Information Collection

Institutional Representative Payee Survey

IC 182087 under ICR 200709-1510-001 · OMB 1510-0074.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1510-0074 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Rep Payee Survey 8-31-07.doc	Other-Telephone Survey
Rep Payee Supp Stmt ER wN.doc Institutional Representative Payee Survey	IC Document

IC Title:

Institutional Representative Payee Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Telephone Survey			Rep Payee Survey 8-31-07.doc		No		Paper Only

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	300	0	0	0	0	0
Annual IC Time Burden (Hours)	75	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Institutional Representative Payee Survey	Rep Payee Supp Stmt ER wN.doc	09/21/2007

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