Waiver of Advance Designation (Internet Version - mySSA)

Advance Designation of Representative Payee

Documents and Forms

Document Name Document Type
mySSA Advance Designation of Representative Payee Screen Package - Revised.pdf Other-mySSA Advance Designation of R
mySSA Advance Designation of Representative Payee Screen Package - Revised.pdf Other-mySSA Advance Designation of R
mySSA Advance Designation of Representative Payee Screen Package - Current.pdf mySSA Advance Designation of Representative Payee Screen Package - Current IC Document
mySSA Advance Designation of Representative Payee Screen Package - Current.pdf mySSA Advance Designation of Representative Payee Screen Package - Current IC Document

Information Collection (IC) Details

IC Title:	Waiver of Advance Designation (Internet Version - mySSA)	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-mySSA Advance Designation of Representative Payee Screens			mySSA 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: 262,996	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	262,996	262,996
Annual IC Time Burden (Hours)	8,767	8,767
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
mySSA Advance Designation of Representative Payee Screen Package - Current	mySSA 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.