Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Individuals/Households: Paper SSA-11-BK Modified 450000 78750 0 Form SSA-11-BK Request to be Selected as Payee
Individuals/Households: Representative Payee System (RPS) Modified 135000 23625 0 Form SSA-11 RPS Screens Request to be Selectred as Payee
Individuals/Households: Representative Payee System (RPS)/Signature Proxy Modified 765000 121125 0 Form SSA-11 Representative Payee System Screens Request to be Selected as Payee
Private Sector: Paper SSA-11-BK New 45000 7875 0 Form SSA-11-BK Request to be Selected as Payee
Private Sector: RPS New 13500 2363 0 Form SSA-11 RPS Screens Request to be Selected as Payee
Private Sector: RPS/Signature Proxy New 76500 12113 0 Form SSA-11 RPS Screens Request to be Selected as Payee
State/Local/Tribal Government: Paper SSA-11-BK New 5000 875 0 Form SSA-11-BK Request to be Selected as Payee
State/Local/Tribal Government: RPS New 1500 263 0 Form SSA-11 RPS Screens Request to be Selected as Payee
State/Local/Tribal Government: RPS/Signature Proxy New 8500 1346 0 Form SSA-11 RPS Screens Request to be Selected as Payee
Total burden requested under this ICR: 1500000 248335 0  
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