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View ICR - OIRA Conclusion

OMB Control No: 1240-0020	ICR Reference No: 201003-1240-020
Status: Historical Active	Previous ICR Reference No: 200508-1215-002
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Representative Payee Report, Representative Payee Report, Short Form, Physician's Medical Officer's Statement
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/12/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/12/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2011	36 Months From Approved
Responses	2,100	0	5,339
Time Burden (Hours)	1,642	0	5,430
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	2,100	5,339	-3,239
Annual Time Burden (Hours)	1,642	5,430	-3,788
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is a decreases in respondents from 5,339 to 2,100 and the burden hours have decreased from 5,430 to 1,642 resulting in a Program Change due to the reduction in the usage of the CM-623 and CM-623s. The CM-623 and 623s will be used only in those claims which require such accounting as a final accounting after the death of a beneficiary, after a change of representative payee, or after the reinstatement of a beneficiary as his/her own payee.