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.