Information Collection

Individuals/Households: Representative Payee System (RPS)

IC 44953 under ICR 201812-0960-004 · OMB 0960-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0014 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
eRPS screen for SSA-11 (Revised).pdf	Other-Internal Use Screens
eRPS Screenshots (current).pdf eRPS screens (current)	IC Document

IC Title:

Individuals/Households: Representative Payee System (RPS)

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 404.2010-404.2055 20 CFR 416.601-416.665

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Use Screens					Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,710,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,710,000	271,800	1,438,200
Annual IC Time Burden (Hours)	342,000	78,330	263,670
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
eRPS screens (current)		02/07/2019

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

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