Representative Payee Parental Custody Monitoring

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0176 can be found here:

Documents and Forms

Document Name Document Type
Form G-99D (12-05) Representative Payee Parental Custody Monitoring Form and Instruction
G-99D (12-05) Parental Custody Report Form G-99D (12-05).pdf Form and Instruction
Form G-99a (04-07).pdf Representative Payee Report IC Document
G-99c (01-09).pdf Representative Payee Evaluation Report IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Representative Payee Parental Custody Monitoring	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 266.7

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	G-99D (12-05)	Parental Custody Report	Form G-99D (12-05).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: RRB-22, Railroad Retirement , Survivor, and Pensioner Benefit System	FR Citation: 75 FR 43727

Number of Respondents: 1,030	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	1,030	1,030
Annual IC Time Burden (Hours)	86	86
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Representative Payee Report	Form G-99a (04-07).pdf	01/10/2008
Representative Payee Evaluation Report	G-99c (01-09).pdf	05/16/2011

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