Representative Payee Report (for Organizational Representative Payees)

Documents and Forms

Document Name Document Type
Form SSA-6234 Representative Payee Report (for Organizational Representative Payees) Form and Instruction
SSA-6234 Representative Payee Report (Organizations) Revised SSA-6234.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Representative Payee Report (for Organizational Representative Payees)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-6234	Representative Payee Report (Organizations)	Revised SSA-6234.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: 750,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	750,000	750,000
Annual IC Time Burden (Hours)	187,500	187,500
Annual IC Cost Burden (Dollars)	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.