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Federal forms, ICRs, and supporting documents

Information Collection

Advance Designation of Representative Payee (Internet Version - mySSA)

IC 237013 under ICR 202507-0960-004 · OMB 0960-0814.

Documents and Forms
Document Name
Document Type
Other-mySSA Advance Designation of R
Other-Advance Designation of Represe
Other-Advance Designation of Represe
Information Collection (IC) Details

View Information Collection (IC)

Advance Designation of Representative Payee (Internet Version - mySSA)
 
No Modified
 
Voluntary
 

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 Advance Designation - mySSA Screen Package.pdf www.ssa.gov (mySocial Security Account) Yes Yes Fillable Fileable Signable
Other-Advance Designation of Representative Payee Annual Notice Advance Designation - Annual Notice.pdf No   Paper Only
Other-Advance Designation of Representative Payee Privacy Act Statement Screen Advance Designation - Internet Privacy Act Statement.pdf www.ssa.gov (mySocial Security Account) Yes No Printable Only

Income Security General Retirement and Disability

 

304,471 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 304,471 0 0 -22,630 0 327,101
Annual IC Time Burden (Hours) 182,683 0 0 149,973 0 32,710
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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