OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Appointment of Representative - SSA-1696

IC 9438 under ICR 202109-0960-006 · OMB 0960-0527.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-e1696 Submittable PDF Screens
Other-e1696 Submittable PDF Screens
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Appointment of Representative - SSA-1696
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 414.1725 20 CFR 416.1507 20 CFR 410.684 20 CFR 404.1720 20 CFR 404.1707

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-1696 Appointment of Representative SSA-1696.pdf www.ssa.gov Yes No Fillable Printable
Other-e1696 Submittable PDF Screens e1696 - Revised Screen Package.pdf www.ssa.gov Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

800,000 0
   
Individuals or Households
 
   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 800,000 0 0 0 0 800,000
Annual IC Time Burden (Hours) 160,000 0 0 0 0 160,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current e1696 Screens e1696 - Current Screen Package.pdf 09/27/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.