SSA-4547 Intranet version (SSI Claims System; MCS; iMAIN)

Advance Designation of Representative Payee

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0814 can be found here:

Documents and Forms

Document Name Document Type
Intranet Advance Designation of Representative Payee Screen Package (revised).pdf Other-SSA-4547 Intranet screens
Intranet Advance Designation of Representative Payee Screen Package (revised).pdf Other-SSA-4547 Intranet screens
Intranet Advance Designation of Representative Payee Screen Package (current).pdf SSA-4547 Intranet screens IC Document
Intranet Advance Designation of Representative Payee Screen Package (current).pdf SSA-4547 Intranet screens IC Document

Information Collection (IC) Details

IC Title:	SSA-4547 Intranet version (SSI Claims System; MCS; iMAIN)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-SSA-4547 Intranet screens			Intranet Advance Designation of Representative Payee Screen Package (revised).pdf		Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,451,966	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	8,451,966	8,451,966
Annual IC Time Burden (Hours)	845,197	845,197
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-4547 Intranet screens	Intranet Advance Designation of Representative Payee Screen Package (current).pdf	08/24/2021

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