OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Identifying Information for Possible Direct Payment of Authorized Fees

ICR 201712-0960-004 · OMB 0960-0730 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form SSA-1695 Identifying Information for Possible Direct Payment of Authorized Fees Form Modified Repair queued
Addendum 0730.doc Supplementary Document Uploaded 2018-04-09 Repair queued
Supporting Statement - 0730.docx Supporting Statement A Uploaded 2018-05-10 Available
IC Document Collections
IC IDCollectionTypeStatusForm
43718 Identifying Information for Possible Direct Payment of Authorized Fees Form Modified
ICR Details
0960-0730 201712-0960-004
Historical Active 201501-0960-003
SSA
Identifying Information for Possible Direct Payment of Authorized Fees
Revision of a currently approved collection   No
Regular
Approved without change 08/03/2018
Retrieve Notice of Action (NOA) 05/10/2018
In accordance with 5 CFR 1320, the information collection is approved for three years.
  Inventory as of this Action Requested Previously Approved
08/31/2021 36 Months From Approved 08/31/2018
400,000 0 400,000
66,667 0 66,667
0 0 0
SSA collects information on Form SSA-1695 to: 1) facilitate direct payment of fees to attorneys and other persons who represent SSA claimants; 2) issue a Form 1099-MISC to representatives whom SSA has paid; and 3) establish a link between claims and other data stored on our appointed representative data base. 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
  
None
Not associated with rulemaking
  83 FR 1651 01/12/2018
83 FR 14306 04/03/2018
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 400,000 400,000 0 0 0 0
Annual Time Burden (Hours) 66,667 66,667 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$100,000
No
    Yes
    Yes
No
No
No
Uncollected
Faye Lipsky 410 965-8783 [email protected]
  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.
05/10/2018