Representative Payee Report

Representative Payee Report (Adult and Child)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0068 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-6230 Representative Payee Report Form and Instruction
SSA-623 Representative Payee Report (Adult) ssa-623-revised.pdf Form and Instruction
SSA-6230 Representative Payee Report (Child) ssa-6230-revised.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Representative Payee Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 404.2065 20 CFR 416.665 20 CFR 404.2035 20 CFR 404.635

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-6230	Representative Payee Report (Child)	ssa-6230-revised.pdf		No		Paper Only
Form and Instruction	SSA-623	Representative Payee Report (Adult)	ssa-623-revised.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,500,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,500,000	250,000	5,250,000
Annual IC Time Burden (Hours)	1,375,000	62,500	1,312,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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