Agency Information Collection Activities: Proposed Request and Comment Request

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January 3, 2022

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Social Security Administration

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<title>Federal Register, Volume 87 Issue 1 (Monday, January 3, 2022)</title>
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[Federal Register Volume 87, Number 1 (Monday, January 3, 2022)]
[Notices]
[Pages 139-144]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-28387]

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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2021-0054]

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

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-2021-0054].

(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#440b166a1621342b3630376a0728212536252a2721043737256a232b32"><span class="__cf_email__" data-cfemail="5f100d710d3a2f302d2b2c711c333a3e2d3e313c3a1f2c2c3e71383029">[email&#160;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-
2021-0054].

The information collection below is pending at SSA. SSA will submit
it to

[[Page 140]]

OMB within 60 days from the date of this notice. To be sure we consider
your comments, we must receive them no later than March 4, 2022.
Individuals can obtain copies of the collection instrument by writing
to the above email address.
Farm Self-Employment Questionnaire--20 CFR 404.1082(c) & 404.1095--
0960-0061. SSA collects the information on Form SSA-7156 on a voluntary
and as-needed basis to determine the existence of an agriculture trade
or business which may affect the monthly benefit, or insured status, of
the applicant. SSA requires the existence of a trade or business before
determining if an individual or partnership has net earnings from self-
employment. When an applicant indicates self-employment as a farmer,
SSA uses the SSA-7165 to obtain the information we need to determine
the existence of an agricultural trade or business, and subsequent
covered earnings for Social Security entitlement purposes. As part of
the application process, we conduct a personal interview, either face-
to-face or via telephone, and document the interview using Form SSA-
7165. We also allow applicants to complete a fillable version of the
form available on our website, which they can complete, print, and
sign. The respondents are applicants for Social Security benefits whose
entitlement depends on whether the worker received covered earnings
from self-employment as a farmer.
Type of Request: Revision of an OMB-approved information
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
Average wait
Average time in field Total annual
Number of Frequency of Average burden Estimated total theoretical office or for opportunity
Modality of completion respondents response per response annual burden hourly cost teleservice cost (dollars)
(minutes) (hours) amount centers ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-7156......................... 1,000 1 10 167 * $14.49 ** 21 *** $7,491
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* We based this figure on average Farmworkers and Laborers, Crop, Nursery, and Greenhouse salaries as reported by Bureau of Labor Statistics data
(<a href="https://www.bls.gov/oes/current/oes452092.htm">https://www.bls.gov/oes/current/oes452092.htm</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.

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 February 2, 2022. Individuals can obtain copies of
these OMB clearance packages by writing to
<a href="/cdn-cgi/l/email-protection#307f621e6255405f4244431e735c555142515e5355704343511e575f46"><span class="__cf_email__" data-cfemail="98d7cab6cafde8f7eaecebb6dbf4fdf9eaf9f6fbfdd8ebebf9b6fff7ee">[email&#160;protected]</span></a>.
1. Application for a Social Security Number Card, the Social
Security Number Application Process (SSNAP), and internet SSN
Replacement Card (iSSNRC) Application--20 CFR 422.103--422.110--0960-
0066. SSA collects information on the SS-5 (used in the United States)
and SS-5-FS (used outside the United States) to issue original or
replacement Social Security cards. SSA also enters the application data
into the SSNAP application when issuing a card via telephone or in
person. In addition, hospitals collect the same information on SSA's
behalf for newborn children through the Enumeration-at-Birth process.
In this process, parents of newborns provide hospital birth
registration clerks with information required to register these
newborns. Hospitals send this information to State Bureaus of Vital
Statistics (BVS), and they send the information to SSA's National
Computer Center. SSA then uploads the data to the SSA mainframe along
with all other enumeration data, and we assign the newborn a Social
Security number (SSN) and issue a Social Security card. Respondents can
also use these modalities to request a change in their SSN records. In
addition, the iSSNRC internet application collects information similar
to the paper SS-5 for no-change replacement SSN cards for adult U.S.
citizens. The iSSNRC modality allows certain applicants for SSN
replacement cards to complete the internet application and submit the
required evidence online rather than completing a paper Form SS-5.
Finally, oSSNAP collects information similar to that which we collect
on the paper SS-5 for no change situations, with the exception of name
change, new or replacement SSN cards for U.S. Citizens (adult and minor
children), and replacement cards only for non-U.S. citizens. oSSNAP
allows these applicants for new or replacement SSN cards to start the
application process on-line, receive a list of evidentiary documents,
and then submit the application data to SSA for further processing by
SSA employees. Applicants need to visit a local SSA office to complete
the application process. The respondents for this information
collection are applicants for original and replacement Social Security
cards, or individuals who wish to change information in their SSN
records, who use any of the modalities described above.
Type of Request: Revision of an OMB-approved information
collection.

[[Page 141]]

iSSNRC Modality
--------------------------------------------------------------------------------------------------------------------------------------------------------
Adult U.S. Citizens requesting a 3,141,061 1 5 261,755 * 25.72 ** 0 *** 6,732,341
replacement card with no changes
through the iSSNRC.....................
Adult U.S. Citizens requesting a 44,818 1 5 3,735 25.72 ** 0 *** 96,060
replacement card with a name change
through iSSNRC.........................
--------------------------------------------------------------------------------------------------------------------------------------------------------
oSSNAP Modality
--------------------------------------------------------------------------------------------------------------------------------------------------------
Adult U.S. Citizens providing 866,575 1 5 72,215 * 25.72 ** 24 *** 10,772,683
information to receive a replacement
card through the oSSNAP \+\............
Adult U.S. Citizens providing 31,521 1 5 2,627 25.72 * 24 *** 391,848
information to receive an original card
through the oSSNAP \+\.................
Adult Non-U.S. Citizens providing 114,429 1 5 9,536 25.72 ** 24 *** 1,422,505
information to receive an original card
through the oSSNAP \+\.................
Adult Non-U.S. Citizens providing 63,925 1 5 5,327 25.72 ** 24 794,673
information to receive a replacement
card through the oSSNAP \+\............
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SSNAP/SS-5 Modality
--------------------------------------------------------------------------------------------------------------------------------------------------------
Respondents who do not have to provide 2,791,499 1 9 418,725 * 25.72 ** 24 *** 39,488,545
parents' SSNs..........................
Respondents whom we ask to provide 102,258 1 9 15,339 * 25.72 ** 24 *** 1,446,542
parents' SSNs (when applying for
original SSN cards for children under
age 12)................................
Applicants age 12 or older who need to 335,587 1 10 55,931 * 25.72 ** 24 *** 4,891,069
answer additional questions so SSA can
determine whether we previously
assigned an SSN........................
Applicants asking for a replacement SSN 2,428 1 60 2428 * 25.72 ** 24 *** 87,427
card beyond the allowable limits (i.e.,
who must provide additional
documentation to accompany the
application)...........................
--------------------------------------------------------------------------------------------------------------------------------------------------------
Enumeration Quality Review
--------------------------------------------------------------------------------------------------------------------------------------------------------
Authorization to SSA to obtain personal 500 1 15 125 * 25.72 ** 24 *** 8,359
information cover letter...............
Authorization to SSA to obtain personal 500 1 15 125 * 25.72 ** 24 *** 8,359
information follow-up cover letter.....
--------------------------------------------------------------------------------------------------------------------------------------------------------
Grand Total
--------------------------------------------------------------------------------------------------------------------------------------------------------
Totals.............................. 11,081,385 .............. .............. 1,146,724 .............. .............. *** 73,235,275
--------------------------------------------------------------------------------------------------------------------------------------------------------
\+\ The number of respondents for this modality is an estimate based on google analytics data for the SS-5 form downloads from SSA.Gov.
* We based this figure on average Hospital Records Clerks (<a href="https://www.bls.gov/oes/current/oes292098.htm">https://www.bls.gov/oes/current/oes292098.htm</a>), and average U.S. worker's hourly wages
(<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>) as reported by the U.S. Bureau of Labor Statistics.
** 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.

2. Statement of Household Expenses and Contributions--20 CFR
416.1130-416.1148--0960-0456. SSA bases eligibility for Supplemental
Security Income (SSI) on the needs of the recipient. In part, we assess
need through determining the amount of income a recipient receives.
This income includes in-kind support and maintenance in the form of
food and shelter home owners provide. SSA uses Form SSA-8011-F3,
Statement of Household Expenses and Contributions, to determine whether
the claimant or recipient receives in-kind support and maintenance.
This is necessary to determine: (1) The claimant's or recipient's
eligibility for SSI, and (2) the SSI payment amount. SSA only uses this
form in cases where SSA needs the householder's (head of household)
corroboration of in-kind support and maintenance. The SSA-8011-F3
provides information, which could affect SSI eligibility and payment
amount. An SSA claims specialist collects the information on Form SSA-
8011-F3 through telephone contact with the respondents, or through
face-to-face interviews. The claims specialist records the information
in our electronic SSI Claims System. When we use this procedure, we do
not use a paper Form SSA-8011-F3, and we do not require a wet
signature, rather we request verbal attestation. However, for those few
instances when we use a paper form, we ensure the appropriate person,
i.e., the householder, signs the form, and then the claims specialist
documents the information in the SSI Claims System; faxes the form into
the appropriate electronic folder; and shreds the form. Respondents are
householders of homes in which an SSI applicant or recipient resides.
Type of Request: Revision of an OMB-approved information
collection.

[[Page 142]]

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Average wait
Average time in field Total annual
Number of Frequency of Average burden Estimated theoretical office or for opportunity
Modality of completion respondents response per response total annual hourly cost teleservice cost (dollars)
(minutes) burden (hours) amount centers ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-8011-F3 (Paper)..................... 21,000 1 15 5,250 * $27.07 ** 21 *** $341,082
Interview (MCS)......................... 398,759 1 15 99,690 * 27.07 ** 21 *** 6,476,660
---------------------------------------------------------------------------------------------------------------
Totals.............................. 419,759 .............. .............. 104,940 .............. .............. *** 6,817,742
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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 claimants 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. Integrated Registration Services (IRES) System--20 CFR 401.45--
0960-0626. The IRES System verifies the identity of individuals,
businesses, organizations, entities, and government agencies seeking to
use SSA's secured internet and telephone applications. Individuals need
this verification to electronically request and exchange business data
with SSA. Requestors provide SSA with the information needed to
establish their identities. Once SSA verifies identity, the IRES system
issues the requestor a user identification number and a password to
conduct business with SSA. Respondents are employers; employees; third
party submitters of wage data business entities providing taxpayer
identification information; appointed representatives; representative
payees; and data exchange partners conducting business in support of
SSA programs.
Type of Request: Revision of an OMB-approved information
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
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 cost
respondents response (minutes) burden (hours) amount centers (dollars) ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
IRES Internet Registrations......... 266,210 1 5 22,184 * $33.66 ** 0 *** $746,413
IRES Internet Requestors............ 14,472,710 1 2 482,424 * 33.66 ** 0 *** 16,238,392
IRES CS (CSA) Registrations......... 15,247 1 11 2,795 * 33.66 ** 19 *** 256,590
-------------------------------------------------------------------------------------------------------------------
Totals.......................... 14,754,167 .............. .............. 507,403 .............. .............. *** 17,241,695
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-00000">https://www.bls.gov/oes/current/oes_nat.htm#00-00000</a>); hourly wages for Information and Record Keeping Analysts hourly salary, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes434199.htm">https://www.bls.gov/oes/current/oes434199.htm</a>); and average hourly wages for paralegals/legal assistants and lawyers as posted by the U.S. Bureau of Labor
Statistics (<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 time for teleservice centers, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on claimants 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. Site Review Questionnaire for Volume and Fee-for-Service Payees
and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665,
416.701, and 416.708--0960-0633. SSA asks organizational representative
payees to complete Form SSA-637, the Site Review Questionnaire for
Volume and Fee-for-Service Payees, to provide information on how they
carry out their responsibilities, including how they manage beneficiary
funds. SSA then obtains information from the beneficiaries these
organizations represent via Form SSA-639, Beneficiary Interview Form,
to corroborate the payees' statements. Due to the sensitivity of the
information, the forms are always completed based on the answers
respondents give during the interviews. The respondents are
individuals; State and local governments; non-profit and for-profit
organizations serving as representative payees; and the beneficiaries
they serve.
Type of Request: Revision of an OMB-approved information
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
Average
Average burden Estimated theoretical Total annual
Modality of completion Number of Frequency of per response total annual hourly cost opportunity cost
respondents response (minutes) burden (hours) amount (dollars) **
(dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-639--Individuals............................... 22,000 1 10 3,667 * $19.01 ** $69,710
SSA-637--Individuals............................... 500 1 120 1,000 * 19.01 ** 19,010
SSA-637--Organizations............................. 4,500 1 120 9,000 * 19.03 ** 171,270
----------------------------------------------------------------------------------------------------
Totals......................................... 27,000 .............. .............. 13,667 .............. ** 259,990
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based the figure for individuals by 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 the figure for organizations by averaging both the average State and local governments (<a href="https://www.bls.gov/oes/current/oes211093.htm">https://www.bls.gov/oes/current/oes211093.htm</a>), and the average non-profit and for-profit organizations serving as representative payees (<a href="https://www.bls.gov/oes/current/oes390000.htm">https://www.bls.gov/oes/current/oes390000.htm</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.

[[Page 143]]

5. Request for Reinstatement (Title II)--20 CFR 404.1592b-
404.1592f--0960-0742. SSA allows certain previously entitled disability
beneficiaries to request expedited reinstatement (EXR) of benefits
under Title II of the Social Security Act when their medical condition
no longer permits them to perform substantial gainful activity. SSA
uses Form SSA-371 to obtain: (1) A signed statement from individuals
requesting an EXR of their Title II disability benefits; and (2) proof
the requestors meet the EXR requirements. SSA maintains the form in the
disability folder of the applicant to demonstrate the requestors'
awareness of the EXR requirements, and their choice to request EXR.
Respondents are applicants for EXR of Title II disability benefits.
Type of Request: Revision of an OMB-approved information
collection.

6. Important Information About Your Appeal, Waiver Rights, and
Repayment Options--20 CFR 404.502-404.521--0960-0779. When SSA
accidentally overpays beneficiaries, the agency informs them of the
following rights: (1) The right to reconsideration of the overpayment
determination; (2) the right to request a waiver of recovery and the
automatic scheduling of a personal conference if SSA cannot approve a
request for waiver; and (3) the availability of a different rate of
withholding when SSA proposes the full withholding rate. SSA uses Form
SSA-3105, Important Information About Your Appeal, Waiver Rights, and
Repayment Options, to explain these rights to overpaid individuals and
allow them to notify SSA of their decision(s) regarding these rights.
The respondents are individuals who are overpaid Social Security
payments.
Type of Request: Revision of an OMB approved information
collection.

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Average wait
Average time in field
Number of Frequency of Average burden Estimated theoretical office or for Total annual
Modality of completion respondents response per response total annual hourly cost teleservice opportunity cost
(minutes) burden (hours) amount centers (dollars) ***
(dollars) * (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3105 (Paper Form).............. 500,000 1 15 125,000 * $10.95 ** 21 *** $3,285,000
Debt Management System............. 166,666 1 15 41,667 * 10.95 ** 21 *** 1,095,000
--------------------------------------------------------------------------------------------------------------------
Totals......................... 666,666 .............. .............. 166,667 .............. .............. *** $4,380,000
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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>).
** 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.

7. Promoting Opportunity Demonstration--0960-0809. Section 823 of
the Bipartisan Budget Act of 2015 required SSA to carry out the
Promoting Opportunity Demonstration (POD) to test a new benefit offset
formula for SSDI beneficiaries. Therefore, SSA is undertaking POD, a
demonstration to evaluate the affect the new policy will have on Social
Security Disability Insurance (SSDI) beneficiaries and their families
in several critical areas. We previously obtained OMB approval for this
demonstration and are close to completing the project. In this
information collection request, we are seeking to renew the approval
for both the POD Monthly Earnings and Impairment-related work Expenses
(IRWE) Reporting Form, and the POD End of Year reporting (EOYR)
Documentation. The POD implementation team collects earnings and IRWE
data from POD treatment group subjects whose monthly earnings exceed
the POD threshold. The POD implementation team submits the data it
collects from treatment group subjects to SSA. SSA uses the data to
apply the POD offset to treatment group subjects' SSDI benefits.
Respondents have two options for reporting their earnings and IRWE
documentation contained in the POD Monthly Form and the POD EOYR Form:
Paper (mail or fax) or an online reporting portal. Respondents are
encouraged to submit their earnings and IRWE documentation monthly but
can submit it the following year in advance of SSA's end of year
reconciliation process. While the collection of the earnings and IRWE
data from respondents on the POD Monthly Form and the POD EOYR Forms is
voluntary, failure to submit data could result in the inaccurate
calculation of SSDI benefits.
Note: We have completed the survey portion of this demonstration
project and expect to finish collecting the data by the end of the
third quarter of fiscal year 2022.
Respondents are SSDI beneficiaries, who provided written consent
before agreeing to participate in the study and whom we randomly
assigned to one of the two study treatment groups.
Type of Request: Revision of an OMB-approved information
collection.

[[Page 144]]

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Average
Average burden Estimated theoretical Total annual
Modality of completion Number of Frequency of Number of per response total annual hourly cost opportunity cost
respondents response responses (minutes) burden (hours) amount (dollars) **
(dollars) *
--------------------------------------------------------------------------------------------------------------------------------------------------------
POD Monthly Earnings and Impairment- 1,000 6 6,000 40 4,000 * $27.07 ** $108,280
related work Expenses (IRWE)
Reporting Form--Paper Version
(faxed in)........................
POD Monthly Earnings and Impairment- 1,000 6 6,000 5 500 * 27.07 ** 13,535
related work Expenses (IRWE)
Reporting Form--Internet Version..
POD End of Year reporting (EOYR) 2,000 1 2,000 8 267 * 27.07 ** 7,228
Documentation.....................
--------------------------------------------------------------------------------------------------------------------
Totals......................... 4,000 .............. 14,000 .............. 4,767 .............. ** 129,043
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average U.S. worker's hourly wages (<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>), as reported by the U.S. Bureau
of Labor Statistics.
** 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: December 27, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-28387 Filed 12-30-21; 8:45 am]
BILLING CODE 4191-02-P

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