Information Collection

Petition To Obtain Approval of A Fee For Representing A Claimant Before The Social Security Administration

IC 9068 under ICR 201012-0960-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1560-U4 Petition To Obtain Approval of A Fee For Representing A Claimant Before The Social Security Administration	Form
SSA-1560-U4 Petition to Obtain Approval of a Fee for Representing a ssa-1560-U4(revised).pdf	Form
ssa-1560-U4.pdf SSA-1560-U4	IC Document

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: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.1520 20 CFR 416.1525 20 CFR 404.1720 20 CFR 404.1725

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
Form	SSA-1560-U4	Petition to Obtain Approval of a Fee for Representing a Claimant Before the Social Security Administration	ssa-1560-U4(revised).pdf		Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 48,110

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	48,110	13,486	34,624
Annual IC Time Burden (Hours)	24,055	6,743	17,312
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-1560-U4	ssa-1560-U4.pdf	01/21/2011

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