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Form SSA-445 Application to Collect a Fee for Payee Services (State/l
Application to Collect A Fee for Payee Services
MOCK UP SSA-445 (revised)
Application to Collect A Fee for Payee Services
OMB: 0960-0719
OMB.report
SSA
OMB 0960-0719
ICR 201109-0960-014
IC 9776
Form SSA-445 Application to Collect a Fee for Payee Services (State/l
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0719 can be found here:
2021-01-28 - Revision of a currently approved collection
2017-11-14 - Revision of a currently approved collection
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File Modified
2011-10-04
File Created
2011-09-26
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