Representative Payee Evaluation Report--State/Local Government

Representative Payee Evaluation Report

OMB: 0960-0069

IC ID: 181091

Information Collection (IC) Details

View Information Collection (IC)

Representative Payee Evaluation Report--State/Local Government
 
No Modified
 
Mandatory
 
20 CFR 404.2062 20 CFR 416.665

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-624-F5 Representative Payee Evaluation Report SSA-624-F5 - Revised Version.pdf Yes No Fillable Printable
Other-Revised PA and PRA Statements SSA-624 - Revised PA and PRA Statements.pdf No   Printable Only

Income Security General Retirement and Disability

 

40 0
   
State, Local, and Tribal Governments
 
   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 40 -7,970 0 0 0 8,010
Annual IC Time Burden (Hours) 20 -3,985 0 0 0 4,005
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-624-F5 SSA-624-F5 - Current Version.pdf 08/01/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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