Information Collection

Representative Payee Parental Custody Monitoring

IC 33983 under ICR 202406-3220-008 · OMB 3220-0176.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form G-99D (04-17) Representative Payee Parental Custody Monitoring	Form and Instruction
G-99D (04-17) Parental Custody Report Form G-99D - (04-22).docx	Form and Instruction
G-99D (04-17) Parental Custody Report Form G-99D - (04-22).docx	Form and Instruction
G-99 (Proposed) Parental Custody Report Form G-99D (XX-XX) Proposed.docx	Form and Instruction
G-99 (Proposed) Parental Custody Report Form G-99D (XX-XX) Proposed.docx	Form and Instruction
Form G-99A (12-16).pdf Representative Payee Report	IC Document
Form G-99A (12-16).pdf Representative Payee Report	IC Document
Form G-99C (12-16).pdf Representative Payee Evaluation	IC Document
Form G-99C (12-16).pdf Representative Payee Evaluation	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 266.7

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
Form and Instruction	G-99D (04-17)	Parental Custody Report	Form G-99D - (04-22).docx		No		Paper Only
Form and Instruction	G-99 (Proposed)	Parental Custody Report	Form G-99D (XX-XX) Proposed.docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: RRB-22, Railroad Retirement , Survivor, and Pensioner Benefit System

FR Citation: 79 FR 58874

Number of Respondents: 2,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,100	2,100
Annual IC Time Burden (Hours)	525	525
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Representative Payee Report	Form G-99A (12-16).pdf	11/19/2020
Representative Payee Evaluation	Form G-99C (12-16).pdf	11/19/2020

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