Representative Payee Report of Benefits and Dedicated Account

OMB 0960-0576

OMB 0960-0576

SSA requires RPs to submit a written report accounting for the use of money paid to Social Security or Supplemental Security Income (SSI) recipients, and to establish and maintain a dedicated account for these payments. SSA uses Form SSA-6233 to: (1) Ensure the RPs use the payments for the recipient’s current maintenance and personal needs; and (2) confirm the expenditures of funds from the dedicated account remain in compliance with the law. Respondents are RPs for SSI and Social Security recipients. We are making minor changes to the form to add a note with instructions to inform the affected payees to complete certain sections of the form.

The latest form for Representative Payee Report of Benefits and Dedicated Account expires 2021-12-31 and can be found here.


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