Notice2021-21141
Agency Information Collection Activities: Comment Request
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 29, 2021
Issuing agencies
Social Security Administration
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<title>Federal Register, Volume 86 Issue 186 (Wednesday, September 29, 2021)</title>
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[Federal Register Volume 86, Number 186 (Wednesday, September 29, 2021)]
[Notices]
[Pages 54007-54011]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-21141]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2021-0036]
Agency Information Collection Activities: 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, and one extension 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.
Comments: <a href="https://www.reginfo.gov/public/do/PRAMain">https://www.reginfo.gov/public/do/PRAMain</a>. Submit your
comments online referencing Docket ID Number [SSA-2021-0036].
(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:
<a href="/cdn-cgi/l/email-protection#054a572b5760756a7771762b4669606477646b6660457676642b626a73"><span class="__cf_email__" data-cfemail="165944384473667964626538557a737764777875735665657738717960">[email protected]</span></a>. Or you may submit your comments online
through <a href="https://www.reginfo.gov/public/do/PRAMain">https://www.reginfo.gov/public/do/PRAMain</a>, referencing Docket
ID Number [SSA-2021-0036].
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 October 29, 2021. Individuals can obtain copies of
these OMB clearance packages by writing to
<a href="/cdn-cgi/l/email-protection#622d304c3007120d1016114c210e070310030c0107221111034c050d14"><span class="__cf_email__" data-cfemail="226d700c7047524d5056510c614e474350434c4147625151430c454d54">[email protected]</span></a>.
1. Application for Parent's Insurance Benefits--20 CFR 404.370,
404.371, 404.373, 404.374 & 404.601-404.603--0960-0012. Section 202(h)
of the Social Security Act (Act) establishes the conditions of
eligibility a claimant must meet to receive monthly benefits as a
parent of a deceased worker who was contributing at least one-half of
the parent's support at the time of the worker's death or when the
worker became disabled. SSA uses information from Form SSA-7-F6,
Application for Parent's Insurance Benefits, to determine if the
claimant meets the eligibility and application criteria. The
respondents are applicants filing for Parent's Insurance Benefits.
Type of Request: Revision of an OMB-approved information
collection.
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Average wait
Average Average time in field Total annual
Number of Frequency of burden per Estimated theoretical office or for opportunity
Modality of completion respondents response response total annual hourly cost teleservice cost
(minutes) burden (hours) amount centers (dollars) ***
(dollars) * (minutes) **
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SSA-7-F6 (Paper)........................ 4 1 15 1 * $27.07 .............. *** $27
Interview (MCS)......................... 325 1 15 81 * 27.07 ** 21 *** 5,279
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Totals.............................. 329 .............. .............. 82 .............. .............. *** 5,306
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* We based this figure on the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-0000">https://www.bls.gov/oes/current/oes_nat.htm#00-0000</a>).
** We based this figure on averaging both the average FY 2021 wait times for field offices and teleservice centers, based on SSA's current management
information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
2. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. When SSA needs information to determine a worker's employment
status to maintain a worker's earning records, the agency uses Form
SSA-7160, Employment Relationship Questionnaire, to determine the
existence of an employer-employee relationship. We use the information
to develop the employment relationship; specifically, to determine
whether a beneficiary is self-employed or an employee. The respondents
are individuals, households, businesses, and state or local governments
seeking to establish their status as employees, and their alleged
employers.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average Estimated theoretical Average wait Total annual
Modality of completion Number of Frequency of burden per total annual hourly cost time in field opportunity
respondents response response burden amount office cost
(minutes) (hours) (dollars) * (minutes) ** (dollars) ***
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SSA-7160........................................ 45 1 25 19 * $22.14 ** 24 *** $820
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* We based this figure on the average U.S. worker's hourly wages of $27.07 (<a href="https://www.bls.gov/oes/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</a>); the median hourly wage of
$21.10 for public sector Information and Records Clerks (<a href="https://www.bls.gov/oes/current/oes434199.htm">https://www.bls.gov/oes/current/oes434199.htm</a>); and the median hourly wage of $18.25 for
State and Local government Information and Records Clerks (<a href="https://www.bls.gov/oes/current/oes434199.htm">https://www.bls.gov/oes/current/oes434199.htm</a>), as reported by Bureau of Labor Statistics
data. We used the average of these three wages to calculate the combined Average Theoretical Hourly Wage of $22.14.
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
[[Page 54008]]
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
3. Statement of Self-Employment Income--20 CFR 404.101, 404.110, &
404.1096--0960-0046. To qualify for insured status, and collect Social
Security benefits, self-employed individuals must demonstrate they
earned the minimum amount of self-employment income (SEI) in a current
year. SSA uses Form SSA-766, Statement of Self-Employment Income, to
collect the information we need to determine if the individual earned
at least the minimum amount of SEI needed for one or more quarters of
coverage in the current year. Based on the information we obtain, we
may credit additional quarters of coverage to give the individual
insured status and expedite benefit payments. Respondents are self-
employed individuals potentially eligible for Social Security benefits.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Modality of completion Number of Frequency of per response total annual hourly cost opportunity
respondents response (minutes) burden (hours) amount cost (dollars)
(dollars) * **
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SSA-766................................................. 910 1 5 76 * $27.07 ** $2,057
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* We based this figure on the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-0000">https://www.bls.gov/oes/current/oes_nat.htm#00-0000</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
4. Substitution of Party Upon Death of Claimant--20 CFR
404.957(c)(4) & 416.1457(c)(4)--0960-0288. A judge may dismiss a
request for a hearing on a pending claim of a deceased individual for
Social Security benefits or Supplemental Security Income (SSI)
payments. Individuals who believe the dismissal may adversely affect
them may complete Form HA-539, Notice Regarding Substitution of Party
Upon Death of Claimant, which allows them to request to become a
substitute party for the deceased claimant. The judge and the hearing
office support staff use the information from the HA-539 to: (1)
Maintain a written record of request; (2) establish the relationship of
the requester to the deceased claimant; (3) determine the substituted
individual's wishes regarding an oral hearing or decision on the
record; and (4) admit the data into the claimant's official record as
an exhibit. The respondents are individuals requesting to be substitute
parties for a deceased claimant.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Modality of completion Number of Frequency of per response total annual hourly cost opportunity
respondents response (minutes) burden (hours) amount cost (dollars)
(dollars) * **
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HA-539.................................................. 4,000 1 5 333 * $10.95 ** $3,646
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* We based this figure on the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
5. Continuation of Supplemental Security Income Payments for the
Temporarily Institutionalized--Certification of Period and Need to
Maintain Home--20 CFR 416.212(b)(1)--0960-0516. When SSI recipients:
(1) Enter a public institution; or (2) enter a private medical
treatment facility with Medicaid paying more than 50 percent of
expenses, SSA reduces recipients' SSI payments to a nominal sum.
However, if this institutionalization is temporary (defined as a
maximum of three months), SSA may waive the reduction. Before SSA can
waive the SSI payment reduction, the agency must receive the following
documentation: (1) A physician's certification stating the SSI
recipient will only be institutionalized for a maximum of three months;
and (2) certification from the recipient, the recipient's family, or
friends, confirming the recipient needs SSI payments to maintain the
living arrangements to which the individual will return post-
institutionalization. To obtain this information, SSA employees contact
the recipient (or a knowledgeable source) to collect the required
physician's certification and the statement of need. SSA does not
require any specific format for these items, so long as we obtain the
necessary attestations. The respondents are SSI recipients, their
family or friends, as well as physicians or hospital staff members who
treat the SSI recipient.
Type of Request: Revision of an OMB-approved information
collection.
NOTE: We created a fillable PDF form to collect the same
information as collected through the SSI Claims System screens. The
new form, SSA-186, Temporary Institutionalization Statement to
Maintain Household and Physician Certification, will make it easier
for the recipients, representative payees, and institutions to
obtain the statement of need and the physician's certification all
on one standardized document.
[[Page 54009]]
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Average Average wait
Average burden Estimated theoretical time for Total annual
Modality of completion Number of Frequency of per response total annual hourly cost teleservice opportunity
respondents response (minutes) burden (hours) amount centers cost (dollars)
(dollars) * (minutes) ** ***
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Statement from other Respondents........ 26,793 1 5 2,233 * $10.95 19** *** $117,351
Physician's Certifications.............. 26,793 1 5 2,233 * 41.30 0 ** 92,223 ***
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Totals.............................. 53,586 .............. .............. 4,466 .............. .............. *** 209,574
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* We based these figures on the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>), and the
average Healthcare Practitioners and Technical Occupations hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes290000.htm">https://www.bls.gov/oes/current/oes290000.htm</a>).
** We based this figure on the average FY 2021 wait times for teleservice centers, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
6. Claimant Statement about Loan of Food or Shelter; Statement
about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. SSA bases an SSI claimant's or recipient's eligibility on
need, as measured by the amount of income an individual receives. Per
our calculations, income includes other people providing in-kind
support and maintenance in the form of food and shelter to SSI
applicants or recipients. SSA uses Forms SSA-5062, Claimant Statement
about Loan of Food or Shelter, and SSA-L5063, Statement about Food or
Shelter Provided to Another, to obtain statements about food or shelter
provided to SSI claimants or recipients. SSA uses this information to
determine whether the food or shelter are bona fide loans or income for
SSI purposes. This determination may affect claimants' or recipients'
eligibility for SSI as well as the amounts of their SSI payments. The
respondents are claimants and recipients for SSI payments, and
individuals who provide loans of food or shelter to them.
Type of Request: Revision of an OMB-approved information
collection.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average Estimated theoretical Average wait Total annual
Modality of completion Number of Frequency of burden per total annual hourly cost time in field opportunity
respondents response response burden amount office cost
(minutes) (hours) (dollars) * (minutes) ** (dollars) ***
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SSA-5062--Paper Version................. 29,026 1 10 4,838 * $19.01 ** 24 *** $312,676
SSA-L5063--Paper Version................ 29,026 1 10 4,838 * 19.01 ** 24 *** 312,676
SSA-5062--SSI Claims System............. 29,026 1 10 4,838 * 19.01 ** 24 *** 312,676
SSA-L5063--SSI Claims System............ 29,026 1 10 4,838 * 19.01 ** 24 *** 312,676
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Totals.............................. 116,104 .............. .............. 19,352 .............. .............. *** 1,250,704
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*> We based this figure on averaging both the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>), and the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</a>).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
7. Application for Circuit Court Law--20 CFR 404.985 & 416.1485--
0960-0581. Individuals claiming that an acquiescence ruling (AR) would
change SSA's prior determination or decision must submit a written
readjudication request with specific information. SSA reviews the
information in the requests to determine if the issues stated in the AR
pertain to the claimant's case, and if the claimant is entitled to
readjudication. If readjudication is appropriate, SSA considers the
issues the AR covers. Any new determination or decision is subject to
administrative or judicial review as specified in the regulations, and
the claimants must provide information to request readjudication. The
respondents are claimants for Social Security benefits and SSI
payments, who request a readjudication of their claim based on an AR
notice.
Type of Request: Extension of an OMB approved information
collection.
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Average
Average Estimated theoretical Total annual
Modality of completion Number of Frequency of burden per total annual hourly cost opportunity
respondents response response burden amount cost
(minutes) (hours) (dollars) * (dollars) ***
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AR-based readjudication requests........................ 10,000 1 17 2,833 * $10.95 ** $31,021
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* We based this figure on the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
8. Social Security Administration Health IT Partner Program
Assessment--Participating Facilities and Available Content Form--20 CFR
404.1614 & 416.1014--0960-0798. The Health Information Technology for
Economic and Clinical Health (HITECH) Act promotes the adoption and
meaningful use of health information technology (IT), particularly in
the context of working with government agencies. Similarly, section
3004 of the Public Health Service Act requires health care providers or
health insurance issuers with government contracts to implement,
acquire, or upgrade their health IT systems and products to meet
adopted standards and
[[Page 54010]]
implementation specifications. To support expansion of SSA's health IT
initiative as defined under HITECH, SSA developed Form SSA-680, the
Health IT Partner Program Assessment--Participating Facilities and
Available Content Form. The SSA-680 allows healthcare providers to
provide the information SSA needs to determine their ability to
exchange health information with the agency electronically. We evaluate
potential partners (healthcare providers and organizations) on: (1) The
accessibility of health information they possess; and (2) the content
value of their electronic health records' systems for our disability
adjudication processes. SSA reviews the completeness of organizations'
SSA-680 responses as one part of our careful analysis of their
readiness to enter into a health IT partnership with us. The
respondents are healthcare providers and organizations exchanging
information with the agency.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Total annual
Modality of completion Number of Frequency of per response total annual hourly cost opportunity
respondents response (minutes) burden (hours) amount cost (dollars)
(dollars) * **
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SSA-680................................................. 30 1 300 150 * $41.30 ** $6,195
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* We based this figures on average Healthcare Practitioners and Technical Occupations, as reported by Bureau of Labor Statistics data. (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-0000">https://www.bls.gov/oes/current/oes_nat.htm#00-0000</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
9. Authorization for the Social Security Administration to Obtain
Personal Information--20 CFR 404.704, 404.820 404.823, 404.1926,
416.203, & 418.3001--0960-0801. SSA uses Form SSA-8510, Authorization
for the Social Security Administration to Obtain Personal Information,
to contact a public or private custodian of records on behalf of an
applicant or recipient of an SSA program to request evidence
information or proofs, which may support a benefit application or
payment continuation. SSA also uses this form to obtain evidence or
proofs to determine the claimant's payment amount. We ask for
information such as the following:
<bullet> Age requirements (e.g., birth certificate, court
documents)
<bullet> Insured status (e.g., earnings, employer verification)
<bullet> Marriage or divorce
<bullet> Pension offsets
<bullet> Wages verification
<bullet> Annuities
<bullet> Dividends, royalties, or other similar payments
<bullet> Property information
<bullet> Benefit verification from a State agency or third party
<bullet> Immigration status (rare instances)
<bullet> Income verification from public agencies or private
individuals
<bullet> Unemployment benefits
<bullet> Insurance policies
<bullet> Alimony or Child Support payments.
If the custodian of the records requires a signed authorization
from the individual(s) whose information SSA requests, SSA may provide
the custodian with a copy of the SSA-8510. Once the respondent
completes the SSA-8510, either using the paper form or using the
Personal Information Authorization Intranet version, SSA uses the form
as the authorization to obtain personal information regarding the
respondent from third parties until the authorizing person (respondent)
withdraws their claim or revokes the permission of its use. The
collection is voluntary; however, failure to verify the individuals'
eligibility can prevent SSA from making an accurate and timely decision
for their benefits. The respondents are individuals who may file for,
or currently receive, Social Security benefits, SSI payments, or
Medicare Part D subsidies.
Type of Request: Revision of an OMB-approved information
collection.
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Average
Average burden Estimated theoretical Average wait Total annual
Modality of completion Number of Frequency of per response total annual hourly cost time in field opportunity
respondents response (minutes) burden (hours) amount office cost (dollars)
(dollars) * (minutes) ** ***
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Paper SSA[dash]8510 for general evidence 8,226 1 5 686 * $19.01 ** 24 *** $75,584
purposes...............................
Personal Information Authorization 192,235 1 5 16,020 * 19.01 ** 24 *** 1,766,295
Intranet Screens for general evidence
purposes...............................
(SSI Claims System).....................
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Totals.............................. 200,461 .............. .............. 16,706 .............. .............. *** 1,841,879
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* We based this figure on averaging both the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>), and the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</a>).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
respondents to complete the application.
Dated: September 24, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[[Page 54011]]
[FR Doc. 2021-21141 Filed 9-28-21; 8:45 am]
BILLING CODE 4191-02-P
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