0732 Supporting Statement (revised)

Supporting Statement for Form SSA-1699

Registration FOR APPOINTED REPRESENTATIVE SERVICES AND DIRECT PAYMENT

OMB No. 0960-0732

1. Justification

1. Introduction/Authorizing Laws and Regulations

If individuals want to become official representatives for Social Security claimants, the Social Security Administration (SSA) needs to collect certain information from them to register and appoint them as such. SSA uses form SSA-1699, Registration for Appointed Representative Services and Direct Payment, for this purpose. Sections 206(a) and 1631(d) of the Social Security Act give SSA the authority to collect the information requested by Form SSA-1699.

2. Description of Collection

SSA uses Form SSA-1699 to register appointed representatives of claimants before SSA who:

• Want to register for direct payment of fees;

• Registered for direct payment of fees prior to 10/31/09, but need to update their information;

• Registered as appointed representatives on or after 10/31/09, but need to update their information; or

• Received a notice from SSA instructing them to complete this form.

By registering these individuals, SSA: (1) Authenticates and authorizes them to do business with us; (2) allows them to access our records or the claimants they represent; (3) facilitates direct payment of authorized fees to appointed representatives; and (4) collects the information we need to meet Internal Revenue Service (IRS) requirements to issue specific IRS forms if we pay an appointed representative in excess of a specific amount ($600). The respondents are appointed representatives who want to use

Form SSA-1699 for any of the purposes cited in this Notice.

2. Use of Information Technology to Collect the Information

A PDF version of Form SSA-1699 is available on line for eligible attorneys or

non-attorneys to print, fill out, and fax back to SSA. Once we receive the form, we process the information and mail a notice along with a USER and REP ID to the representative. SSA requires representatives who have to update their registration information (i.e., representative’s name, address, SN, business affiliation, tax address, etc.) to submit a new Form SSA-1699.

SSA did not create an electronic version of Form SSA-1699 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 17,600 respondents complete the form. This is less than the GPEA cut-off of 50,000.

2. Why We Cannot Use Duplicate Information

The nature of the information we are collecting and the manner in which we are collecting it preclude duplication. SSA does not use another collection instrument to obtain similar data.

5. Minimizing Burden on Small Respondents

This collection does not significantly affect small businesses or other small entities.

5. Consequences of Not Collecting Information or Collecting it Less Frequently

If we did not use Form SSA-1699, SSA would have no means of authenticating representatives, allowing them direct access to beneficiary records, facilitating direct payment of authorized fees to representatives, or issuing the necessary IRS forms. Because we only collect the information on an as-needed basis, we cannot conduct the information collection less frequently.

There are no technical or legal obstacles to burden reduction.

5. Special Circumstances

There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.

5. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on March 20, 2013, at

78 FR 17276 and we received no public comments. The 30-day FRN published on

May 23, 2013 at 78 FR 30952. If we receive any comments in response to this Notice, we will forward them to OMB. We did not consult with the public in the revision of this form.

5. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents (except for payment of authorized fees).

5. Assurances of Confidentiality

SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.

5. Justification for Sensitive Questions

The information collection does not contain any question of a sensitive nature.

5. Estimates of Public Reporting Burden

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Total Annual Burden (hours)
SSA-1699	52,800	1	20	17,600

This figure represents burden hours, and we did not calculate a separate cost burden.

5. Annual Cost to the Respondents

This collection does not impose a known cost burden on the respondents.

5. Annual Cost to Federal Government

The annual cost to the Federal Government is approximately $350,000. This estimate is a projection of the costs for printing and processing the information collection.

5. Program Changes or Adjustments to the Information Collection Request

There are no changes to the public reporting burden.

5. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

5. Displaying the OMB Approval Expiration Date

OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.

18. Exceptions to Certification Statement

SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).

B. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.

3