SECDEF) to prescribe the Federal write-in absentee ballot for absent uniformed service voters and overseas voters in general elections for Federal office. The form serves as a backup ballot for voters who did not receive their State ballot with enough time to vote and return it to their local election official. The authority for the States to collect personal information comes from UOCAVA.Emergency Justfication:The Department of War (DoW) requests emergency processing to revise the Federal Post Card Application (FPCA, SF 76, OMB 0704-0503) and Federal Write-In Absentee Ballot (FWAB, SF 186, OMB 0704-0502). These immediate revisions are essential to the mission of the Federal Voting Assistance Program (FVAP) to eliminate voter confusion and ensure the forms strictly comply with the Uniformed and Overseas Citizens Absentee Voting Act (UOCAVA) and the Help America Vote Act (HAVA) of 2002. Specifically, the revisions clarify voter identification requirements and remove an inaccurate eligibility checkbox for citizens who have never lived in the U.S. DoW cannot reasonably comply with standard PRA clearance procedures because the next Federal election is fewer than 90 days away, and UOCAVA requires States to transmit absentee ballots no later than 45 days before the election. Public harm (voter disenfranchisement) is reasonably likely to occur if the standard clearance time periods are followed. Therefore, DoW requests to bypass the standard public comment periods to ensure these legally compliant forms are implemented in time for the upcoming election.

Authorizing Statutes

Presidential Action:

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Medical Loss Ratio (MLR) Data Form for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP) (CMS-10476)

Key Information

Abstract

Under the Affordable Care Act (ACA), and implementing regulations at 42 CFR, Medicare Advantage (MA) organizations and Prescription Drug Plan (PDP) sponsors are required to submit annual medical loss ratio (MLR) reports (at the contract level) to the Secretary of HHS concerning the amount spent on claims, quality improvement expenses, non-claims costs, Federal and State taxes, licensing and regulatory fees, and revenue. Plan sponsors must provide a remittance to the Secretary if the amount spent in a reporting year on certain costs compared to its revenue (excluding Federal and States taxes and licensing and regulatory fees) is below a certain ratio, referred to as the medical loss ratio (MLR). MA organizations and Part D sponsors are required to report their MLR to CMS, and are subject to financial and other penalties for a failure to meet a statutory requirement that they have an MLR of at least 85 percent. The Affordable Care Act requires several levels of sanctions for failure to meet the 85 percent minimum MLR requirement, including remittance of funds to CMS, a prohibition on enrolling new members, and ultimately contract termination. Plan sponsors will use the MLR Reporting Tool to provide contract-level MLR information to CMS. The information provided in this MLR Report is the basis for computing the contract's MLR percentage and remittance amount, if any, for a contract year.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 111 - 152 1857(e)	View Law

Pub.L. 111 - 148 1103	View Law

Presidential Action:

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Request for State or Federal Workers' Compensation Information

Key Information

Abstract

The OWCP Division of Coal Mine Workers’ Compensation must collect information regarding the status of any worker's compensation inquiry for Federal or State claims regarding benefits received attributable to black lung disability. The OWCP Form CM-905 requests the amount of those workers' compensation benefits and is submitted from Federal or state agencies when the beneficiary has filed a claim for workers' compensation benefits due to pneumoconiosis or is receiving benefits that may need to be offset.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

30 USC 901	View Law

Presidential Action:

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Federal-State Unemployment Insurance Program Data Exchange Standardization

Key Information

Abstract

The Department is required by the Middle Class Tax Relief and Job Creation Act of 2012 to designate eXtensible Markup Language (XML) as a data exchange standard. The data exchange standards help improve the interoperability of these systems that collect and exchange information for UI administrative purposes. Through this regulation, the Department makes use of data exchange standards for ICON and SIDES. To improve UI program operations by states, the Department has been the facilitating entity for development and implementation of automated systems that states may adopt for efficiently processing claims and improving program integrity. These automated systems, which have been developed through a collaborative effort with states and the National Association of Workforce Agencies (NASWA), have replaced manual paper processing with automated exchanges of information between states as well as those between states and employers. The Department provides funding to facilitate the development and implementation of these automated systems, and encourages the use of these systems by states. The Federal requirement to use this standard requires the Department to establish, through regulation, that all such exchanges of electronic information must use XML to comply with the Act.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1111	View Law

Presidential Action:

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Teacher Cancellation Low Income Directory

Key Information

Abstract

The Department of Education (the Department) is requesting OMB approval for a reinstatement without change to 1845-0077 Teacher Cancellation Low Income Directory. The Higher Education Act of 1965, as amended, (HEA) allows for up to a one hundred percent cancellation of a Federal Perkins Loan and loan forgiveness of a Federal Family Education Loan and Direct Loan program loan if the graduate teaches full-time in an elementary or secondary school serving low-income students. The data collected for the development of the Teacher Cancellation Low Income Directory provides web-based access to a list of all elementary and secondary schools, and educational service agencies that serve a total enrollment of more than 30 percent low income students (as defined under Title I, Part A of the Elementary and Secondary Education Act of 1965, as amended). The Directory allows post-secondary institutions to determine whether or not a teacher, who received a Federal Perkins Loan, Direct Loan, or Federal Family Education Loan at their school, is eligible to receive loan cancellation or forgiveness or that a teacher who received a TEACH Grant is meeting the service obligation. This revision request updates the collection with an optional school type data element.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

20 USC 1078-10	View Law

Presidential Action:

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Federal Post Card Application (FPCA)

Key Information

Abstract

The Federal government neither collects nor retains any personal information associated with these forms. The burden for collecting this information resides with the States. The Uniformed and Overseas Citizens Absentee Voting Act (UOCAVA), 52 U.S.C. 203, requires the Presidential designee (Secretary of Defense) to prescribe an official post card form, containing both an absentee voter registration application and an absentee ballot application, for use by the States who have the authority to collect personal information as part of the absentee voting process.Emergency Justfication:The Department of War (DoW) requests emergency processing to revise the Federal Post Card Application (FPCA, SF 76, OMB 0704-0503) and Federal Write-In Absentee Ballot (FWAB, SF 186, OMB 0704-0502). These immediate revisions are essential to the mission of the Federal Voting Assistance Program (FVAP) to eliminate voter confusion and ensure the forms strictly comply with the Uniformed and Overseas Citizens Absentee Voting Act (UOCAVA) and the Help America Vote Act (HAVA) of 2002. Specifically, the revisions clarify voter identification requirements and remove an inaccurate eligibility checkbox for citizens who have never lived in the U.S. DoW cannot reasonably comply with standard PRA clearance procedures because the next Federal election is fewer than 90 days away, and UOCAVA requires States to transmit absentee ballots no later than 45 days before the election. Public harm (voter disenfranchisement) is reasonably likely to occur if the standard clearance time periods are followed. Therefore, DoW requests to bypass the standard public comment periods to ensure these legally compliant forms are implemented in time for the upcoming election.

Authorizing Statutes

Presidential Action:

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Agricultural Prices

Key Information

Abstract

The National Agricultural Statistics Service (NASS) is submitting a substantive change request to revise the currently approved information collection for Agricultural Prices (OMB No. 0535-0003). This substantive change request is to the Prices Received data collections, to add collecting Annual Hay Prices. This survey will be conducted annually and has similar methodology to the other hay prices surveys already included in this request. This change request also includes a change in reporting units in the Prices Paid for Feed survey from 50 lb to 40 lb, due to feedback from survey respondents. There are no other changes to the survey methodology or procedures previously approved.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

7 USC 3601.1	View Law

18 USC 1905	View Law

Pub.L. 115 - 435 302	View Law

7 USC 1391	View Law

7 USC 2204	View Law

7 USC 2276	View Law

7 USC 1446	View Law

7 USC 1303	View Law

Presidential Action:

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The Family and Medical Leave Act of 1993, As Amended

Key Information

Abstract

This ICR implements statutory notice and certification provisions and to assist employees and employers in meeting their FMLA third-party notification obligations as required by the Family and Medical Leave Act of 1993 (FMLA). The subject recordkeeping requirements are necessary in order for the DOL to carry out its statutory obligation under FMLA section 106 to investigate and ensure employer compliance. 29 U.S.C. § 2616.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

29 USC 2616	View Law

Presidential Action:

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Emergency Ambulance Transports and Beneficiary Signature Requirements in 42 CFR 424.36(b) (CMS-10242)

Key Information

Abstract

Because it is very difficult to obtain a beneficiary's signature (or the signature of a person authorized to sign on behalf of the beneficiary) on a claim when the beneficiary is being transported by ambulance in emergency situations, we are proposing that, for emergency ambulance transport services, an ambulance provider or supplier may submit the claim without a beneficiary's signature, as long as certain documentation requirements are met.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

18 Stat. 1835

18 Stat. 1842

18 Stat. 1848

18 Stat. 1814

Presidential Action:

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Emergency and Foreign Hospital Services and Supporting Regulation in 42 CFR Section 424.103 (CMS-1771)

Key Information

Abstract

This form is used in connection with claims for emergency hospital services provided by hospitals that do no have an agreement in effect under Section 1866 of the Social Security Act. 42 CFR 424.103 (b) requires that before a non-participating hospital may be paid for emergency services rendered to a Medicare beneficiary, a statement must be submitted that is

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

18 Stat. 1814

Presidential Action:

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(CMS-10282) Comprehensive Outpatient Rehabilitation Facilites (CORFs) Conditions of Participation (CoP) and Supporting Regulations

Key Information

Abstract

The purpose of this package is to request Office of Management and Budget (OMB) approval of the collection of information requirements for the conditions of participation (CoPs) that comprehensive outpatient rehabilitation facilities (CORFS) must meet to participate in the Medicare Program.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1395x(cc)	View Law

Presidential Action:

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Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services (CMS-10344)

Key Information

Abstract

This provision is mandated by the Affordable Care Act, section 3309. To implement this provision, CMS needs data from the States, identifying full benefit dual-eligible individuals who are receiving home and community-based services. The States will provide these data as a new data value on their monthly MMA Phase Down report. These data are not available from any other source. CMS will use these new data to set the affected beneficiaries' Medicare Part D copayment to zero.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 111 - 148 3309	View Law

Presidential Action:

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Financial Report for the Institutional Service Endowment Activities

Key Information

Abstract

This financial reporting form will be utilized for Title III Part A, Title III Part B and Title V Program Endowment Activities. The purpose of this Financial Report is to have the grantees report annually the kinds of investments that have been made, the income earned and spent, and whether any part of the Endowment Fund Corpus has been spent. This information allows us to give technical assistance and determine whether the grantee has complied with the statutory and regulatory investment requirements.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

Pub.L. 98 - 95 331	View Law

Presidential Action:

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Incident Reporting for Automated Driving Systems (ADS) and Level 2 Advanced Driver Assistance Systems (ADAS)

Key Information

Abstract

This information collection request (ICR) is for an extension of a currently approved information collection that requires manufacturers of motor vehicles and equipment and operators of motor vehicles to submit incident reports for certain crashes involving Automated Driving Systems (ADS) and Level 2 Advanced Driver Assistance Systems (ADAS). NHTSA’s Standing General Order 2021-01 (General Order) requires vehicle and equipment manufacturers and operators of vehicles equipped with ADS or Level 2 ADAS to report crashes that meet specified criteria to the National Highway Traffic Safety Administration (NHTSA). This ICR covers the reporting requirements in the General Order with modifications that will be made in response to comments. ADS and ADAS are new technologies that fundamentally alter the task of driving a motor vehicle by automating certain driver inputs (e.g., steering, acceleration, and braking) and decision making (e.g., path following and obstacle avoidance) that would otherwise be left to human control. Given the rapid evolution of these technologies and testing of new technologies and features on publicly accessible roads, it is critical for NHTSA to exercise its robust oversight over potential safety defects in vehicles operating with ADS and Level 2 ADAS. Crashes involving these vehicles have already resulted in multiple fatalities and serious injuries, and NHTSA anticipates that the number of these crashes will continue to grow in the near future given the increased number of these vehicles on the road and the increased number of vehicle and equipment manufacturers in the market. The General Order provides the agency with critical and timely safety data, which assists the agency in identifying potential safety issues resulting from the operation of advanced technologies on public roads. Access to this crash data may show whether there are common patterns in vehicle crashes or systematic problems with specific vehicles or systems, any of which may reflect a potential safety defect. NHTSA requested and received emergency review and approval of this information collection. NHTSA submitted the request on June 29, 2021. On June 30, 2021, OMB granted NHTSA a six-month approval for this information collection and assigned this information collection the OMB control number 2127-0754. NHTSA is seeking a three-year extension of this information collection. When NHTSA submitted its request for emergency review, the agency estimated that the annual burden would be 12,539 hours and $0. NHTSA now estimates the annual burden to be 31,319 hours and $0. This is an increase of 19,046 hours and $0. The changes in burden estimate are a result of information received from reporting entities regarding time spent reporting information under the 6-month emergency clearance, actual reporting volume for five-months, and the change to the General Order to create a new 5-day reporting category (in place of 1-day and 10-day reports in certain circumstances). Adjustments were also made to remove burden time for training and creating accounts (which took place in the first 6 months for current reporting entities). NHTSA also created a new category of burden to account for additional screening time spent by reporting entities to ensure that they are meeting their reporting requirements. The change in burden hours represents a program change resulting in a decrease in burden hours by 8,320 hours and adjustments resulting in an increase of 27,100 hours.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

49 USC 30166	View Law

49 USC 30118-30120	View Law

49 USC 301	View Law

Presidential Action:

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Request Type:

National Student Loan Data System (NSLDS)

Key Information

Abstract

Title IV, Part G of the Higher Education Act of 1965, as amended, (HEA) as further amended by the 1998 Amendments to the HEA (P.L. 105-244) section 485B, requires the Secretary of the U.S. Department of Education (the Department) to establish a National Student Loan Data System (NSLDS) that contains information about Federal Family Education Loan (FFEL) Program loans, Federal Perkins loans (including National Direct Student Loans and National Defense Student Loans), William D. Ford Federal Direct Student loans (Direct Loan), Federally Insured Student Loans (FISL) and Federal Grants including Pell Grants, Academic Competitiveness Grants (ACG), Iraq and Afghanistan Service Grants (IASG), National Science and Mathematics Access to Retain Talent (SMART) and Teacher Education Assistance for College and Higher Education (TEACH) Grants. NSLDS is operated out of Federal Student Aid (FSA) and is used for research, policy analysis, monitoring student enrollment, identifying loan holders and servicers, calculating default rates, monitoring program participants, and verifying student aid eligibility. This is a request for a reinstatement without change of the current information collection and burden assessed to 1845-0035.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

20 USC 1087	View Law

Presidential Action:

Title:

Reference Number:

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Action:

Request Type:

Collection of Diagnostic Data in the Abbreviated RAPS Format from Medicare Advantage Organizations for Risk Adjusted Payments (CMS-10062)

Key Information

Abstract

Section 1853 of the Social Security Act, hereafter referred to as “the Act,” requires CMS to make advance monthly payments to a Medicare Advantage (MA) organization for each beneficiary enrolled in an MA plan offered by the organization for coverage of Medicare Part A and Part B benefits. Section 1853(a)(1)(C) of the Act requires CMS to adjust the monthly payment amount for each enrollee to take into account the health status of MA plan enrollees. CMS used RAPS data, in combination with encounter data and Fee-For-Service (FFS) data, to develop the diagnosis-based portion of the risk scores for risk adjusted payment to MA organizations, PACE organizations, and MMPs. Risk adjustment allows CMS to pay plans for the health risk of the beneficiaries they enroll, instead of paying an identical average amount for each enrollee. By risk adjusting plan payments, CMS is able to make appropriate and accurate payments for enrollees with differences in expected costs. Risk adjustment is used to adjust bidding and payment based on the health status and demographic characteristics of an enrollee. Risk scores measure individual beneficiaries’ relative risk and the risk scores are used to adjust payments for each beneficiary’s expected expenditures. By risk adjusting plan bids, CMS is able to also use standardized bids as base payments to plans.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1395w-23	View Law

42 USC 1395 w-23	View Law

Presidential Action:

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Student Assistance General Provision - Subpart E - Verification Student Aid Application Information

Key Information

Abstract

This request is for a reinstatement without change of the information collection supporting the policies and reporting requirements contained in Subpart E of Part 668 – Verification and Updating of Student Aid Application Information. Sections 668.53, 668.54, 668.55, 668.56, 668.57, 668.59 and 668.61 contain information collection requirements (OMB control number 1845-0041). This subpart governs the verification and updating of information provided on the Free Application for Federal Student Aid (FAFSA®) which is used to calculate an applicant’s Student Aid Index (SAI) for purposes of determining an applicant’s need for student financial assistance under Title IV of Higher Education Act of 1965, as amended (HEA).

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

20 USC 1091,1094,1095	View Law

Presidential Action:

Title:

Reference Number:

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Action:

Request Type:

External Reviewer Application Instructions

Key Information

Abstract

The data collection effort will provide information required by the AmeriCorps to enable it to effectively select individuals outside AmeriCorps to serve as peer reviewers and panel facilitators for its grant review processes. Applications will be accepted from any individual who is interested in serving as a peer reviewer or facilitator.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 12585(d)	View Law

Presidential Action:

Title:

Reference Number:

Omb Control Number:

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Concluded:

Action:

Request Type:

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Key Information

Abstract

This collection of information is necessary to enable AmeriCorps to obtain customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

44 USC 3501 et.seq.	View Law

Presidential Action:

Title:

Reference Number:

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Action:

Request Type:

Disability Accommodation Request Form

Key Information

Abstract

This form is completed by AmeriCorps State and National grantees who want to receive reimbursement for funds spent accommodating AmeriCorps members with disabilities.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 12501 et seq.	View Law

Presidential Action:

Title:

Reference Number:

Omb Control Number:

Agency:

Received:

Concluded:

Action:

Request Type:

Financial Disclosure for Civil Monetary Penalty (CMP) Debt

Key Information

Abstract

When SSA imposes a civil monetary penalty (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. The agency 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.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 1320	View Law

Presidential Action:

Title:

Reference Number:

Omb Control Number:

Agency:

Received:

Concluded:

Action:

Request Type:

Appointment Scheduling Calendar (ASC)

Key Information

Abstract

The Appointment and Scheduling Calendar (ASC) allows for both customer self-scheduling and technician assisted scheduling through an electronic scheduling tool through the ASC platform for initial claims appointment requests. ASC facilitates both customer self-scheduling and technician scheduling, allowing SSA to collect essential information from customers, including their name, Social Security number, zip code, telephone number, and email address. Additionally, customers have the option to consent to electronic messaging or to opt out, as well as specify their preferred method of communication (email or text), language preference, preferred service office, and appointment day and time preferences. SSA uses this information to schedule in-office, phone, or video appointments for processing enumeration, PE actions, or initial claim appointments. Customers scheduling their PE or initial claim appointments through a technician have the option to create a one-time passcode, enabling them to securely update their appointment online. The technician documents this one-time passcode along with the customer's other appointment preferences. Customers begin the process by accessing SSA.gov and engaging an online questionnaire to determine the nature of their business. If applications are available for customers to self-serve, the system routes them to those applications to complete their business. If not, customers are given the option to self schedule an appointment through ASC. If the customer moves forward, the system directs them to create a credential using Login.gov or ID.me. Once they complete credentialing, customers access ASC to complete required screens and fields to select a date and time for an appointment with an SSA field office (FO) to provide the proofs necessary to obtain a replacement or original SSN card or complete a PE action. Upon completing the required screens and fields, the system presents customers with a screen to review and submit all of the data they input regarding the requested appointment. If customers encounter issues with ASC, or they need to request an appointment type which requires technician assistance (e.g., scheduling, rescheduling, or cancelling PE or initial claims appointments), they may contact SSA by phone to have an FO or Telephone Service Center (TSC) technician schedule their appointment. Technicians follow existing processes and policies to identify the caller as a legitimate customer, and converse with the customer to determine the nature of their business and if they require an appointment. If the technician determines the customer needs an appointment, the technician accesses ASC and completes the required screens and fields for the enumeration, PE appointment, or for an initial claim appointment. Once the technician completes the ASC screens, the technician can review all of the information the customer provided with the customer. If the customer indicates it is correct the technician submits and schedules the appointment. We conduct this information collection each time a customer accesses the online tool or contacts SSA by phone to schedule an appointment. The respondents are individuals looking to schedule their SSA visit, either through self-scheduling or technician assisted modalities, using ASC. We are making De Minimus IT Modification Changes to ASC screens to update the Privacy Act Statement screens.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Presidential Action:

Title:

Reference Number:

Omb Control Number:

Agency:

Received:

Concluded:

Action:

Request Type:

Application for Lump-Sum Death Payment

Key Information

Abstract

SSA uses Form SSA-8 to collect information needed to authorize payment of the lump sum death payment (LSDP) to a surviving individual (e.g., widow, widower, or children of the deceased, etc.) as defined in section 202(i) of the Act. Respondents complete the application for this one-time payment through: (1) use of the paper form; (2) the Internet modality through the Universal Benefits Application portal, (3) submission of a completed fillable static PDF webform through our Upload Documents portal (OMB No. 0960 0830), or (4) a personal interview with an SSA employee either via telephone, or in a field office. For all personal interviews (either telephone or in person), we collect the information via our electronic Modernized Claim System (MCS) screens. When a respondent completes the paper Form SSA-8, they mail it back to SSA. The respondents are applicants for the LSDP.

Federal Register Notices

60-Day FRN	View Notice
30-Day FRN	View Notice

Authorizing Statutes

42 USC 402	View Law

Presidential Action: