TN 5 (04-95)

GN 03930.160 Form SSA-1560A (Authorization to Charge and Collect a Fee)

A. When To Use

We use this form to notify the representative of the fee amount authorized, under the fee petition process, for services provided in representing the claimant(s) in proceedings before SSA. We also send a copy to notify the claimant(s).

B. Exhibit - English

To view this form, go to SSA-1560A.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203930160
GN 03930.160 - Form SSA-1560A (Authorization to Charge and Collect a Fee) - 09/28/2017
Batch run: 10/02/2017
Rev:09/28/2017