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Federal forms, ICRs, and supporting documents

Information Collection

Representative Payee Report of Benefits and Dedicated Account, 20 CFR 416.546 & 640, and 20 CFR 416.635 & 665

IC 9534 under ICR 201208-0960-010 · OMB 0960-0576.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Representative Payee Report of Benefits and Dedicated Account, 20 CFR 416.546 & 640, and 20 CFR 416.635 & 665
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.665 20 CFR 416.546 20 CFR 416.635 20 CFR 416.640

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-6233 Representative Payee Report of Benefits and Dedicated Account SSA-6233 (revised).pdf No   Paper Only

Income Security General Retirement and Disability

 

30,000 0
   
Individuals or Households
 
   0 %

  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 30,000 0 0 0 0 30,000
Annual IC Time Burden (Hours) 10,000 0 0 0 0 10,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-6233 (current) SSA-6233 (current).pdf 09/18/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.