Information Collection Request

Representative Payee Monitoring

ICR 202011-3220-005 · OMB 3220-0151 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form G-99A (12-16) Representative Payee Monitoring Form Modified Repair queued
SSA-624-F5 - (09-2013).pdf Supplementary Document Uploaded 2020-11-19 Repair queued
3220-0151.docx Supporting Statement A Uploaded 2020-11-24 Repair queued
SSA-788 (01-15).pdf Supplementary Document Uploaded 2017-06-16 Repair queued
Form RB-5 (05-17).pdf Supplementary Document Uploaded 2017-06-16 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
33950 Representative Payee Monitoring Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 01/31/2021
6,320 6,320
1,885 1,885
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Representative Payee Monitoring G-99A (12-16), G-99C (12-16), G-106 (Proposed), G-99A (Proposed), G-99C (Proposed) Representative Payee Report ,   Representative Payee Evaluation Report ,   Statement of Care and Responsibility to Annuitant ,   REpresentative Payee Report ,   Represenative Payee Evaluation Report

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,320 6,320 0 0 0 0
Annual Time Burden (Hours) 1,885 1,885 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No