Advance Designation of Representative Payee (Intranet Version - Paper Form SSA-4547)

Advance Designation of Representative Payee

Documents and Forms

Document Name Document Type
Form SSA-4547 Advance Designation of Representative Payee (Intranet Version - Paper Form SSA-4547) Form
Intranet Advance Designation of Representative Payee Screen Package - Revised.pdf Other-Intranet Advance Designation o
Intranet Advance Designation of Representative Payee Screen Package - Revised.pdf Other-Intranet Advance Designation o
SSA-4547 Advance Designation of Representative Payee SSA- 4547 (revised).pdf Form
SSA-4547 Advance Designation of Representative Payee SSA- 4547 (revised).pdf Form
SSA-4547 (current).pdf SSA-4547 - Current IC Document
SSA-4547 (current).pdf SSA-4547 - Current IC Document
Intranet Advance Designation of Representative Payee Screen Package - Current.pdf Intranet Advance Designation of Representative Payee Screen Package - Current IC Document
Intranet Advance Designation of Representative Payee Screen Package - Current.pdf Intranet Advance Designation of Representative Payee Screen Package - Current IC Document

Information Collection (IC) Details

IC Title:	Advance Designation of Representative Payee (Intranet Version - Paper Form SSA-4547)	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
Form	SSA-4547	Advance Designation of Representative Payee	SSA- 4547 (revised).pdf		Yes	No	Fillable Fileable Signable
Other-Intranet Advance Designation of Representative Payee Screens			Intranet Advance Designation of Representative Payee Screen Package - Revised.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 473,052	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	473,052	473,052
Annual IC Time Burden (Hours)	473,052	473,052
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-4547 - Current	SSA-4547 (current).pdf	06/06/2024
Intranet Advance Designation of Representative Payee Screen Package - Current	Intranet Advance Designation of Representative Payee Screen Package - Current.pdf	10/27/2022

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