Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Representative Payee Evaluation Report--Individuals/Households Modified 6956 3478 0 Form SSA-624-F5 Representative Payee Evaluation Report
Other-Revised PA and PRA Statements
Representative Payee Evaluation Report--Private Sector Modified 280 140 0 Form SSA-624-F5 Representative Payee Evaluation Report
Other-Revised PA and PRA Statements
Representative Payee Evaluation Report--State/Local Government Modified 40 20 0 Form SSA-624-F5 Representative Payee Evaluation Report
Other-Revised PA and PRA Statements
Total burden requested under this ICR: 7276 3638 0  
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