Information Collection

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

IC 9068 under ICR 201612-0960-005 · OMB 0960-0104.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0104 can be found here:

2020-04-07 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1560-U4 (revis Petition To Obtain Approval of A Fee For Representing A Claimant Before The Social Security Administration	Form
SSA-1560-U4 (revis Petition to Obtain Approval of a Fee for Representing a 0960-0104 SSA-1560-U4 (updated changes).pdf	Form
SSA-1560-U4 (current).pdf SSA-1560-U4 Current Version	IC Document

Information Collection (IC) Details

View Information Collection (IC)

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 404.1725 20 CFR 404.1730(c)(2)(i) 20 CFR 404.1720 20 CFR 404.1730(c)(2)(ii) 20 CFR 416.1520 20 CFR 416.1525 20 CFR 416.1530(c)(2)(i) 20 CFR 416.1530(c)(2)(ii)

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 (revised)	Petition to Obtain Approval of a Fee for Representing a Claimant Before the Social Security Administration	0960-0104 SSA-1560-U4 (updated changes).pdf		Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 44,365

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	44,365	-3,745	48,110
Annual IC Time Burden (Hours)	22,183	-1,872	24,055
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-1560-U4 Current Version	SSA-1560-U4 (current).pdf	12/21/2016

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