Request for Business Entity Taxpayer Information

Forms and Documents

Document Name	Status
Form SSA-1694 Request for Business Entity Taxpayer Information Form	Modified
Supporting Statement 0731.docx Supporting Statement A	2012-07-16
Addendum to the Supporting Statement 0960-0731.doc Supplementary Document	2012-05-18

IC Document Collections

IC ID	Document Title	Status
43719	Request for Business Entity Taxpayer Information Form	Modified
189463	Request for Business Entity Taxpayer Information Other-Electronic Screens	Modified

ICR Details

OMB Control No: 0960-0731	ICR Reference No: 201204-0960-007
Status: Historical Active	Previous ICR Reference No: 200902-0960-013
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Business Entity Taxpayer Information
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/31/2012
	Date Received in OIRA: 07/19/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	10/31/2012
Responses	2,000	0	2,000
Time Burden (Hours)	334	0	334
Cost Burden (Dollars)	0	0	0

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Abstract: The SSA uses Form SSA-1694 to collect information from law firms or other business entities that have partners or employees to whom SSA pays fees that SSA has authorized as compensation for the representation of claimants before SSA. SSA uses the information to meet Form 1099-MISC requirements for issuance. The respondents are law firms or other business entities with partners or employees who are attorneys or other qualified individuals who represent claimants before SSA.

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Authorizing Statute(s): US Code: 42 USC 406 Name of Law: Representation of claimants before Commissioner
   US Code: 42 USC 1383 Name of Law: Procedure for payment of benefits
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 27264	05/09/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 41874	07/16/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Request for Business Entity Taxpayer Information	SSA-1694	Request for Business Entity Taxpayer Information
Request for Business Entity Taxpayer Information

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,000	2,000	0	0	0	0
Annual Time Burden (Hours)	334	334	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $220,745

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/19/2012

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