Waiver of Advance Designation (Internet Version - iClaim)

Advance Designation of Representative Payee

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0814 can be found here:

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

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

Is this a Common Form? No		IC Status: New

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

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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	657,489	657,489
Annual IC Time Burden (Hours)	21,916	21,916
Annual IC Cost Burden (Dollars)	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.