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Application to Act as Representative Payee
Application to Act as Representative Payee
OMB: 3220-0052
IC ID: 33863
OMB.report
RRB
OMB 3220-0052
ICR 199711-3220-001
IC 33863
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0052 can be found here:
2023-03-28 - Revision of a currently approved collection
2019-12-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application to Act as Representative Payee
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
G-478
No
No
Form
AA-5
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20,300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
20,300
0
0
0
0
20,300
Annual IC Time Burden (Hours)
16,350
0
0
0
0
16,350
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.