Information Collection

Representative Payee Application/Information Necessary for a Competency Determination

IC 33606 under ICR 201712-3206-014 · OMB 3206-0140.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0140 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 20-7 Representative Payee Application/Information Necessary for a Competency Determination	Form and Instruction
RI 20-7 Representative Payee Application RI20-007_2018_02.pdf	Form and Instruction
RI 20-7 Representative Payee Application RI20-007_2018_02_MarkUp.pdf	Form and Instruction
RI 30-3 Information Necessary for a Competency Determination RI30-003_2018_02.pdf	Form
RI 30-3 Information Necessary for a Competency Determination RI30-003_2018_02_MarkUp.pdf	Form
RI 20-7 Representative Payee Application RI20-007_2016_08_MarkUp.pdf	Form and Instruction
RI 30-3 Information Necessary for a Competency Determination RI30-003_2015_01_MarkUp.pdf	Form and Instruction

IC Title:

Representative Payee Application/Information Necessary for a Competency Determination

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 20-7	Representative Payee Application	RI20-007_2016_08_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 30-3	Information Necessary for a Competency Determination	RI30-003_2015_01_MarkUp.pdf	Yes	No	Printable Only
Form and Instruction	RI 20-7	Representative Payee Application	RI20-007_2018_02.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-7	Representative Payee Application	RI20-007_2018_02_MarkUp.pdf	Yes	No	Fillable Printable
Form	RI 30-3	Information Necessary for a Competency Determination	RI30-003_2018_02.pdf	Yes	No	Printable Only
Form	RI 30-3	Information Necessary for a Competency Determination	RI30-003_2018_02_MarkUp.pdf	Yes	No	Printable Only

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: 12,480

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	Previously Approved
Annual Number of Responses for this IC	12,480	12,480
Annual IC Time Burden (Hours)	6,490	6,490
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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