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Waiver of Advance Designation (Internet Version - iClaim)
Advance Designation of Representative Payee
OMB: 0960-0814
IC ID: 256843
OMB.report
SSA
OMB 0960-0814
ICR 202406-0960-001
IC 256843
( )
Documents and Forms
Document Name
Document Type
iClaim Advance Designation of Representative Payee Screen Package - Revised.pdf
Other-iClaim Advance Designation of
iClaim Advance Designation of Representative Payee Screen Package - Revised.pdf
Other-iClaim Advance Designation of
iClaim Advance Designation of Representative Payee Screen Package - Current.pdf
iClaim Advance Designation of Representative Payee Screen Package - Current
IC Document
iClaim Advance Designation of Representative Payee Screen Package - Current.pdf
iClaim Advance Designation of Representative Payee Screen Package - Current
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Waiver of Advance Designation (Internet Version - iClaim)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-iClaim Advance Designation of Representative Payee Screens
iClaim Advance Designation of Representative Payee Screen Package - Revised.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
657,489
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
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
657,489
0
0
0
0
657,489
Annual IC Time Burden (Hours)
21,916
0
0
0
0
21,916
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
iClaim Advance Designation of Representative Payee Screen Package - Current
iClaim 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.