Information Collection

Report Of Function, Child - Birth Up To 1st Birthday, Age 1 To 3rd Birthday, 3rd To 6th Birthday, 6th To 12th Birthday, 12th To 18th Birthday

IC 115729 under ICR 199410-0960-004 · OMB 0960-0542.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0542 can be found here:

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Information Collection (IC) Details

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IC Title:	REPORT OF FUNCTION, CHILD - BIRTH UP TO 1ST BIRTHDAY, AGE 1 TO 3RD BIRTHDAY, 3RD TO 6TH BIRTHDAY, 6TH TO 12TH BIRTHDAY, 12TH TO 18TH BIRTHDAY	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-3375, 6				No	No
Form	7, 8, & 9				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500,000	500,000
Annual IC Time Burden (Hours)	166,667	166,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.