Information Collection

Waiver of Advance Designation (Internet Version - mySSA)

IC 256842 under ICR 202507-0960-004 · OMB 0960-0814.

Documents and Forms

Document Name Document Type
Advance Designation - mySSA Screen Package.pdf www.ssa.gov (mySocial Security Account) Other-mySSA Advance Designation of R

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Waiver of Advance Designation (Internet Version - mySSA)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

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

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,442	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,442	-261,554	262,996
Annual IC Time Burden (Hours)	48	-8,719	8,767
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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

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