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View ICR - OIRA Conclusion

OMB Control No: 0960-0069	ICR Reference No: 202603-0960-018
Status: Active	Previous ICR Reference No: 202204-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Representative Payee Evaluation Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/20/2026
	Date Received in OIRA: 04/27/2026
Terms of Clearance: The agency made minor revisions to clarify why this form is not electronically submittable.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2029	36 Months From Approved	10/31/2026
Responses	6,751	0	6,838
Time Burden (Hours)	12,582	0	9,246
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	6,751	6,838	0	-87
Annual Time Burden (Hours)	12,582	9,246	3,486	-150
Annual Cost Burden (Dollars)	0	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: No

Burden Reduction Due to:

Short Statement: When we last cleared this IC in 2023, the burden was 3,420 hours. However, we are currently reporting a burden of 3,376 hours. This change stems from a decrease in the number of responses from 6,838 to 6,751. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change. These figures represent current Management Information data. Note: The total burden reflected in ROCIS is 12,582, while the burden cited in #12 of the Supporting Statement is 3,376. This discrepancy is because the ROCIS burden reflects the following components: field office and teleservice center waiting times + a rough estimate of a 30-minute, one-way, drive burden. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

Annual Cost to Federal Government: $127,976

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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