Registration for Appointed Representative Services and Direct Payment

ICR 202108-0960-007

OMB: 0960-0732

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2021-11-18
Supplementary Document
2021-11-18
IC Document Collections
IC ID
Document
Title
Status
43720 Modified
ICR Details
0960-0732 202108-0960-007
Received in OIRA 201903-0960-007
SSA
Registration for Appointed Representative Services and Direct Payment
Revision of a currently approved collection   No
Regular 11/18/2021
  Requested Previously Approved
36 Months From Approved 10/31/2022
10,382 17,700
3,461 5,900
0 0

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 for 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 above.

US Code: 42 USC 406 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  86 FR 46897 08/20/2021
86 FR 64585 11/18/2021
No

1
IC Title Form No. Form Name
Form SSA-1699 SSA-1699 Registration for Appointed Representative Services and Direct Payment

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,382 17,700 0 0 -7,318 0
Annual Time Burden (Hours) 3,461 5,900 0 0 -2,439 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
When we last cleared this IC in 2019, the burden was 5,900 hours. However, we are currently reporting a burden of 3,460 hours. This change stems from a decrease in the number of average responses from 17,700 to 10,382. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change.

$192,000
No
    Yes
    Yes
No
No
No
No
Faye Lipsky 410 965-8783 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/18/2021


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