Medical History and Disability Report (Disabled Child)

Medical History and Disability Report (Disabled Child)

OMB: 0960-0574

IC ID: 9526

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Information Collection (IC) Details

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Medical History and Disability Report (Disabled Child)
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-3820-F4 No No


    

523,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 523,000 0 0 0 0 523,000
Annual IC Time Burden (Hours) 174,333 0 0 0 0 174,333
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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