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Federal forms, ICRs, and supporting documents

Information Collection

Application for Substitution of Payee and Duties as Representative Payee (Institutions)

IC 179617 under ICR 201608-3220-001 · OMB 3220-0052.

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

View Information Collection (IC)

Application for Substitution of Payee and Duties as Representative Payee (Institutions)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 267 20 CFR 266 20 CFR 269

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction RB-5 Your Duties as Representative Payee-Representative's Payee's Record Form RB-5 (12-13).pdf No   Paper Only
Form AA-5 (proposed) Application for Substitution of Payee Form AA-5 (Proposed).pdf No   Paper Only
Form and Instruction RB-5 (Proposed) RB-5 Booklet: Your Duties as Representative Payee-Representative Payee's Record Form RB-5 (Proposed).pdf No   Paper Only
Form and Instruction AA-5 Application for Substitution of Payee Form AA-5 (09-15).pdf No   Paper Only

Income Security General Retirement and Disability

RRB-22, Railroad Retirement, Survivor, and Pensioner Benefit System   79 FR 58874

3,825 0
   
Private Sector Businesses or other for-profits
 
   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 4,575 0 0 0 0 4,575
Annual IC Time Burden (Hours) 4,038 0 0 0 0 4,038
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-11-BK (1-2014) Form SSA-11-BK (01-14).pdf 08/22/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.