Before an organization may collect a fee for representative payee services, a form
SSA-445, Application to Collect a Fee for Payee Services, must be completed and submitted
to the local Social Security office, and SSA must approve authorization.
The following items are required from the organizational payee as part of the FFS
application process:
1. Organization is a State or Local Government Agency
-
•
The SSA-445, Application to Collect a Fee for Payee Services;
-
•
The organization’s mission statement;
-
•
A list of the beneficiaries the organization already serves, including name, address
and SSN; and
-
•
A statement as to whether or not the organization currently charges any of the beneficiaries
for its services, or collects any fees/money from any other sources for providing
payee services.
2. Organization is Not a State or Local Government Agency
In addition to the requirements stated in GN 00506.010B.1., if the organization is not a state or local government agency, the payee is also
required to provide:
-
•
A copy of bonding and/or insurance agreement;
-
•
A copy of their state license (provided that licensing is available in the State);
-
•
Proof of tax-exempt status in accordance with Sec. 501(c) of the Internal Revenue
Code; and
-
•
A letter describing how it meets the community-based criteria in GN 00506.100.B.2.