Information Collection

Representative Payee Report-Special Veterans Benefits

IC 43708 under ICR 201803-0960-009 · OMB 0960-0621.

Documents and Forms

Document Name Document Type
Form SSA-2001-F6 Representative Payee Report-Special Veterans Benefits Form
0621 Revised Privacy Act Statement.docx Other-Privacy Act Statement (revised
SSA-2001-F6 Representative Payee Report - Special Veterans Benefits SSA-2001-F6 (revised).pdf Form
SSA-2001-F6 (current).pdf Current SSA-2001-F6 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Representative Payee Report-Special Veterans Benefits	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 408.665

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-2001-F6	Representative Payee Report - Special Veterans Benefits	SSA-2001-F6 (revised).pdf		No		Paper Only
Other-Privacy Act Statement (revised)			0621 Revised Privacy Act Statement.docx		No		Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16	-34	50
Annual IC Time Burden (Hours)	5	-3	8
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-2001-F6	SSA-2001-F6 (current).pdf	04/25/2018

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