View Information Collection (IC)

View Information Collection (IC)

Representative Payee Report, Representative Payee Report (Short Form), and Physician's/Medical Officer's Statement
No Modified
Required to Obtain or Retain Benefits
20 CFR 725.506 20 CFR 725.510 -.513

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CM-623 Representative Payee Report cm-623.pdf Yes No Fillable Printable
Form and Instruction CM-623S Representative Payee Report (Short Form) cm-623s.pdf Yes No Fillable Printable
Form and Instruction CM-787 Physician's/Medical Officer's Statement cm-787.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

DOL/OWCP-2  67 FR 16870

1,325 0
Individuals or Households
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,325 0 415 0 0 910
Annual IC Time Burden (Hours) 679 0 -553 0 0 1,232
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.