Information Collection

Petition to Obtain Approval of a Fee for Representing a Claimant Before the Social Security Administration

IC 9065 under ICR 200211-0960-006 · OMB 0960-0104.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0104 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Petition to Obtain Approval of a Fee for Representing a Claimant Before the Social Security Administration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-1560-U4				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 34,624	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	34,624	34,624
Annual IC Time Burden (Hours)	17,312	17,312
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.