PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
404.1705(c); 416.1505(c) - Your representative(s) must be registered with us in the manner we prescribe before you submit the appointment(s) - SSA-1699 (0960-0732)
New
15382
5127
0
Form and Instruction
SSA-1699
Registration for Appointed Representative Services and Direct Payment
404.1707(a); 416.1507(a) - You [claimant] complete and sign our prescribed appointment form - SSA-1696 (0960-0527)
New
1100000
128333
0
Form and Instruction
SSA-1696
Claimant's Appointment of a Representative
Other-Notice
404.1707(a); 416.1507(a) - Your representative completes and signs our prescribed appointment form - SSA-1696 (0960-0527)
New
1100000
91667
0
Form and Instruction
SSA-1696
Claimant's Appointment of a Representative
Other-Notice
404.1720(f) 416.1520 (f) - A representative who is eligible for direct payment of an authorized fee may assign direct payment of the authorized fee to an entity that is eligible - SSA-1696 (0960-0527)
New
500000
41667
0
Form and Instruction
SSA-1696
Claimant's Appointment of a Representative
Other-Notice
404.1730(e)(2); 416.1530(e)(2) - A representative may rescind an assignment before the date on which we notify you of our first favorable determination or decision - SSA-1696 (0960-0527)
New
150000
7500
0
Form and Instruction
SSA-1696
Claimant's Appointment of a Representative
Other-Notice
404.1735; 416.1535 - An entity is eligible for direct payment under certain circumstances - SSA-1694 (0960-0731)
New
7000
2100
0
Form and Instruction
SSA-1694
Entity Registration and Taxpayer Information
Total burden requested under this ICR:
2872382
276394
0
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