Information Collection Request

Advance Designation of Representative Payee

ICR 202507-0960-004 · OMB 0960-0814 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-4547 Advance Designation of Representative Payee Form Modified Available
Form SSA-4547 Advance Designation of Representative Payee Form Modified Available
Addendum - 0814.docx Supplementary Document Uploaded 2026-03-23 Available
Addendum - 0814.docx Supplementary Document Uploaded 2026-03-23 Available
Supporting Statement - 0814.docx Supporting Statement A Uploaded 2026-03-23 Repair queued
Supporting Statement - 0814.docx Supporting Statement A Uploaded 2026-03-23 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
256843 Waiver of Advance Designation (Internet Version - iClaim) Other-iClaim Advance Designation of Representative Payee Screens Modified
256842 Waiver of Advance Designation (Internet Version - mySSA) Other-mySSA Advance Designation of Representative Payee Screens Modified
256631 Waiver of Advance Designation (Intranet Version) Other-Intranet Advance Designation of Representative Payee Scree Modified
237014 Advance Designation of Representative Payee (Internet Version - iClaim) Other-iClaim Advance Designation of Representative Payee Screens Modified
237013 Advance Designation of Representative Payee (Internet Version - mySSA) Other-mySSA Advance Designation of Representative Payee Screens Modified
237007 Advance Designation of Representative Payee (Intranet Version - Paper Form SSA-4547) Form ModifiedAdvance Designation of Representative Payee
237007 Advance Designation of Representative Payee (Intranet Version - Paper Form SSA-4547) Form ModifiedAdvance Designation of Representative Payee
237007 Advance Designation of Representative Payee (Intranet Version - Paper Form SSA-4547) Other-Intranet Advance Designation of Representative Payee Scree Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2026
4,303,121 2,942,388
3,365,367 987,364
0 0





table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,303,121 2,942,388 0 0 1,360,733 0
Annual Time Burden (Hours) 3,365,367 987,364 0 0 2,378,003 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No