PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Application for Substitution of Payee and Duties As Representative Payee (Individuals)
Modified
13725
12112
0
Form
AA-5
Application for Substitution of Payee
Form and Instruction
RB-5
RB-5 Booklet; Your Duties as Representative Payee- Representative Payee's Record
Form
AA-5 (proposed)
Application for Substitution of Payee
Form and Instruction
RB-5 (proposed)
RB-5 Booklet: Your Duties as Representative Payee-Representative Payee's Record
Application for Substitution of Payee and Duties as Representative Payee (Institutions)
Modified
4575
4038
0
Form and Instruction
AA-5
Application for Substitution of Payee
Form and Instruction
RB-5
Your Duties as Representative Payee-Representative's Payee's Record
Form
AA-5 (proposed)
Application for Substitution of Payee
Form and Instruction
RB-5 (proposed)
RB-5 Booklet: Your Duties as Representative Payee-Representative Payee's Record
Statement Regarding Patient's Capability to Manage Payments
Unchanged
2000
200
0
Form and Instruction
G-478
Statement Regarding Patient's Capability to Manage Payments
Total burden requested under this ICR:
20300
16350
0
To view an IC, click on IC Title
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