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Form AA-5 Application for Substitution of Payee
Application to Act as Representative Payee
Form AA-5 (05-17)
Application for Substitution of Payee and Duties As Representative Payee (Individuals)
OMB: 3220-0052
OMB.report
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OMB 3220-0052
ICR 201912-3220-003
IC 33865
Form AA-5 Application for Substitution of Payee
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3220-0052 can be found here:
2023-03-28 - Revision of a currently approved collection
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File Type
application/pdf
File Title
KM_284e-20191230112757
File Modified
2019-12-30
File Created
2019-12-30
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