Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Appointment of Representative - SSA-1696 and SSA-1696-App Modified 1100000 220000 0 Form and Instruction SSA-1696 Appointment of Representative
Other-SSA-1696-APP - Submittable PDF Screens
Claimant's Revocation of the Appointment of a Representative - SSA-1696-SUP1 Modified 5505 459 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 Modified 254825 21235 0 Form and Instruction SSA-1696-SUP2 Representative's Withdrawal of Acceptance of an Appointment
Total burden requested under this ICR: 1360330 241694 0  
To view an IC, click on IC Title