Representative's Withdrawal of Acceptance of an Appointment - SSA-1696-SUP2

Appointment of Representative

OMB: 0960-0527

IC ID: 235152

Information Collection (IC) Details

View Information Collection (IC)

Representative's Withdrawal of Acceptance of an Appointment - SSA-1696-SUP2
 
No Modified
 
Voluntary
 
20 CFR 416.1507 20 CFR 404.1720 20 CFR 416.1520 20 CFR 404.1707 20 CFR 408.1101

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-1696-SUP2 Representative's Withdrawal of Acceptance of an Appointment SSA-1696-SUP2 - Current Version.pdf www.ssa.gov Yes No Fillable Printable

Income Security General Retirement and Disability

 

254,825 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 254,825 0 0 21,825 0 233,000
Annual IC Time Burden (Hours) 21,235 0 0 1,818 0 19,417
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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