Information Collection

Waiver of Advance Designation (Internet Version - mySSA)

IC 256842 under ICR 202406-0960-001 · OMB 0960-0814.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
mySSA Advance Designation of Representative Payee Screen Package - Revised.pdf	Other-mySSA Advance Designation of R
mySSA Advance Designation of Representative Payee Screen Package - Revised.pdf	Other-mySSA Advance Designation of R
mySSA Advance Designation of Representative Payee Screen Package - Current.pdf mySSA Advance Designation of Representative Payee Screen Package - Current	IC Document
mySSA Advance Designation of Representative Payee Screen Package - Current.pdf mySSA Advance Designation of Representative Payee Screen Package - Current	IC Document

IC Title:

Waiver of Advance Designation (Internet Version - mySSA)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

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-mySSA Advance Designation of Representative Payee Screens			mySSA Advance Designation of Representative Payee Screen Package - Revised.pdf		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: 262,996

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	262,996	262,996
Annual IC Time Burden (Hours)	8,767	8,767
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
mySSA Advance Designation of Representative Payee Screen Package - Current	mySSA Advance Designation of Representative Payee Screen Package - Current.pdf	10/27/2022

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