Representative Payee Survey

RI 38-115, Representative Payee Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0208 can be found here:

Documents and Forms

Document Name Document Type
Form RI 38-115 Representative Payee Survey Form and Instruction
RI 38-115 Representative Payee Survey RI 38-115 August 2010.pdf Form and Instruction
RI 38-115 August 2010 Markup.pdf RI 38-115 August 2010 Markup IC Document
RI38-115_May2008_MarkUp.pdf RI38115_May2008_MarkUp IC Document

Information Collection (IC) Details

IC Title:	Representative Payee Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 38-115	Representative Payee Survey	RI 38-115 August 2010.pdf		No		Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 73 FR 15013

Number of Respondents: 11,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	11,000	11,000
Annual IC Time Burden (Hours)	3,667	3,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RI 38-115 August 2010 Markup	RI 38-115 August 2010 Markup.pdf	05/03/2010
RI38115_May2008_MarkUp	RI38-115_May2008_MarkUp.pdf	05/03/2010

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