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Federal forms, ICRs, and supporting documents

Information Collection

Form SSA-1699

IC 43720 under ICR 202108-0960-007 · OMB 0960-0732.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Form SSA-1699
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-1699 Registration for Appointed Representative Services and Direct Payment SSA-1699 (revised).pdf No   Fillable Printable

Income Security General Retirement and Disability

 

10,382 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10,382 0 0 -7,318 0 17,700
Annual IC Time Burden (Hours) 3,461 0 0 -2,439 0 5,900
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-1699 - Current SSA-1699 (current).pdf 11/18/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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