Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Appointment of Representative - SSA-1696 Modified 800000 160000 0 Form and Instruction SSA-1696 Appointment of Representative
Other-e1696 Submittable PDF Screens
Claimant's Revocation of the Appointment of a Representative - SSA-1696-SUP1 Unchanged 21000 1750 0 Form and Instruction SSA-1696-SUP1 Claimant's Revocation of the Appointment of a Representative
Representative's Withdrawal of Acceptance of an Appointment - SSA-1696-SUP2 Unchanged 233000 19417 0 Form and Instruction SSA-1696-SUP2 Representative's Withdrawal of Acceptance of an Appointment
Total burden requested under this ICR: 1054000 181167 0  
To view an IC, click on IC Title