Information Collection

Non-Attorney Representative Demonstration Project --Application

IC 9753 under ICR 201011-0960-010 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Online Application Final.pdf www.cps.ca.gov/tlc/ssa/howtoapply.asp Other-Online Collection Screens

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Non-Attorney Representative Demonstration Project --Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

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

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Online Collection Screens			Online Application Final.pdf	http://www.cps.ca.gov/tlc/ssa/howtoapply.asp	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-180	180
Annual IC Time Burden (Hours)	-180	180
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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