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May 8, 2009   
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DOL Form CM-623

View ESA-OWCP-DCMWC's Form CM-623 Online htm
Agency: ESA-OWCP-DCMWC
Title: CM-623, Representative Payee Report
Form Description: CM-623, Representative Payee Report: Benefits may be paid to a representative payee on behalf of the entitled individual when the beneficiary is unable to manage his or her benefits. The CM-623 is used to collect information from the payee to assure that the beneficiary's needs are met.
OMB Control Number: 1215-0173

 

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