Information Collection

Representative Payee Application/Information Necessary for a Competency Determination

IC 33606 under ICR 201712-3206-014 · OMB 3206-0140.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0140 can be found here:

Documents and Forms

Document Name Document Type
Form RI 20-7 Representative Payee Application/Information Necessary for a Competency Determination Form and Instruction
RI 20-7 Representative Payee Application RI20-007_2018_02.pdf Form and Instruction
RI 20-7 Representative Payee Application RI20-007_2018_02_MarkUp.pdf Form and Instruction
RI 30-3 Information Necessary for a Competency Determination RI30-003_2018_02.pdf Form
RI 30-3 Information Necessary for a Competency Determination RI30-003_2018_02_MarkUp.pdf Form
RI 20-7 Representative Payee Application RI20-007_2016_08_MarkUp.pdf Form and Instruction
RI 30-3 Information Necessary for a Competency Determination RI30-003_2015_01_MarkUp.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Representative Payee Application/Information Necessary for a Competency Determination	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 20-7	Representative Payee Application	RI20-007_2016_08_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 30-3	Information Necessary for a Competency Determination	RI30-003_2015_01_MarkUp.pdf	Yes	No	Printable Only
Form and Instruction	RI 20-7	Representative Payee Application	RI20-007_2018_02.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-7	Representative Payee Application	RI20-007_2018_02_MarkUp.pdf	Yes	No	Fillable Printable
Form	RI 30-3	Information Necessary for a Competency Determination	RI30-003_2018_02.pdf	Yes	No	Printable Only
Form	RI 30-3	Information Necessary for a Competency Determination	RI30-003_2018_02_MarkUp.pdf	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 73 FR 15013

Number of Respondents: 12,480	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	12,480	12,480
Annual IC Time Burden (Hours)	6,490	6,490
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.