Fee Agreement for Representation before the Social Security Administration

ICR 201808-0960-004

OMB: 0960-0810

Federal Form Document

ICR Details
0960-0810 201808-0960-004
Active
SSA
Fee Agreement for Representation before the Social Security Administration
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 12/07/2018
Retrieve Notice of Action (NOA) 08/17/2018
In accordance with 5 CFR 1320, the information collection is approved for three years.
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved
600,000 0 0
120,000 0 0
0 0 0

Under the Social Security Act, SSA requires individuals who represent a claimant before the agency and want to receive a fee for their services to obtain SSA’s authorization of the fee. One way to obtain the authorization is to submit the fee agreement. To facilitate this process, individuals can use Form SSA-1693. SSA uses the information from the SSA-1693 to review the request and authorize any fee to representatives who seek to charge and collect a fee from a claimant. The respondents are the representatives who help claimants through the application process.

None
None

Not associated with rulemaking

  83 FR 26732 06/08/2018
83 FR 38441 08/06/2018
No

  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 600,000 0 0 600,000 0 0
Annual Time Burden (Hours) 120,000 0 0 120,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This new form increases the public reporting burden. See chart above for burden figures. We will update our estimate in #12 as necessary once we implement this new form and obtain management information data.

$36,550
No
    Yes
    Yes
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.
08/17/2018


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