Fee Agreement for Representation before the Social Security Administration

ICR 202106-0960-004

OMB: 0960-0810

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2021-06-25
Supporting Statement A
2018-12-06
IC Document Collections
ICR Details
0960-0810 202106-0960-004
Active 201808-0960-004
SSA
Fee Agreement for Representation before the Social Security Administration
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/25/2021
Retrieve Notice of Action (NOA) 06/25/2021
Within four months of the approval of this ICR, the agency will set up a listening session between SSA, OMB, and at least one stakeholder organization representing appointed representative to receive their feedback on the e1693 and e1696, to include challenges in using the system and suggested process, IT, verbiage, or policy improvements designed to increase the use or reduce the burden of using of the electronic forms.
  Inventory as of this Action Requested Previously Approved
12/31/2021 12/31/2021 12/31/2021
600,000 0 600,000
120,000 0 120,000
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. This is a Non-Substantive IT Mod Change Request to include a submittable PDF under this ICR.

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 600,000 600,000 0 0 0 0
Annual Time Burden (Hours) 120,000 120,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$36,550
No
    Yes
    Yes
No
No
No
Yes
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.
06/25/2021


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