Information Collection

Non-Attorney Representative Demonstration Project --Application

IC 9753 under ICR 200612-0960-009 · OMB 0960-0699.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0699 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2007 Online Application 01-09-07.pdf www.cps.ca.gov/tlc/ssa/howtoapply.asp	Other-Online Collection Screens
Non-Attorney Repersentative Demonstration Project -- Pap SSA Candidate Application paper (2007 Version)12 13 06 F.doc	Form and Instruction
SSA Candidate Application paper (2008 Version) - 3 30 2007.doc revised application	IC Document

IC Title:

Non-Attorney Representative Demonstration Project --Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.1745-404.1799 20 CFR 416.1545-416.1599

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Online Collection Screens			2007 Online Application 01-09-07.pdf	http://www.cps.ca.gov/tlc/ssa/howtoapply.asp	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Non-Attorney Repersentative Demonstration Project -- Paper Application	SSA Candidate Application paper (2007 Version)12 13 06 F.doc		No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 70 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
revised application	SSA Candidate Application paper (2008 Version) - 3 30 2007.doc	03/30/2007

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