SECTION 205(A) AND (J) OF THE SOCIAL
SECURITY ACT PROVIDE FOR PAYMENT OF SOCIAL SECURITY BENEFITS TO A
RELATIVE OR SOME OTHER PERSON WHEN IN THE BEST INTEREST OF THE
BENEFICIARY. THIS FORM IS USED TO ACCOUNT FOR THE USE OF SOCIAL
SECURITY PAYMENTS CERTAIN INSTITUTIONAL REPRESENTATIVE PAYEES
RECEIVE ON BEHALF OF THAT BENEFICIARY.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.