Information Collection Request
Representative Payee Report of Benefits and Dedicated Account
ICR 202406-0960-002 · OMB 0960-0576 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0960-0576 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form SSA-6233-BK Representative Payee Report of Benefits and Dedicated Account, 20 CFR 416.546 & 640, and 20 CFR 416.635 & 665 |
Form and Instruction | Modified | Missing upstream |
 Justification for Non-Substantive Changes - 0960-0576.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-06-07 | Repair queued |
| Addendum - 0576 (Final).docx |
Supplementary Document | Uploaded 2021-11-19 | Repair queued |
| Supporting Statement - 0576 (Final).docx |
Supporting Statement A | Uploaded 2021-11-24 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 9534 |  Representative Payee Report of Benefits and Dedicated Account, 20 CFR 416.546 & 640, and 20 CFR 416.635 & 665 |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | SSA |
| OMB Control No | 0960-0576 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202104-0960-010 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |