Information Collection

Fee Agreement for Representation before the Social Security Administration

IC 232717 under ICR 202111-0960-003 · OMB 0960-0810.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0810 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1693 Fee Agreement for Representation before the Social Security Administration	Form and Instruction
SSA-1693 Fee Agreement for Representation before the Social Secur SSA-1693 - Revised Version.pdf	Form and Instruction
e1693 Fee Agreement for Representation before the Social Secur e1693 - Current Version.pdf	Form and Instruction
SSA-1693 - Current Version.pdf Current SSA-1693	IC Document

IC Title:

Fee Agreement for Representation 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:

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 and Instruction	SSA-1693	Fee Agreement for Representation before the Social Security Administration	SSA-1693 - Revised Version.pdf	www.ssa.gov	Yes	No	Fillable Printable
Form and Instruction	e1693	Fee Agreement for Representation before the Social Security Administration	e1693 - Current Version.pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,000	-595,000	600,000
Annual IC Time Burden (Hours)	1,083	-118,917	120,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-1693	SSA-1693 - Current Version.pdf	12/14/2021

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