This form is approved for two years only. SSA planned to introduce a new system in Spring 2010, to enable information to be filled out online without requiring social security numbers. When the new system is completed, this form will be discontinued.
Inventory as of this Action
Requested
Previously Approved
08/31/2012
36 Months From Approved
08/31/2010
400,000
0
400,000
66,667
0
66,667
0
0
0
SSA uses Form SSA-1695 to collect information from appointed representatives that will be used to process and facilitate direct payment to a financial institution of authorized fees in each claim. This information will also be used to meet any requirement for issuance of a Form 1099-MISC. The respondents are attorneys and other individuals who represent claimants for benefits before SSA.
US Code:
42 USC 406
Name of Law: The Social Security Act
US Code:
42 USC 1382b
Name of Law: The Social Security Act
US Code:
26 USC 6041
Name of Law: The Internal Revenue Code
US Code:
26 USC 6045(f)
Name of Law: The Internal Revenue Code
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.
Form SSA-1695 Identifying Information for Possible Direct Payment of Authorized Fees
Supporting Statement - 0730.doc
Identifying Information for Possible Direct Payment of Authorized Fees