Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Representative Payee Report and Physician's/Medical Officer's Statement	Modified	1190	410	0	Form and Instruction	CM-623	Representative Payee Report
	Modified	1190	410	0	Form and Instruction	CM-787	Physician's Medical Officer's Statement
Representative Payee Report, Representative Payee Report, Short Form, and Physician's/Medical Officer's Statement	Modified	910	1232	0	Form and Instruction	CM-623	Representative Payee Report
					Form and Instruction	CM-623S	Representative Payee Report (Short Form)
					Form and Instruction	CM-787	Physician's/Medical Officer's Statement
Total burden requested under this ICR:		2100	1642	0
To view an IC, click on IC Title