Registration of Individuals and Staff for Appointed Representative Services

ICR 201601-0960-003

OMB: 0960-0732

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2016-05-17
Supplementary Document
2016-05-17
IC Document Collections
IC ID
Document
Title
Status
43720 Modified
ICR Details
0960-0732 201601-0960-003
Historical Active 201308-0960-002
SSA
Registration of Individuals and Staff for Appointed Representative Services
Revision of a currently approved collection   No
Regular
Approved without change 08/17/2016
Retrieve Notice of Action (NOA) 05/17/2016
  Inventory as of this Action Requested Previously Approved
08/31/2019 36 Months From Approved 08/31/2016
16,000 0 52,800
5,333 0 17,600
0 0 0

SSA uses Form SSA-1699 to register appointed representatives of claimants before SSA who: • Want to register for direct payment of fees; • Registered for direct payment of fees prior to 10/31/09, but need to update their information; • Registered as appointed representatives on or after 10/31/09, but need to update their information; or • Received a notice from SSA instructing them to complete this form. By registering these individuals, SSA: (1) authenticates and authorizes them to do business with us; (2) allows them to access our records for the claimants they represent; (3) facilitates direct payment of authorized fees to appointed representatives; and, (4) collects the information we need to meet Internal Revenue Service (IRS) requirements to issue specific IRS forms if we pay an appointed representative in excess of a specific amount ($600). The respondents are appointed representatives who want to use Form SSA-1699 for any of the purposes cited above.

US Code: 42 USC 406 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  81 FR 6568 02/08/2016
81 FR 22698 04/18/2016
No

1
IC Title Form No. Form Name
Form SSA-1699 SSA-1699 Registration for Appointed Representative Services and Direct Payment

  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 16,000 52,800 0 0 -36,800 0
Annual Time Burden (Hours) 5,333 17,600 0 0 -12,267 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The significant decrease in burden hours stems from a decrease in the estimated number of respondents. Because of an improved MI data source, we were able to update our estimation methodology resulting in the change in burden. We will continue to monitor the management information data, and will make future changes to the burden data as needed.

$163,000
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/17/2016


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