Representative Payee Report of Benefits and Dedicated Account, 20 CFR 416.546 & 640, and 20 CFR 416.635 & 665

Representative Payee Report of Benefits and Dedicated Account

OMB: 0960-0576

IC ID: 9534

Documents and Forms

Document Name Document Type
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
SSA-6233-BK Representative Payee Report of Benefits and Dedicated Account SSA-6233 (revised).pdf Form and Instruction
Privacy Act Statement 0960-0576 (revised).docx Other-Revised Privacy Act Statements
SSA-6233 (current).pdf SSA-6233-BK - Current IC Document